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

Curative effect analysis of minocycline hydrochloride sustained release agent combined with Vitapex in the treatment of elderly patients with chronic periodontitis complicated with pulp lesions

目的探讨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2014年7月至2015年12月在佛山市禅城区向阳医院口腔综合科就诊的130例老年慢性牙周炎合并牙髓病变患者,采用随机数字表法分为观察组和对照组,每组各65例。对照组采用碘甘油联合常规根管治疗,观察组采用盐酸米诺环素软膏联合Vitapex治疗,比较两组牙周相关指标、龈沟液炎性因子和临床疗效等。结果观察组有效率90.77%,明显高于对照组的75.38%(P<0.05);牙周袋探诊深度(PD)、牙龈指数(GI)、龈沟出血指数(SBI)、菌斑指数(PLI)、牙齿松动度(TM)均明显低于对照组(均P<0.05);龈沟液肿瘤坏死因子-α(TNF-α)、高敏C反应蛋白(hs-CRP)、白细胞介素-4(IL-4)含量均明显低于对照组(均P<0.05)。结论盐酸米诺环素缓释剂联合Vitapex治疗有助于提高老年慢性牙周炎合并牙髓病变患者临床疗效,可能与改善牙周症状、下调龈沟液中炎性因子水平有关。

Objective To investigate the clinical efficacy of minocycline hydrochloride sustained-release agent combined with Vitapex in the treatment of elderly patients with chronic periodontitis complicated with pulp lesions. Methods Totally 130 elderly patients with chronic periodontitis complicated with pulp lesions treated in our department of sto- matology from July 2014 to December 2015 were selected as the research objects and they were randomly divided into the observation group and the control group, with 65 cases in each group. The patients in the control group were treated with iodine glycerol combined with conventional root canal therapy, while the patients in the observation group were treat- ed with minocycline hydrochloride ointment combined with Vitapex. The periodontal indexes, gingival crevicular fluid in- flammatory factors and clinical efficacy and other indicators were compared between the two groups. Results The effec- tive rate of observation group was 90.77%, which was significantly higher than 75.38% of the control group （X^2 = 5.417, P 〈 0.05）. The probing depth of periodontal pocket （PD）, gingival index （GI）, sulcular bleeding index （SBI）, plaque in- dex （PLI）and tooth mobility （TM）of periodontal pockets were significantly lower than those of the control group （P 〈 0.05 ）and the levels of tumor necrosis factor alpha （TNF-α）, high sensitive C reactive protein （hs-CRP）and interleukin- 4 （IL-4）in gingival crevicular fluid were significantly lower than those in the control group （P 〈 0.05）. Conclusion The treatment of minocycline hydrochloride sustained-release agent combined with Vitapex is helpful to improve the clinical efficacy in elderly patients with chronic periodontitis complicated with pulp lesions, which may be related to im- proving periodontal symptoms and lowering the levels of inflammatory factors in gingival crevicular fluid.