益生菌辅助治疗慢性牙周炎的疗效的meta分析

A meta-analysis of clinical effect of using probiotics as an adjunct to the treatment of chronic periodontitis

目的:评价益生菌是否有辅助龈下刮治和根面平整(scaling and root planing,SRP)治疗慢性牙周炎(chronic periodontitis,CP)的效果。方法:计算机检索PubMed、Embase、the Cochrane Library、Web of science、Scopus、中国万方和知网数据库中关于益生菌辅助治疗牙周炎的随机对照临床试验(randomized controlled trials,RCT)。按照Cochrane评分标准,对纳入的文献进行质量评价,使用RevMan 5.3软件对数据进行统计学分析。结果:根据检索策略,共纳入了9篇文献进行meta分析。结果显示在辅助益生菌治疗后1个月内,牙周探诊深度(probing depth,PD)显著降低[MD=-0.49,95%CI(-0.76,-0.23),P<0.01],临床附着水平(clinical attachment level,CAL)获得[MD=0.23,95%CI(0.23,0.38),P<0.01]。3个月后PD深度减少[MD=-0.50,95%CI(-0.89,-0.10),P<0.01],中等深度的牙周袋PD减少[MD=-0.20,95%CI(-0.28,-0.11),P<0.01]和深牙周袋PD的减少[MD=-0.54,95%CI(-0.82,-0.25),P<0.01],CAL获得[MD=0.23,95%CI(0.08,0.38),P<0.01]。结论:治疗慢性牙周炎时,辅助使用益生菌制剂对于牙周袋深度的减少有显著效果。

Objective:To evaluate whether the probiotic had benefits in the treatment of chronic periodontitis(CP)with or without scaling and root planing(SRP).Methods:Electronic literature search was conducted by authors to select randomized controlled trials(RCTs)comparing SRP + probiotic versus SRP alone in the following database:PubMed,Embase,the Cochrane Library,Web of science,Scopus,CNKI and Wanfang.According to Cochrane scoring criteria,the quality of the included literature was evaluated.RevMan 5.3 software was applied for meta analysis.Results:According to our search strategy,9 articles were included for the meta-analysis in the end.The results showed that within one month after the treatment of probiotics,probing depth(PD)had a significant reduction[MD=-0.49,95%CI(-0.76,-0.23),P<0.01],clinical attachment level(CAL) gain[MD=0.23,95%CI(0.23,0.38),P<0.01].At three months,PD reduction[MD=-0.50,95%CI(-0.89,-0.10),P<0.01],the moderate pockets PD reduction[MD=-0.20,95%CI(-0.28,-0.11),P<0.01]and the deep pockets PD reduction[MD=-0.54,95%CI(-0.82,-0.25),P<0.01],CAL gain[MD=0.23,95%CI(0.08,0.38),P<0.01].Conclusion:In the treatment of chronic periodontitis,the supplementary use of probiotics has a significant effect on the reduction of periodontal pocket depth.