臺灣博碩士論文加值系統

背景
氯己定(Chlorhexidine)漱口水,因口味不佳、口感差、可能引起味覺改變、 少數患者在使用後會有局部刺激和過敏反應、且長時間使用容易造成牙齒表面 琺瑯質染色等副作用,而受到部份患者抗拒。因此,尋找具有相同抑菌及抗菌 成份,且不具刺激性口感,同時又不會造成牙齒染色之漱口水藥物,可解決大 多數牙周病患者無法有效清除口內牙菌斑,而病情無法獲得控制之困擾。
中藥牢牙散加味漱口水,其主要成份有升麻、地骨皮、羌活、龍膽草及青鹽、 梅片等矯味劑,而這些主要成份均為本草綱目記載之藥物,而且大多有抗菌、 抗發炎之性質。本試驗主要目的即是檢測含中藥與氯己定漱口水,對於牙菌斑 之控制及牙齦炎療效之臨床評估。
材料與方法
本實驗是從準備接受牙周手術之患者中,挑選出符合研究條件之受試者。由 於這些患者在術後兩週內,需依賴漱口水來照護術後傷口。受試者在試驗期間 分別使用牢牙散加味漱口水與氯己定漱口水,並在使用一週後記錄受試區域牙 齦發炎(GI)指數、牙齒外在染色指數(SI)以及牙菌斑指數(PI)。
結果
受試者人數為十五位,其中有十二位是女性及三位男性,其年齡分佈為 25 至 48 歲,平均年齡為 34.1 歲。
使用氯己定漱口水及牢牙散加味漱口水一週後,受試者的 GI 分別為 0.55±0.27(氯己定)與 0.51±0.26(中藥)。而 SI 為 0.69±0.42 (氯己定)與 0.57±0.42 (中 藥)。與試驗前一週的基準值相較,試驗後 GI 及 SI 都有降低,且在統計學上有 顯著差異。兩種漱口水使用後相比,GI、SI 與 PI,兩者並無統計學上的差異。
討論
II根據實驗結果顯示,使用兩種漱口水之後,GI 皆有改善。因此,在牙齦炎 之抑制上,兩種漱口水在統計學上皆有顯著效果(P<0. 05),而兩組之間相互比 較,則無統計上之差異。因此,牢牙散加味漱口水與氯己定漱口水對於控制牙 齦炎上,兩者在臨床上之效果相當。本實驗所使用之牢牙散加味配方中的各個 主要成份,大都具有抗菌及抗發炎之性質,而實驗結果也顯示這些特質對於控 制牙齦炎具有臨床之效果。
結論
在本次試驗中顯示,牢牙散加味漱口水與氯己定漱口水在短期使用中,兩者 在臨床上對控制牙齦炎的效果並無統計學上之差異,且無不良反應或是副作用 的產生,對於習

Background
Mouthrinses containing chlorhexidine are associated with unpleasant taste, interference with normal taste, local irritation and allergies, and tooth enamel discoloration after long-term use. In this study, a modified Lao Ya Powders mouthrinse containing rhizoma cimicifugae, cortex radicis lycii chinensis, radix et rhizoma notopterygii, radix gentiana scabrae, and flavoring agents, such as halitium and borneol was used to compare with chlorhexidine mouthrinses on inhibiting the dental plaque accumulation and gingivitis.
Material and Method
15 participants who were preparing to receive periodontal surgeries were included in this study. The participants were prescribed a modified Lao Ya Powders mouthrinse or a chlorhexidine mouthrinse, and the gingival index (GI), tooth stain index (SI), and dental plaque index (PI) were recorded each week after use.
Result
At the end of Week 1, the GI of participants who used the chlorhexidine mouthrinse and the modified Lao Ya Powders mouthrinse was 0.55 ± 0.27 and 0.51 ± 0.26, respectively, and the SI was 0.69±0.42 and 0.57±0.42, respectively. Compared with the baseline records, the GIs and the SIs statistics differentially decreased. The GIs, SIs, and PIs did not differ significantly between the two groups.
Discussion
The results showed both types of mouthrinse had significant effects on inhibiting gingivitis (P < 0.05) after 1 week used. In conclusion, the modified Lao Ya Powders mouthrinse and the chlorhexidine mouthrinse had similar clinical effects on controlling gingivitis. In this experiment, the ingredients in the modified Lao Ya Powders mouthrinse possess antibacterial and anti-inflammatory properties, and the experiment results confirmed their clinical effects on gingivitis control.
IVConclusion
The results showed that short-term use of the modified Lao Ya Powders mouthrinse and the chlorhexidine mouthrinse have the same clinical effects on gingivitis control and yielded no adverse reactions or side effects. Therefore, people who are used to using Chinese medicine or are unable to tolerate the smell of chlorhexidine mouthrinse are provided with an alternative option when purchasing oral health care products.

指導教授推薦書...................................................................................................................................
口試委員會審定書..............................................................................................................................
誌謝..........................................................................................................................................................iii
中文摘要 .............................................................................................................................................. iv
英文摘要 ............................................................................................................................................ vi
目 錄................................................................................................................................................. viii
表目錄.............................................................................................................................................. x
圖目錄................................................................................................................................................. xi
第 1 章 緒論.................................................................................................................1
1.1 研究動機........................................................................................................2
第 2 章 文獻回顧.........................................................................................................4
2.1 常用漱口水中的化學成份............................................................................5
2.2 中藥漱口水之成分與作用............................................................................9
2.3 中藥配方漱口水..........................................................................................11
第 3 章 研究方法.......................................................................................................15
3.1 研究目的......................................................................................................16
3.2 研究假說......................................................................................................17
3.3 實驗設計......................................................................................................18
3.4 臨床檢查與記錄..........................................................................................21
3.5 統計方法......................................................................................................26
第 4 章 實驗結果.......................................................................................................27
ix
4.1 實驗結果......................................................................................................28
第 5 章 討論...............................................................................................................34
5.1 受測者的篩選與分組..................................................................................35
5.2 受測者應遵守試驗規定..............................................................................36
5.3 實驗設計......................................................................................................37
5.4 氯己定漱口水濃度的選擇..........................................................................38
5.5 指數的選擇..................................................................................................39
5.6 牙菌斑與牙齦炎之控制..............................................................................41
5.7 牙齒染色的副作用......................................................................................43
5.8 中藥漱口水不會產生牙齒染色的副作用..................................................43
5.9 臨床試驗的規範..........................................................................................44
第 6 章 結論...............................................................................................................46
第 7 章 參考文獻.......................................................................................................48
附件.............................................................................................................................55


表目錄
表 4.1 受試者年齡與性別 .........................................................................................37
表 4.2 基準值之牙齦指數與牙齒染色指數 .............................................................37
表 4.3 使用漱口水一週後之牙齦指數與牙菌斑指數 .............................................38
表 4.4 試驗前後牙齦指數之比較 .............................................................................38
表 4.5 試驗前後染色指數..........................................................................................40


圖目錄
圖3.1實驗流程圖 ..........................................................................................29
圖3.2牙菌斑評估 ..........................................................................................31
圖3.3牙齦炎評估 ..........................................................................................32
圖3.4牙齒染色指數評估................................................................................33
圖4.1試驗前後GI之比較(MEAN, SD)...............................................................39
圖4.2 使用兩種漱口水後PI之比較(MEAN, SD) ..................................................40
圖4.3 使用兩種漱口水後BSI、LSI與SI之比較(MEAN, SD)...................................41

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