Effect of topical application of minocycline hydrochloride ointment assisted with subgingival scaling and root planing on periodontium of patients with chronic periodontitis
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摘要: 目的 探讨局部应用盐酸米诺环素软膏辅助龈下刮治术及根面平整术对慢性牙周炎患者牙周的影响。 方法 选取2015年6月-2016年12月在温州医科大学附属第一医院接受治疗的152例慢性牙周炎患者为研究对象,采用随机数字法分为2组,每组76例。2组均给予龈下刮治术及根面平整术等基础治疗,对照组在此基础上给予碘甘油,观察组给予盐酸米诺环素软膏。治疗后,比较2组患者牙周相关指标情况[牙周袋深度(PD)、附着水平(AL)、菌斑指数(PLI)、牙龈出血指数(SBI)]、炎性因子[白介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子(TNF)-α]、临床疗效与不良反应。采用SPSS 16.0统计软件对数据进行统计学分析。 结果 观察组总有效率为94.74%,明显高于对照组的75.00%(P<0.05)。治疗后,2组PD、AL、PLI、SBI均明显降低(P<0.05),且观察组显著低于对照组(P<0.05)。治疗后,2组IL-6水平无明显变化(P>0.05),观察组CRP、TNF-α水平明显降低(P<0.05),且明显低于对照组(P<0.05)。观察组、对照组不良反应率为分别为6.58%、5.26%,差异无统计学意义(P>0.05)。 结论 局部应用盐酸米诺环素软膏辅助龈下刮治术及根面平整术对慢性牙周炎疗效显著,可明显改善牙周症状,其机制可能与调解患者机体CRP、TNF-α有关。Abstract: Objective To investigate the effect of topical application of minocycline hydrochloride ointment assisted with subgingival scaling and root planing on periodontium of patients with chronic periodontitis. Methods Total 152 patients with chronic periodontitis in the First Affiliated Hospital of Wenzhou Medical University were selected and divided into two groups according to the random number method, each group 76 cases. All patients were given subgingival scaling and root surface roughness. The control group was given iodine glycerol, and the observation group was given intravenous minocycline ointment. After the treatment, the periodontium related indexes[periodontal pocket depth (PD), attachment level (AL), plaque index (PLI), gingival bleeding index (SBI)], the inflammatory factor[interleukin-6 (IL-6), C-reactive protein (CRP), tumor necrosis factor (TNF)-α], clinical efficacy and adverse reactions of the two groups were compared. Results The total effective rate of the observation group was 94.74%, which was significantly higher than that of the control group (75.00%), P<0.05. After the treatment, PD, AL, PLI, SBI of the two groups were significantly decreased (P<0.05), and the observation group was significantly lower than the control group (P<0.05). After the treatment, there were no significantly difference on IL-6 levels in both two groups (P>0.05). The CRP and TNF-α of the observation group were significantly reduced (P<0.05), and significantly lower than that of the control group (P<0.05). The adverse reaction rate of the observation group and control group were 6.58% and 5.26%, respectively, which were not statistically significant (P>0.05). Conclusion Local application of minocycline hydrochloride ointment assisted with subgingival scaling and root canal surgery has a significant effect on chronic periodontitis. It can improve periodontal symptoms, the mechanism might be related to the regulation of the levels of CRP and TNF-α.
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