牙周基础治疗联合抗生素治疗牙周炎合并糖尿病60例疗效观察

Therapeutic effect of systemic antibiotics combined with non-surgical periodontal therapy on periodontitis in patients with type 2 diabetes

目的观察抗生素联合牙周基础治疗对中重度慢性牙周炎合并2型糖尿病患者牙周指数和糖代谢的影响。方法60例中重度慢性牙周炎合并2型糖尿病患者随机分为观察组和对照组各30例。2组糖尿病治疗方案相同,对照组牙周病采取牙周基础治疗,观察组在对照组治疗基础上联合应用抗生素。记录并比较2组治疗前和治疗后3个月牙周探诊深度(probing depth,PD)、菌斑指数(plaque index,PLI)、临床附着丧失(clinic attachment loss,CAL)、出血指数(sulcus bleeding index,SBI)及空腹血糖(fasting plasma glucose,FPG)、糖化血红蛋白(glycosylated hemoglobin,HbA_1c)水平。结果 2组治疗前HbA_1c、FPG水平及PD、PLI、SBI、CAL比较差异均无统计学意义(P>0.05);对照组治疗后PD[(3.65±0.26)mm]、PLI(1.51±0.33)、SBI(1.79±0.16)及FPG[(7.85±1.25)mmol/L]、HbA1c[(6.96±1.46)%]水平均较治疗前[PD(6.38±0.50)mm、PLI为2.78±0.65、SBI为3.02±0.27、FPG(9.65±1.04)mmol/L、HbA_1c(7.93±1.75)%]降低(P<0.05),CAL[(4.43±0.72)mm]与治疗前[(5.09±0.55)mm]比较差异无统计学意义(P>0.05);观察组治疗后PD[(3.06±0.34)mm]、PLI(1.13±0.34)、SBI(1.37±0.32)、CAL[(3.73±0.57)mm]、FPG[(6.93±1.20)mmol/L]和HbA_1c[(6.16±1.24)%低于治疗前[PD(6.26±0.48)mm、PLI为2.86±0.61、SBI为3.20±0.39、CAL(4.99±0.48)mm、FPG(9.70±1.43)mmol/L、HbA_1c(7.96±0.97)%](P<0.05),且低于对照组治疗后,差异均有统计学意义(P<0.05)。结论牙周基础治疗联合抗生素应用可促进中重度慢性牙周炎合并2型糖尿病患者牙周健康,改善糖代谢水平。

Objective To explore the influence of systemic antibiotics in combination with non-surgical periodontal therapy on periodontal index and glycometabolism in patients with type 2 diabetes and periodontitis.Methods Sixty patients with type 2 diabetes mellitus（T2DM）and moderate or severe periodontitis were randomly divided into observation group and control group,with 30 patients in each group.Both two groups received the same treatment for T2 DM.Control group received non-surgical periodontal therapy alone and observation group received systemic antibiotics in combination with non-surgical periodontal therapy.The probing depth（PD）,plaque index（PLI）,clinic attachment loss（CAL）,sulcus bleeding index（SBI）,fasting plasma glucose（FPG）and glycosylated hemoglobin（HbA1c）were recorded and compared before and after 3-month treatment between two groups.Results There were no significant differences in HbA1 c,FPG,PD,PLI,SBI and CAL before treatment between two groups（P〈0.05）.PD（（3.65±0.26）mm）,PLI（1.51±0.33）,SBI（1.79±0.16）,FPG（（7.85±1.25）mmol/L）and HbA1c（（6.96±1.46）%）after3-month treatment were significantly lower than those before treatment（PD：（6.38±0.50）mm,PLI：2.78±0.65,SBI：3.02±0.27,FPG：（9.65±1.04）mmol/L,HbA1c：（7.93±1.75）%）（P〈0.05）,and there was no significant difference in CAL before（（5.09±0.55）mm）and after 3-month treatment（（4.43±0.72）mm）in control group（P〈0.05）.PD（（3.06±0.34）mm）,PLI（1.13±0.34）,SBI（1.37±0.32）,CAL（（3.73±0.57）mm）,FPG（（6.93±1.20）mmol/L）and HbA1c（（6.16±1.24）%）after 3-month treatment were significantly lower than those before treatment in observation group（PD：（6.26±0.48）mm,PLI：2.86±0.61,SBI：3.20±0.39,CAL：（4.99±0.48）mm,FPG：（9.70±1.43）mmol/L,HbA1c：（7.96±0.97）%）（P〈0.05）and after treatment in control group（P〈0.05）.Conclusion Systemic antibiotics in combination with non-surgical periodontal therapy can effectively improve the levels of periodontal status and glycometabolism in patients with T2 DM and periodontitis.