透明质酸钠凝胶治疗慢性牙周炎临床疗效观察及对血清炎性因子变化的影响

Clinical observation of sodium hyaluronate in the treatment of chronic periodontitis and its influence on serum inflammatory factors

目的:探讨透明质酸钠凝胶治疗慢性牙周炎的疗效及对血清超敏C-反应蛋白(hs-CRP)、白细胞介素8(IL-8)和肿瘤坏死因子-α(TNF-α)水平变化的影响。方法:选择2017年3月至2019年3月在杭州西溪医院就诊的98例慢性牙周炎患者,按随机数字表法分为两组,对照组49例患者给予替硝唑片治疗,观察组49例患者给予替硝唑片联合透明质酸钠凝胶治疗,两组疗程均为4周。比较两组治疗4周后的总有效率,治疗前与治疗4周后牙龈指数(GI)、龈沟出血指数(SBI)、菌斑指数(PLI)及血清hs-CRP、IL-8和TNF-α水平变化。记录两组治疗4周期间的不良反应发生情况。结果:观察组总有效率高于对照组[93.88%(46/49)比71.43%(35/49)],差异有统计学意义(χ2=8.612,P<0.05)。观察组治疗4周后GI、SBI和PLI低于对照组(1.10±0.23比1.63±0.36、0.38±0.10比0.71±0.15、0.83±0.29比1.36±0.21),差异有统计学意义(P<0.05)。观察组治疗4周后血清hs-CRP、IL-8和TNF-α水平低于对照组[(4.53±1.29)mg/L比(7.65±1.82)mg/L、(6.17±1.08)ng/L比(9.98±1.56)ng/L、(2.27±0.26)μg/L比(3.98±0.32)μg/L],差异有统计学意义(P<0.05)。两组患者治疗期间未发生明显不良反应。结论:透明质酸钠治疗慢性牙周炎患者临床疗效显著,可降低血清hs-CRP、IL-8和TNF-α水平,从而减轻炎性反应。

Objective To investigate the effect of sodium hyaluronate on chronic periodontitis and its influence on serum hyper sensitive C-reactive protein(hs-CRP),interleukin 8(IL-8)and tumor necrosis factor-α(TNF-α).Methods Using the random number table method,98 patients with chronic periodontitis from March 2017 to March 2019 in Hangzhou Xixi Hospital were randomly divided into observation group(49 cases)and control group(49 cases).The control group was treated with tinidazole tablets,and the observation group was treated with sodium hyaluronate on the basis of the control group.The course of treatment was 4 weeks.The total effective rate was compared and the gingival index(GI),sulcus bleeding index(SBI),plaque index(PLI),and the levels of serum hs-CRP,IL-8,TNF-αbefore and 4 weeks after treatment were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group:93.88%(46/49)vs.71.43%(35/49),the difference was statistically significant(χ2=8.612,P<0.05).After treatment of 4 weeks,the scores of GI,SBI and PLI in the observation group were lower than those in the control group:(1.10±0.23 vs.1.63±0.36,0.38±0.10 vs.0.71±0.15,0.83±0.29 vs.1.36±0.21),the differences were statistically significant(P<0.05).After treatment of 4 weeks,the levels of hs-CRP,IL-8 and TNF-αin the observation group were lower than those in the control group:(4.53±1.29)mg/L vs.(7.65±1.82)mg/L,(6.17±1.08)ng/L vs.(9.98±1.56)ng/L,(2.27±0.26)μg/L vs.(3.98±0.32)μg/L,the differences were statistically significant(P<0.05).No obvious adverse reactions occurred in the two groups.Conclusions Sodium hyaluronate has a significant clinical effect on chronic periodontitis.It can reduce the levels of hs-CRP,IL-8,TNF-αand alleviate the inflammatory reaction.