盐酸米诺环素联合甲硝唑治疗慢性牙周炎的效果观察

Effect of minocycline hydrochloride combined with metronidazole in the treatment of chronic periodontitis

目的探讨慢性牙周炎患者采用盐酸米诺环素联合甲硝唑治疗的效果及对龈沟液中相关炎症因子水平的影响。方法选取舟山市妇女儿童医院收治的126例慢性牙周炎患者,采用随机数字表法分为联合组和对照组,每组各63例,联合组采用盐酸米诺环素+甲硝唑治疗,对照组采用盐酸米诺环素,疗程均为4周,比较两组患者的牙龈指数(gingival index,GI)、出血指数(bleeding index,BI)、探诊深度(periodontal probing depth,PD)、附着丧失(attach-ment loss,AL)及龈沟液(gingival crevicular fluid,GCF)中基质金属蛋白酶1(matrix metalloproteinase-1,MMP-1)、基质金属蛋白酶8(matrix metalloproteinase-8,MMP-8)、巨噬细胞炎症蛋白-1α(macrophage inflammatory protein 1α,MIP-1α)、可溶性细胞间黏附分子1(soluble adhesion molecules-1,sICAM-1)及疗效。结果治疗前,联合组和对照组的GI、BI、PD、AL、GCF中MMP-1、MMP-8、MIP-1α、sICAM-1测定值比较,差异无统计学意义(P>0.05);治疗后,联合组的GI、BI、PD、AL、GCF中MMP-1、MMP-8、MIP-1α、sICAM-1均低于对照组(P<0.05)。治疗后,联合组的显效率57.38%高于对照组的37.29%,两组临床疗效比较,差异有统计学意义(P<0.05);治疗过程中,联合组的不良反应发生率8.20%与对照组的3.39%比较,差异无统计学意义(P>0.05)。结论盐酸米诺环素联合甲硝唑治疗慢性牙周炎能显著改善患者牙周炎症反应,提高临床治疗效果。

Objective To explore the effect of minocycline hydrochloride combined with metronidazole in patients with chronic chronic periodontitis and the effect on the level of related inflammatory factors in blood glucose crevicular fluid(GCF).Methods A total of 126 patients with chronic periodontitis admitted to Zhoushan Women and Children’s Hospital were selected and randomly divided into a combination group and a control group with 63 cases in each group.The combination group was treated with minocycline hydrochloride+metronidazole,the control group was treated with minocycline hydrochloride,The course of treatment is 4 weeks.Results Before treatment,there was no significant difference in the measured values of matrix metalloproteinase-1(MMP-1),matrix metalloproteinase-8(MMP-8),macrophage inflammatory protein 1α(MIP-1α)and soluble adhesion molecules-1(sICAM-1),bleeding index(BI),periodontal probing depth(PD),attach-ment loss(AL)and gingival crevicular fluid(GCF)between the combined group and the control group(P>0.05).After treatment,the measured values of MMP-1,MMP-8,MIP-1αand sICAM-1 in GI,BI,PD,AL and GCF in the combined group were lower than those in the control group(P<0.05).After 4 weeks of treatment,the markedly effective rate of the combined group was 57.38% higher than that of the control group,37.29%,and the difference was statistically significant between the two groups(P<0.05).During the treatment,the incidence of adverse reactions in the combination group was 8.20% compared with 3.39% in the control group,and the difference was not statistically significant(P>0.05).Conclusion Minocycline hydrochloride combined with metronidazole in the treatment of chronic periodontitis can significantly improve the condition of periodontal inflammation and improve the clinical effect.