2种牙菌斑控制法对胃黏膜幽门螺杆菌再感染的影响研究

Effects on Helicobacter pylori reinfection in gastric mucosa by two oral plaque control methods

目的比较2种牙菌斑控制法对胃黏膜幽门螺杆菌(H.pylori)再感染率的影响,探讨H.pylori相关性胃病患者行菌斑控制的必要性及有效方法。方法将148例胃炎和消化性溃疡患者随机分为试验一组(54例)、试验二组(55例)和对照组(39例),经消化内科抗H.pylori系统治疗并碳13尿素呼气试验证实H.pylori被根除后,试验一组行日常菌斑控制,试验二组除日常菌斑控制外增加牙菌斑的口腔专业处理,对照组未行上述处理。半年后行碳13尿素呼气试验检查确定各组胃黏膜H.pylori的感染率。结果试验一组中5例患者因停用含漱液漱口被淘汰,试验二组中8例患者因未严格执行牙菌斑控制被淘汰。试验一组、试验二组、对照组患者H.pylori的感染率分别为67.3%、19.1%、82.1%。统计分析表明,试验二组患者H.pylori的感染率低于对照组、试验一组(掊2=33,P<0.05;掊2=31.06,P<0.05),试验一组患者H.pylori的感染率与对照组之间无统计学差异(掊2=2.43,0.1<P<0.25)。结论牙菌斑是胃H.pylori再感染的重要来源,H.pylori相关性胃病患者应控制牙菌斑,以专业牙菌斑处理加药物含漱为佳。

Objective To investigate the reinfection rate of Helicobacter pylori （H.pylori） in gastric mucosa by two measures of oral plaque control on patients, and to demonstrate the necessity and better method of plaque control on those patients. Methods 148 patients suffered gastritis or gastroduodenal ulcer were assigned into test group 1 （54 patients）, test group 2 （55 patients） and control group （39 patients）. 13C-urea breath test proved that there were no H.pylori in their gastric mucosa. Daily plaque control was used in test group 1, oral professorial interventions were added into test group 2, neither daily plaque control nor oral professorial interventions was conducted in control group. All patients were conducted 13C-urea breath test again after half a year to determine the reinfection rate of H.pylori in gastric mucosa. Results 5 patients were eliminated because of stopping mouthwash in the test group 1, 8 patients failed to control dental plaque in the test group 2. The infection rates of H.pylori in gastric mucosa of test group 1, test group 2 and control group were 67.3%, 19.1%, 82.1%, respectively. The infection rate of H.pylori of test group 2 was lower significantly than that in control group and test group 1 （x^2= 33, P〈0.05; x^2=31.06, P〈0.05）. There were no significant difference between test group 1 and control group（X^2=2.43, 0.1〈P〈0.25）. Condttsion Dental plaque is an important source of gastric H.pylori reinfection. Dental plaque control procedures should be performed in the treatment of gastric disease correlated with H.pylori. The method of mixing professional dental plaque control and solution of mouthwash was better.