盐酸米诺环素软膏联合替硝唑治疗对慢性牙周炎患者龈沟液中IL-10、TGF-β及外周血Th17、Treg水平的影响

The influence of periocline ointment combined with tinidazole on levels of gingival crevicular fluid IL-10 and TGF-β and peripheral blood Th17 and Treg in patients with chronic periodontitis

目的观察盐酸米诺环素软膏联合替硝唑治疗对慢性牙周炎(CP)患者龈沟液中白介素-10(IL-10)、转化生长因子β(TGF-β)及外周血辅助性T细胞17(Th17)、调节性T细胞(Treg)水平的影响。方法采用前瞻性研究,按随机数表法将保定市第一中心医院收治的86例CP患者分为盐酸米诺环素软膏+替硝唑组(研究组,n=43)和替硝唑组(对照组,n=43)。比较两组患者治疗前及治疗4周后牙周炎检查指标[牙周袋深度(PPD)、牙龈指数(GI)、牙周附着水平(PAL)、牙菌斑指数(PLI)]差异,于治疗前及治疗4周后检测两组患者龈沟液IL-10、TGF-β及外周血Th17、Treg水平,记录不良反应情况。结果治疗4周后,两组PPD、GI、PAL、PLI及外周血Th17、Treg水平均较治疗前降低,且研究组低于对照组(P <0. 05);两组龈沟液IL-10、TGF-β水平均较治疗前升高,且研究组高于对照组(P <0. 05)。两组总不良反应发生率差异无统计学意义(P> 0. 05)。结论盐酸米诺环素软膏联合替硝唑治疗CP可显著改善患者临床症状,减轻炎症反应,改善免疫功能,且安全性良好。

Objective To observe the influence of periocline ointment combined with tinidazole on the levels of gingival crevicular fluid interleukin-10(IL-10)and transforming growth factorβ(TGF-β)and peripheral blood helper T cell 17(Th17)and regulatory T cell(Treg)in patients with chronic periodontitis(CP).Methods Eighty-six patients with CP were divided into periocline ointment+tinidazole group(study group,n=43)and tinidazole group(control group,n=43)according to the random number table method.The examination indexes of periodontitis[periodontal pocket depth(PPD),gingival index(GI),periodontal adhesion level(PAL),plaque index(PLI)]were compared between the two groups before treatment and after 4 w of treatment.Before treatment and after 4 w of treatment,the levels of gingival crevicular fluid IL-10 and TGF-βand peripheral blood Th17 and Treg were measured in the two groups,and the adverse reactions were recorded.Results After 4 w of treatment,the levels of PPD,GI,PAL,PLI and peripheral blood Th17 and Treg in the two groups were lower than those before treatment,and the levels in study group were lower than those in control group(P<0.05).The level of gingival crevicular fluid IL-10 and TGF-βin the two groups were higher than those before treatment,and the levels in study group were higher than those in control group(P<0.05).There was no significant difference in the total incidence rate of adverse reactions between the two groups(P>0.05).Conclusion Periocline ointment combined with tinidazole for CP can significantly improve the clinical symptoms,reduce inflammatory response and improve immune function,and it has good safety.