抗生素联合牙周基础治疗中重度慢性牙周炎合并2型糖尿病的疗效观察

Clinical effects of antibiotics combined with initial periodontal therapy on moderate to severe chronic periodontitis complicated with T2DM

目的观察抗生素联合牙周基础治疗(IPT)中重度慢性牙周炎(CP)合并2型糖尿病(T2DM)的疗效。方法将2015-01~2016-12该院治疗的64例中重度CP合并T2DM患者随机分为观察组和对照组,每组32例。观察组予以抗生素(口服甲硝唑片+阿莫西林胶囊)联合IPT,对照组则仅实施IPT。比较治疗前和治疗后1个月时两组患者牙周指数[牙周袋探深度(PD)、菌斑指数(PLI)、龈沟出血指数(SBI)]、糖代谢[空腹血糖(FPG)、糖化血红蛋白(HbA1c)]、炎性因子[超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)]水平变化。结果治疗后1个月,两组牙周指数(PD、PLI、SBI)、糖代谢指标(FPG、HbA1c)、炎症因子(hs-CRP、TNF-α)水平相比治疗前明显下降(P<0.05),且观察组明显低于对照组(P<0.05)。结论抗生素联合IPT可显著降低中重度CP合并T2DM患者牙周指数,有效改善糖代谢,对疾病转归有利。

Objective To observe the clinical effects of antibiotics combined with initial periodontal therapy(IPT)on moderate to severe chronic periodontitis(CP)complicated with type 2 diabetes mellitus(T2DM).Methods Sixty-four patients with moderate to severe CP complicated with T2DM who were treated in our hospital from January 2015 to December 2016 were enrolled.The patients were randomly divided into observation group and control group,with 32 cases in each group.The patients in the observation group were given antibiotics(oral metronidazole tablets+amoxicillin capsules)in combination with IPT,while the control group only underwent IPT.The changes of periodontal indexes[periodontal pocket depth(PD),plague index(PLI);sulcus bleeding index(SBI)],glucose metabolism indexes[fasting blood glucose(FPG),glycosylated hemoglobin A1c(HbA1c)]and inflammatory factors[high sensitive C-reactive protein(hs-CRP),tumor necrosis factor(TNF-α)]were compared between the two groups before treatment and one month after treatment.Results At 1 month after treatment,the levels of the periodontal indexes(PD,PLI,SBI),glucose metabolism indexes(FPG,HbA1c)and inflammatory factors(hs-CRP,TNF-α)in the two groups were significantly lower than those before treatment(P<0.05);compared with those in the control group,the levels of the above indexes in the observation group were significantly lower(P<0.05).Conclusion Antibiotic combined with IPT can significantly reduce the periodontal indexes of the patients with moderate to severe CP and T2DM,and effectively improve glucose metabolism,which is beneficial to the disease outcome.