【作者】 朱昞； 李继遥； 周学东；

【Author】 ZHOU Bing, LI Ji-yao, ZHOU Xue-dong.(Key Laboratory of Oral Biomedical Engineering, Ministry of Education, Sichuan University; Lab of Caries Research, West China College of Stomatology, Sichuan University.Chengdu 610041,Sichuan Province, China)

【机构】 口腔生物医学工程教育部重点实验室； 四川大学华西口腔医学院龋病研究室；

【摘要】 目的:参考已有的天然药物药效评价方法,采用循证医学综合评价的统计学方法,通过建立数学模型,综合天然药物的细菌学效能和牙矿化效能参数值,对十味天然药物的防龋效能进行全面客观的评价,为防龋药物筛选实验的药效学评价提供科学依据。方法:(1)指标的筛选和指标体系的建立。选择天然药物对口腔致龋菌的作用和对牙脱矿再矿化的作用两个层次的指标作为子目标层构建天然药物防龋效能综合评价的指标体系。细菌学效能的评价指标包括天然药物对主要致龋菌变形链球菌产酸、对唾液包被羟磷灰石的粘附、产胞外多糖的抑制实验和对细菌生长代谢的影响。牙矿化作用的评价指标包括天然药物的釉质脱矿再矿化实验的钙离子释出浓度和CLSM总荧光强度两个指标。(2)确定评价指标的权重。按照层次分析法的原理设计“专家咨询表”,邀请国内龋病学领域具有较高学术水平的专家,对各个指标在综合评价过程中的重要程度进行赋值,最后计算获得指标的权重系数。(3)选取TOPSIS法和模糊综合评价法,建立天然药物防龋药效综合评价的数学模型。结果:(1)建立了天然药物防龋药效综合评价的递阶层次结构的指标体系,确定了各评价指标的权重,建立了天然药物防龋药效综合评价的数学模型。(2) TOPSIS法和模糊综合评价法两种综合评价方法在细菌学作用、牙矿化作用及防龋药效三个层面的评价结果高度一致,具有统计学意义,结果可信度高。(3)分别对十味天然药物的细菌学作用、牙矿化作用及防龋药效进行综合评价,在三个指标层面上得到了天然药物作用效果的优劣顺序。结论:(1)本研究建立的天然药物防龋药效综合评价的数学模型能够用于药物防龋药效的综合评价,评价结果可信度高。为具有多重机制防龋药物的筛选和药效学评价提供了方法学参考。(2)本研究建立的综合评价的数学模型可用于防龋药物初筛过程的药效评价,有利于从众多待筛的药物中找出药效确实的防龋新药,可以节约大量的人力物力,具有潜在的经济效益和社会效益。更多还原

【Abstract】 OBJECTIVE: Dental caries is fundamentally a microbial disease, which involves the hard tissue of tooth. The prevention of dental caries have been extensively studied worldwide, and there are many theories and prescribes in ancient Chinese natural medicine deal with dental caries, which facilitate the study of preventing dental caries by herbal medicine. It has been proved that some of the Chinese natural medicines can not only inhibit the growth and metabolism of cariogenic bacterial, but have favorable effect in the process of demineralization and remineralization of dental hard tissue. Traditional statistical assessment method can not evaluate the dual anticaries effect of Chinese traditional medicine properly, so this study focused on the multi-indexes comprehensive assessments applying to the evaluation of the anticaries effect of Chinese traditional medicine. METHODS: TOPSIS and Fuzzy Comprehensive Evaluation is applied in the comprehensive assessment for the evaluation of the anticaries effect of Chinese traditional medicines. The weights of assessment indexes were determined by the method of analytic hierarchy process. RESULTS: Appling the two methods to assessment, results are consistent, which showed that the assessment conclusions are credible. TOPSIS can expand the other’s applying range. Among the two methods, Fuzzy Comprehensive Evaluation is the most subjective and acquires the lest information because index weighting is not needed. The results of the comprehensive assessment forecast the possibility of eleven tested Chinese traditional medicines in future utilizing of caries prevention. CONCLUSION: TOPSIS method and Fuzzy Comprehensive Evaluation are both good methods for comprehensive assessing anticaries effect of Chinese traditional medicines, but Fuzzy Comprehensive Evaluation is more impersonal than TOPSIS, and can exclude the influence of the out-of-line data as much as acquire more in formation. The example proved that applying these two methods in anticaries effect evaluation is successful. Both methods can be used to forecast the future utilizing for anticaries area.更多还原