抗生素联合牙周基础治疗对合并慢性牙周炎的T2DM患者血糖控制影响的荟萃分析

Effects of systemic antibiotics combined with periodontal basic therapy on blood glucose control in patients with T2DM complicated with chronic periodontitis:a meta-analysis

目的全面评估与单纯牙周基础治疗(龈下刮治和根面平整,SRP)相比,牙周基础治疗联合全身性抗生素治疗,对2型糖尿病伴慢性牙周炎患者血糖控制的影响.方法通过计算机检索PubMed、EMBASE、The Cochrane Library、WanFang Data、LILACS、CNKI、CBM等数据库中所有关于牙周基础治疗联合全身性抗生素治疗对2型糖尿病合并慢性牙周炎患者HbA1c影响的随机对照研究,并由2名专业研究者严格筛选文献、提取资料后,采用RevMan5.3软件进行荟萃分析,通过χ^2检验分析各研究结果之间的异质性后,选用固定效应模型进行荟萃分析.结果最终纳入5项研究,荟萃分析结果显示,对于合并慢性牙周炎的2型糖尿病患者,与单纯牙周基础治疗相比,联合应用抗生素并不能显著降低其HbA1c水平(OR=-0.12,95%CI:-0.39~0.15,P=0.39).结论牙周基础治疗联合应用抗生素治疗慢性牙周病对2型糖尿病患者血糖控制无额外获益.

Objective To assess the effects of periodontal basic therapy (scarling and root planning,SRP) combined with systemic antibiotics,compared with peridontal basic therapy along,on blood glucose control in patients with type 2 diabetes mellitus complicated with chronic periodontitis.Methods The databases including PubMed,EMBASE,The Cochrane Library,WanFang Data,LILACS,CNKI and CBM were searched to collect all randomized control trials (RCTs) about the effects of systemic antibiotics combined with peridontal basic therapy on HbA1c control in patients with type 2 diabetes mellitus complicated with chronic periodontitis.The meta-analysis was performed using RevMan 5.3 software after rigorous screening of the literature by two professional researchers and extraction of data.After analyzing the heterogeneity between the results of each study through the χ^2 inspection,the fixed effect model was selected for meta-analysis.Results Finally,five studies were included.The results of the meta-analysis showed that compared with peridontal basic therapy alone,there was no significant difference in the reduction of HbAlc in patients with type 2 diabetes mellitus treated with adjunctive use of antibiotics(OR =-0.12,95% CI:-0.39-0.15,P =0.39).Conclusion Combined use of systemic antibiotics with peridontal basic therapy in the treatment of chronic periodontal disease has no additional benefit for glycemic control in patients with type 2 diabetes.