益生菌联合牙周基础治疗对牙周炎合并2型糖尿病患者龈沟液中炎症因子和骨代谢因子的影响

Effect of probiotics combined with periodontal therapy on inflammatory factors and bone metabolic factors in gingival crevicular fluid of patients with periodontitis combined type 2 diabetes

目的分析益生菌联合牙周基础治疗对牙周炎合并2型糖尿病患者龈沟液中炎症因子和骨代谢因子的影响。方法选取2017年7月至2021年1月安徽医科大学附属阜阳医院收治的伴牙槽嵴吸收的牙周炎合并2型糖尿病患者150例,采用随机数字表法分为研究组和对照组,各75例,均给予牙周基础治疗,研究组加用益生菌治疗。对比2组患者治疗效果、治疗前后龈沟液炎症因子[白介素-6(IL-6)、超敏C反应蛋白(hs-CRP)及肿瘤坏死因子-α(TNF-α)]、骨代谢因子[骨钙素(OC)]水平及牙周状态[龈沟出血指数(SBI)、探诊深度(PD)、临床附着丧失(CAL)]变化。结果治疗3个月后,研究组总有效率为85.33%,高于对照组的64.00%,差异有统计学意义(P<0.05)。2组患者治疗4周后龈沟液IL-6、hs-CRP、TNF-α、OC水平[研究组:(3.01±0.29)、(8.23±0.91)、(3.68±0.54)、(346.32±51.59)μg/L;对照组:(3.66±0.38)、(12.14±1.24)、(5.41±0.69)、(450.35±52.67)μg/L]均较治疗前[研究组:(5.41±0.66)、(17.41±2.49)、(7.59±1.13)、(648.29±65.77)μg/L;对照组:(5.38±0.71)、(17.52±2.38)、(7.61±1.14)、(649.57±66.38)μg/L]下降(P<0.05),且研究组低于对照组(P<0.05)。2组患者治疗3个月后SBI、PD[研究组:0.37±0.15,(3.32±0.41)mm;对照组:0.97±0.21,(3.71±0.36)mm]均较治疗前[研究组:3.67±0.45,(5.59±0.38)mm;对照组:3.65±0.47,(5.62±0.40)mm]下降(P<0.05),且研究组低于对照组(P<0.05)。结论在牙周基础治疗上,将益生菌应用于2型糖尿病伴牙槽嵴吸收的牙周炎治疗,能够取得较理想的临床疗效,且能够有效调节龈沟液炎症因子与骨代谢因子水平,促进牙周状态改善。

Objective To analyze the effect of probiotics combined with periodontal therapy on inflammatory factors and bone metabolic factors in gingival crevicular fluid of patients with periodontitis combined type 2 diabetes.Methods One hundred and fifty patients with periodontitis accompanied by alveolar ridge absorption combined type 2 diabetes admitted to Fuyang Hospital of Anhui Medical University from July 2017 to January 2021 were randomly divided into study group and control group,with 75 cases in each group.All patients were given periodontal basic treatment,and study group was additionally treated with probiotics.The therapeutic effects,changes of inflammatory factors(IL-6,hs-CRP,and TNF-α)and bone metabolic factor(OC)in gingival crevicular fluid,and periodontal status(SBI,PD,and CAL)before and after treatment were compared between two groups.Results After 3 months of treatment,the total effective rate of study group was 85.33%,which was higher than that of control group(64.00%,P<0.05).Compared with the values before treatment[study group:(5.41±0.66),(17.41±2.49),(7.59±1.13),(648.29±65.77)μg/L;control group:(5.38±0.71),(17.52±2.38),(7.61±1.14),(649.57±66.38)μg/L],the levels of IL-6,hs-CRP,TNF-α,and OC in gingival crevicular fluid decreased after 4 weeks of treatment in both groups[study group:(3.01±0.29),(8.23±0.91),(3.68±0.54),(346.32±51.59)μg/L;control group:(3.66±0.38),(12.14±1.24),(5.41±0.69),(450.35±52.67)μg/L;P all<0.05];the decreases in study group were lower than those of control group(P<0.05).After 3 months of treatment,SBI and PD in both groups decreased[study group:0.37±0.15,(3.32±0.41)mm;control group:0.97±0.21,(3.71±0.36)mm]compared with those before treatment[study group:3.67±0.45,(5.59±0.38)mm;control group:3.65±0.47,(5.62±0.40)mm;P all<0.05],and SBI and PD in study group were lower than those in control group after 3 months of treatment(P<0.05).Conclusion On the basis of periodontal initial treatment,the application of probiotics in the treatment of type 2 diabetes patients combined periodontitis accompanying alveolar ridge absorption can achieve better clinical efficacy,and can effectively regulate inflammatory factors and bone metabolic factor in gingival crevicular fluid,and promote the improvement of periodontal status.