盐酸米诺环素治疗牙周牙髓综合征的临床疗效及安全性评价

Clinical efficacy and safety of minocycline in treatment of periodontal pulp syndrome

目的评价盐酸米诺环素不同给药方式治疗牙周牙髓综合症的临床疗效和安全性。方法将100例牙周牙髓综合征患者随机分为试验组50例和对照组50例。对照组在牙周袋内局部予以盐酸米诺环素结合传统根管治疗,每周一次,连续使用6周;试验组经根管途径予以盐酸米诺环素结合现代根管治疗术进行治疗,5-7 d复诊一次,经一至数次换药达到根管充填标准后,充填根管。于手术前后观察菌斑指数、牙周袋探诊深度、探诊后出血指数及牙龈指数;于术后即刻、术后3,6个月评价临床疗效并统计不良反应发生率。结果治疗后,2组患者菌斑指数、牙周袋探诊深度、探诊后出血指数和牙龈指数均较治疗前显著下降（P〈0.05）,且试验组的菌斑指数、牙周袋探诊深度、探诊后出血指数和牙龈指数均明显低于对照组（P〈0.05）。试验组和对照组治疗后术后即刻、术后3,6个月治疗的总有效率分别为94.00%和82.00%（P〈0.05）、92.00%和80.00%（P〈0.05）、92.00%和76.00%（P〈0.05）。2组患者的不良反应发生率比较差异无统计学意义（P〉0.05）。结论经根管途径予以盐酸米诺环素结合现代根管治疗术治疗牙周牙髓综合征有利于提高牙周牙髓综合征的临床疗效,值得在临床上推广使用。

Objective To evaluate the clinical efficacy and safety of minocycline via root canal combined with modern root canal therapy in the treatment of periodontal pulp syndrome. Methods One hundred patients with periodontal pulp syndrome were randomly divided into treatment group（ n = 50） and control group（ n = 50）. Patients in control group were treated with minocycline via periodontal pocket combined with traditional root canal therapy,once a week,6 weeks. Patients in treatment group were treated with minocycline via root canal combined with modern root canal therapy,5- 7 d visit once,root canal was filled after one to several dressing to achieve root canal standard. The plaque index,tooth mobility,probing pocket depth,bleeding on probing index and gingival index were observed before and after surgery. The clinical efficacy was evaluated at the right moment,3 months and 6 months after surgery,and the adverse drug reactions were counted. Results The plaque indexes,periodontal pocket diagnose depth,bleeding index and gingival index of patients in both groups were significantly descent after treatment（ P〈0. 05）,and in treatment group,they were significantly lower than those in control group（ P〈0. 05）. The total curative effective rates in treatment group and control group were 94. 00% and 82. 00%（ P〈0. 05） instantly after operation,92. 00% and 80. 00%（ P〈0. 05） at three months after operation,92. 00% and 76. 00%（ P〈0. 05） at six months after operation. The incidence of adverse drug reactions of the two groups was compared and the difference was not statistically significant（ P〉0. 05）. Conclusion Minocycline via root canal combined with modern root canal therapy can improve clinical effect of periodontal pulp syndrome,and suit to widely using in clinic.