常规牙周基础治疗对2型糖尿病伴牙周炎的疗效研究

Therapeutic effect of conventional periodontal therapy on patients with type 2 diabetes mellitus with periodontitis

目的观察常规牙周基础疗法治疗2型糖尿病伴牙周炎的疗效,并分析患者血糖、血清生化指标的变化。方法选取2017年3月—2019年6月武汉市中医医院接受干预治疗的114例2型糖尿病伴牙周炎患者作为研究对象,根据随机数字表法分为对照组和研究组,每组57例。对照组选用常规治疗,研究组在常规治疗基础上予以牙周基础治疗;比较两组患者治疗前、后牙周噬菌斑数(PLI)、牙周袋底至龈缘距离(PD)、探诊后出血百分数(BOP)、出血指数(BI)及牙周袋至釉牙骨质界距离(CAL);观察两组患者治疗前、后空腹血糖(FBG)和糖化血红蛋白(HbAlc)水平的变化,并分析血清生化指标水平,如甘油三酯(TG)、血钙(Ca)等。结果两组患者治疗前PLI、PD、BOP、CAL及BI指标水平差异无统计学意义(P>0.05);两组患者治疗后PLI、PD、BOP、CAL及BI指标水平差异有统计学意义(P<0.05);两组患者治疗前HbAlc、T-Bil、FBG、Ca、P、Ca/P、TG、Lipoprotein a及ApoAl指标水平差异无统计学意义(P>0.05);两组患者治疗后HbAlc、Ca/P、血清P、TG、ApoA1、T-Bil水平差异有统计学意义(P<0.05)。结论牙周基础治疗能够改善2型糖尿病伴牙周炎患者Ca/P、HbAlc、血脂代谢水平及牙周参数,临床可推广及应用。

Objective To observe the effect of conventional periodontal therapy on type 2 diabetes with periodontitis,and to analyze the changes in blood glucose and serum biochemical indicators of patients.Methods A total of 114 patients with type 2 diabetes and periodontitis who underwent intervention treatment in our hospital from March 2017 to June 2019 were selected as the analysis objects.They were divided into two groups according to the random number table method.One group was the control group(57 cases),and the other group was the study group(57 cases).The former group was treated with conventional therapy,and the latter group was treated with periodontal therapy based on conventional therapy.The periodontal clinical parameters of the two groups of patients,periodontal pocket bottom to gingival margin(PD),percent bleeding after exploration(BOP),bleeding index(BI),and periodontal pocket to enamel cementum boundary(CAL),were compared before and after treatment;fasting blood glucose(FBG)and glycated hemoglobin(HbAlc)levels before and after treatment and analysis of serum biochemical indicators such as triglycerides(TG),blood calcium(Ca),etc.,were detected.Results There were no differences in the levels of PD,PLI,BOP,CAL,HbAlc,T-Bil,FBG,Ca,P,Ca/P,TG,lipoprotein and ApoAl before treatment(P>0.05).The levels of BI,PD,BOP,PLI,CAL,HbAlc,calcium to phosphorus,serum P and TG decreased,ApoA1 and T-Bil levels increased(P<0.05),but there was no difference in FBG levels(P>0.05).Compared with the control group,the BI,PD,BOP,PLI,CAL,HbAlc,calcium-phosphorus ratio,serum P,TG levels decreased,ApoA1 and T-Bil levels increased(P<0.05),but no difference in FBG levels.(P>0.05).Conclusion Periodontal basic treatment can improve serum calcium-phosphorus ratio,blood lipid metabolism level,glycated hemoglobin,and periodontal parameters in patients with type 2 diabetes and periodontitis,which can be promoted and applied clinically.