甲硝唑控释药膜和盐酸米诺环素缓释剂治疗慢性牙周炎的效果分析

The application and effect analysis of metronidazole controlled release pellicles and minocycline hydrochloride sustained-release agent on the treatment of chronic periodontitis

目的探讨甲硝唑控释药膜和盐酸米诺环素缓释剂治疗慢性牙周炎的应用效果。方法将82例慢性牙周炎患者随机分为A、B组,分别给予甲硝唑控释药膜和盐酸米诺环素缓释剂处理。比较两组治疗后1个月的临床效果,治疗前、治疗后1周、1个、3个月的一般指标[探诊深度(probing depth,PD)、附着水平(attachment level,AL)、菌斑指数(plaque index,PLI)和龈沟出血指数(sulcus bleeding index,SBI)]及龈沟液中的炎性因子[白介素-6(interleukin-6,IL-6)、白介素-8(interleukin-8,IL-8)和肿瘤坏死因子(tumor necrosis fator-α,TNF-α)],治疗前、治疗后1个、3个月的龈沟液胶原酶Ⅱ活性(collagenaseⅡ,COL-Ⅱ)和用药中的不良反应情况。结果 B组治疗1个月后的"痊愈"例数多于A组(P<0.05),但两组总有效率无差异;除治疗1个月后的PD外,B组治疗后1、3个月的一般指标、龈沟液炎性指标水平及COL-Ⅱ活性均优于A组,其中除PD、AL、治疗后1个月的IL-6和IL-8(P<0.05),其余均为P<0.01;两组的不良反应无统计学差异(P>0.05)。结论甲硝唑控释药膜和盐酸米诺环素缓释剂治疗牙周病的总有效率相当,但后者远期的一般指标、龈沟液炎性指标及胶原酶Ⅱ活性优于甲硝唑控释药膜。

Objective To explore the effect of metronidazole controlled release pellicles and minocycline hydrochloride sustained-re- lease agent on the treatment of chronic periodontitis. Methods 82 cases with chronic periodontitis were randomly divided into A group（ metronidazole controlled release pellicles） and B group（ minocycline hydrochloride sustained-release agent）. The following indi- ces were analyzed between both groups - general parameters （ probing depth （ PD ） , attachment level （AL） , plaque index （PLI） and sul- cus bleeding index （SBI） ） and inflammatory eytokines in gingival crevieular fluid （ interleukin-6 （ IL-6 ） , interleukin-8 （ IL-8 ） and tumor necrosis factor-a（TNF-α） ） before treatment, and lweek, 1 month and 3 months after treatment, as well as collagenase lI activi- ty（COL-Ⅱ ） before treatment and 1 week, 1 month and 3 months after treatment. Adverse reaction was also analyzed between two groups. Results The number of cases cured in group B was more than that in group A（ P 〈 0.05） 1 month after treatment, but the total effective rates were not different between two groups. Apart from PD 1 month after treatment, the general parameters, the inflam- matory markers and COL- Ⅱ activity of gingival crevicular fluid of B group 1 and 3 months after treatment were better than those of A group（ P 〈 0.01 , except IL-6, IL-8 one month after treatment and PD, AL（ P 〈 0.05 ） ）. There was no significant difference in adverse reaction between two groups （ P 〉 0.05 ）. Conclusions The total effective rates of metronidazole controlled release pellicles and mino- cycline hydrochloride sustained-release agent on periodontitis were similar, but the long-term effect and inflammatory markers of gingi- val crevicular fluid and COL- Ⅱ activity of the latter were superior to the former.