盐酸米诺环素缓释剂联合Vitapex治疗老年慢性牙周炎合并牙髓病变疗效分析

Analysis of minocycline hydrochloride combined with Vitapex in treating senile chronic periodontal-endodontic combined lesions

目的 :评价盐酸米诺环素缓释剂联合Vitapex治疗老年慢性牙周炎合并牙髓病变的临床疗效。方法 :选取2012年6月—2014年6月收治的慢性牙周炎合并牙髓病变老年患者120例,随机等分为观察组和对照组各60例。对照组行常规根管治疗,观察组在常规治疗基础上使用Vitapex根管内置药,并向牙周袋内注入盐酸米诺环素缓释软膏,比较2组患者治疗前后血清C反应蛋白(C reactive protein,CRP)、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、白细胞介素17(interleukin-17,IL-17)水平、牙周袋探诊深度(probing depth,PD)、牙龈指数(gingival index,GI)、出血指数(bleeding index,BI)、菌斑指数(plaque index,PLI)以及1年后的疗效。采用SPSS18.0软件包进行数据处理。结果:与治疗前相比,2组患者治疗后血清CRP,TNF-α及IL-17水平均有所下降,观察组下降更加明显,组间比较差异显著(P<0.05)。与治疗前相比,2组患者治疗4周和8周时PD、GI、BI、PLI均有所下降,观察组显著低于对照组(P<0.05)。经过1年的随访,观察组的治疗总有效率为83.33%,对照组为68.33%,差异显著(P<0.05)。结论 :对于老年慢性牙周炎合并牙髓病变的患者,在常规根管治疗基础上联合应用Vitapex及盐酸米诺环素可显著提高疗效,操作简便,值得临床推广。

PURPOSE： To investigate the effect of minocycline hydrochloride combined with Vitapex in treating senile chronic periodontal-endodontic combined lesions. METHODS： One hundred twenty patients with senile chronic periodontitis and endodontic lesions patients treated in our hospital between Jun.2012 to Jun.2014 were selected. They were divided into experimental group （n=60） and control group （n=60）. Patients in the control group were given conventional root canal therapy, while patients in the experimental group were given Vitapex and minocycline hydrochloride. The clinical effect between two groups was compared. SPSS18.0 software package was used for statistical analysis. RESULTS： Compared with pre-treatment, the levels of IL-17, TNF-α and CRP in serum were decreased in two groups, but the levels in the experimental group were significantly lower than those in the control group（P〈0.05）. Compared with pre-treatment, PD, GI, BI, PLI were decreased in two groups, but the levels in the experimental group were significantly lower than those in the control group（P〈0.05）. The effective rate of experimental group was 83.33% and the control group was 68.33%, the difference was statistically significant （P〈0.05）. CONCLUSIONS： For chronic periodontitis and endodontic lesions, besides conventional root canal therapy, Vitapex combined with minocycline hydrochloride can significantly improve the clinical effect.