盐酸米诺环素软膏治疗急性智齿冠周炎的临床效果和微生物学评价

Efficacy of minocycline hydrochloride ointment in the treatment of pericoronitis of wisdom tooth: A clinical and microbial study

目的:观察盐酸米诺环素软膏治疗急性冠周炎的临床效果和冠周袋内细菌的变化。方法:选择第三磨牙急性冠周炎患者70例,分为2组(n=35)。盲袋内冲洗后试验组盲袋内导入盐酸米诺环素软膏;对照组导入碘甘油。观察临床疗效,同时进行冠周袋内细菌革兰氏染色,观察细菌浓度和螺旋体、G+菌、G-菌所占比例的变化,对盲袋内细菌总量进行实时荧光定量PCR法检测治疗前后的变化。结果:试验组和对照组临床有效率分别为94.29%和74.29%(P<0.05)。治疗后2组细菌浓度、螺旋体比例、G-的比例均显著下降(P<0.01),试验组均少于对照组(P<0.01)。2组G+菌的比例(%)治疗后上升(P<0.01),试验组高于对照组(P<0.01)。治疗后2组细菌总量(经对数转换)均下降(P<0.01),试验组少于对照组(P<0.01)。结论:盐酸米诺环素软膏可有效控制冠周组织炎症,缓解局部疼痛、肿胀等症状,同时降低冠周袋内微生物的浓度以及G-菌和螺旋体的构成比,说明盐酸米诺环素软膏可以有效控制冠周感染。

Objective： To evaluate the clinical and microbial efficacy of minocycline hydrochloride ointment in the treatment of perico- ronitis of wisdom tooth. Methods： 70 cases of acute pericoronitis of wisdom tooth were divided into 2 groups randomly（ n = 35）. Mino- cycline hydrochloride ointment（MHO） or iodine glycerol（IG） were applied into the pericoronal pocket of the patients in MHO and IG group respectively after pocket irrigation. The data of the clinical observation were collected at the baseline and after the therapy. The bacteria in the pockets were examined by Gram staining. Total bacteria was examined by Real-time PCR. Results： The effective ratio in MHO and IG group was 94.29% and 74.29% respectively（P 〈0.05）, G~ proportion was increased in the 2 groups（P 〈0.01 ） ; bac- teria concentration, spirochete proportion, G- proportion and total bacteria（ after log transformation） were decreased in both groups after treatment（P 〈0.01 ） ; MHO was more effective than IG（P 〈0.01 ）. Conclusion： Minocycline hydrochloride ointment is more effective in the treatment of pericoronitis than iodine glycerol.