牙周基础治疗对慢性牙周炎合并2型糖尿病患者牙周炎症控制、血清炎症指标及血糖代谢的影响

Effect of periodontal basic treatment on inflammatory control,serum levels of inflammatory markers and glucose metabolism in patients with chronic periodontitis complicated by type 2 diabetes

目的探讨牙周基础治疗对慢性牙周炎合并2型糖尿病患者牙周炎症控制、血清炎症指标及血糖代谢的影响。方法选取湖南省某医院2015年5月-2017年1月收治的60例慢性牙周炎合并2型糖尿病患者为研究对象,采用随机数字表法随机分为对照组与观察组,每组30例。对照组患者采用常规基础治疗,观察组患者在对照组基础上采用牙周基础治疗,比较2组患者治疗前后牙周炎症指标、血清炎症指标及血糖代谢指标。结果治疗前,2组患者牙龈出血指数(GBI)及探诊深度(PD)比较,差异无统计学意义(P>0.05);治疗后,2组患者GBI及PD均小于治疗前,且观察组患者GBI及PD小于对照组,差异均有统计学意义(P<0.05)。治疗前,2组患者血清肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(CRP)、空腹血糖(FPG)及糖化血红蛋白(HbA1c)水平比较,差异均无统计学意义(P>0.05);治疗后,2组患者血清TNF-α,CRP,FPG及HbA1c水平均低于治疗前,且观察组患者血清TNF-α,CRP,FPG及HbA1c水平均低于对照组,差异均有统计学意义(P<0.05)。结论对慢性牙周炎合并2型糖尿病患者进行牙周基础治疗,能明显改善患者牙周环境、减轻局部及全身炎症反应,并对患者血糖调控具有促进作用,值得临床推广。

Objective To assess the effect of periodontal basic treatment on the inflammatory control,serum levels of inflammatory markers and glucose metabolism in patients with chronic periodontitis complicated by type 2 diabetes.Methods Sixty patients with both chronic periodontitis and type 2 diabetes were enrolled from a Hunan hospital between May 2015 and January 2017.Using a random number table,patients were randomized into the trial group（n=30）or the control group（n=30）.Patients in the trial group received routine treatment plus periodontal basic treatment,while those in the control group received routine treatment alone.The parameters reflecting the severity of periodontal inflammation and glucose metabolism as well as the serum levels of inflammatory markers were assessed and compared.Results Before treatment,the gingival bleeding index（GBI）and probing depth（PD）were similar between the two groups（P〉0.05）;after treatment,the GBI and PD were improved in both groups,but significantly better in the trial group compared with those in the control group（P〈0.05）.At baseline,the serum levels of tumor necrosis factorα（TNF-α）,hypersensitive C-reactive protein（CRP）,fasting plasma glucose（FPG）and glycosylated hemoglobin（HbA1 c）were comparable between the two groups（P〉 0.05）;after treatment,the serum TNF-α,CRP,FPG and HbA1 clevels were reduced in both groups,but significantly lower in the trial group compared with those in the control group（P〈0.05）.Conclusion For patients with chronic periodontitis complicated by type 2 diabetes,periodontal basic treatment could greatly improve the periodontal status,alleviate both local and systemic inflammatory response,and facilitate glucose control,which is worthy of clinical use.