伐昔洛韦联合龈下刮治和根面平整治疗重度慢性牙周炎的疗效观察

Observation of curative effect by valaciclovir combined with subgingival scaling and root planning in the treatment of severe chronic periodontitis

目的探讨伐昔洛韦联合龈下刮治和根面平整治疗重度慢性牙周炎的应用价值。方法 60例(134颗患牙)重度慢性牙周炎患者作为研究对象,随机分为对照组和观察组,每组30例(67颗患牙)。两组均进行全面专科检查,观察组口服伐昔洛韦治疗,对照组口服安慰剂,48 h后由同一组医师进行手术治疗,并进行超声龈上洁治术、龈下刮治术、根面平整术,常规口腔卫生宣教,2周内0.2%康复新漱口。对比治疗前、术前、4周后,两组实验牙菌斑指数(PLI)、出血指数(BI)、牙周袋探诊深度(PD)、附着丧失(CAL)、龈沟液含量。结果术前观察组BI、GCF低于治疗前及同期对照组(P<0.05),4周后两组患者PLT、BI、PD、GCF均低于治疗前,且观察组低于对照组(P<0.05),观察组CAL低于治疗前及对照组;4周后观察组BI为(2.14±0.57)、PD为(5.54±1.26)mm、GCF为(1.53±1.14)μl,低于术前的(2.68±0.64)、(7.48±0.63)mm、(1.84±1.14)μl,差异具有统计学意义(P<0.05)。结论伐昔洛韦联合龈下刮治和根面平整治疗重度慢性牙周炎疗效较好,可增进疗效。

Objective To investigate application value by valaciclovir combined with subgingival scaling and root planning in the treatment of severe chronic periodontitis. Methods A total of 60 patients（134 teeth） with severe chronic periodontitis as study subjects were randomly divided into control group and observation group, with 30 cases（67 teeth） in each group. Both groups received complete speciality examination. The observation group received oral administration of valaciclovirfor treatment, and the control group received oral administration of placebo. After 48 h, both groups received operation treatment by the same physicians, along with ultrasonic supragingival scaling, subgingival scaling, root planning and conventional oral hygiene education, and they also took 0.2% Kangfuxin for gargle within 2 weeks. Comparison was made on plaque index（PLT）, bleeding index（BI）, periodontal depth（PD）, clinical attachment loss（CAL） and gingival crevicular fluid（GCF） content between the two groups before treatment, before operation and in 4 weeks after treatment. Results Before operation, the observation group had lower BI and GCF than those before treatment and in the control group（P〈0.05）. After 4 weeks, both groups had lower PLT, BI, PD and GCF than those before treatment, and the observation group had lower levels than the control group（P〈0.05）. The observation group had lower CAL than those before treatment and in the control group. After 4 weeks, the observation group had lower BI as（2.14±0.57）, PD as（5.54±1.26） mm, and GCF as（1.53±1.14） μl than（2.68±0.64）,（7.48±0.63） mm and（1.84±1.14） μl before operation, and their difference had statistical significance（P〈0.05）. Conclusion Combination of valaciclovir, subgingival scaling and root planning shows excellent effect in treating severe chronic periodontitis, and this method can enhance curative effect.