盐酸米诺环素联合翻瓣术辅助治疗慢性牙周炎疗效的Meta分析

Efficacy of minocycline hydrochloride combined with flap surgery for chronic periodontitis: a Meta-analysis

目的系统评价牙周翻瓣术中使用2%盐酸米诺环素处理根面的疗效,为其治疗慢性牙周炎提供循证医学证据。方法检索中国期刊全文数据库、维普、万方、中国生物医学文献数据库、Pub Med、Science Direct和Embase等数据库,检索时限为从建库到2017年7月。由2名评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Rev Man 5.3对数据进行Meta分析。结果最终纳入7个随机对照实验,共217例受试者。Meta分析结果显示,与单纯翻瓣术(FO)组比较,盐酸米诺环素联合翻瓣术(FM)组患者随访3个月时的探诊深度减少[MD=-0.55,95%CI(-0.84,-0.26),P=0.000 2],菌斑指数降低[MD=-0.08,95%CI(-0.15,-0.01),P=0.03],随访6个月时探诊深度减少[MD=-0.62,95%CI(-1.04,-0.21),P=0.003]方面更加明显,组间比较差异有统计学意义(P<0.05)。FM组患者随访3个月时在临床附着丧失获得[MD=-0.21,95%CI(-0.47,0.04),P=0.10]方面改变的差异无统计学意义(P>0.05)。结论在翻瓣下机械清创治疗慢性牙周炎中,使用2%盐酸米诺环素处理根面减少探诊深度和炎症控制方面有明显的效果。

Objective This study aimed to evaluate the efficacy of 2% minocycline hydrochloride combined with flap surgery in the treatment of chronic periodontitis. The superiority of this therapy to simple flap surgery was also explored. Methods We searched the databases of CNKI, VIP, Wanfang, Chinese Biomedical Literature, Pub Med, Science Direct, and Embase from inception to July 2017. Two reviewers independently screened literature, extracted data, and evaluated the bias risk of included studies. Then, Meta-analysis was performed using Rev Man 5.3 software. Results A total of seven randomized controlled trials involving 217 patients were included. Meta-analysis showed that, in two groups, the changes in probing depth（PD） [MD=-0.55, 95%CI（-0.84,-0.26）, P=0.000 2] and plaque index [MD=-0.08, 95%CI（-0.15,-0.01）, P=0.03] at 3 and 6 months of PD [MD=-0.62, 95%CI（-1.04,-0.21）, P=0.003] had statistically significant difference（P0.05）. The clinical attachment loss（CAL） [MD=-0.21, 95%CI（-0.47, 0.04）, P=0.10] had no statistically significant difference after 3 months（P0.05）, but the improvement in CAL was significantly improved by minocycline hydrochloride combined with flap therapy. Conclusion Periodontal flap combined with minocycline adjuvant therapy for chronic periodontitis is effective in short-term observations.