高压氧联合甲硝唑膜治疗糖尿病牙周炎临床疗效的Meta分析

Meta-analysis of the efficacy of hyperbaric oxygen combined with metronidazole membrane in the treatment of diabetic periodontitis

目的采用Meta分析评价高压氧(HBO)联合甲硝唑膜治疗糖尿病牙周炎的临床疗效。方法系统检索8个数据库(PubMed、Embase、Cochrane library、Web of Science、CBM、VIP、WanFang Data和CNKI),根据纳入及排除标准筛选相关研究资料,并提取数据,采用Cochrane协作网提供的方法进行方法学质量评估,采用Revman 5.3软件进行数据分析,采用STATA 15软件进行敏感性分析,采用Egger’s检验检测发表偏倚。结果共纳入12项随机对照试验(RCTs)。HBO联合甲硝唑膜治疗能显著提高糖尿病牙周炎的疗效[OR=3.76,95%CI(2.62~5.41),P<0.01]。改善患者咀嚼功能:咬力[WMD=109.66,95%CI(90.20~129.12),P<0.01]、咀嚼效率[WMD=13.05,95%CI(7.59~18.51),P<0.01];且改善患者牙周状况:探诊深度[WMD=-1.00,95%CI(-1.59~-0.41),P<0.01]、牙周袋深度[WMD=-0.88,95%CI(-1.22~-0.54),P<0.01]、牙龈出血指数[WMD=-0.80,95%CI(-1.12~-0.48),P<0.01])。Egger’s检验结果显示存在发表偏倚(t=3.47,P<0.05)。结论HBO联合甲硝唑膜治疗糖尿病牙周炎疗效优于单纯常规治疗,能有效改善患者的咀嚼功能及牙周状况。

Objective To evaluate the clinical effect of hyperbaric oxygen(HBO)combined with metronidazole membrane in the treatment of diabetic periodontitis.Methods The relevant studies were retrieved from 8 databases(PubMed,Embase,Cochrane library,Web of Science,CBM,VIP,Wanfang Data,and CNKI)and screened according to inclusion and exclusion criteria,then the data were extracted.The methodological quality evaluation was conducted using simple methods provided by Cochrane Collaboration.The data were analyzed by Revman 5.3 software,and the publication bias detection and sensitivity analysis were conducted by STATA 15 software.Results A total of 12 randomized controlled trials(RCTs)were included.The results of meta-analysis showed that HBO combined with metronidazole membrane therapy can significantly improve the efficacy of diabetic periodontitis[OR=3.76,95%CI(2.62,5.41),P<0.01],improve patient’s masticatory function(bite force)[WMD=109.66,95%CI(90.20,129.12),P<0.01]and masticatory efficiency[WMD=13.05,95%CI(7.59,18.51),P<0.01]),periodontal status(probing depth)[WMD=-1.00,95%CI(-1.59,-0.41),P<0.01],periodontal pocket depth[WMD=-0.88,95%CI(-1.22,-0.54),P<0.01],and gingival bleeding index[WMD=-0.80,95%CI(-1.12,-0.48),P<0.01].The results of Egger’s test indicated publication bias(t=3.47,P<0.05).Conclusion The effect of HBO combined with metronidazole membrane in the treatment of diabetic periodontitis is better than that of conventional treatment,which can effectively improve the patient’s masticatory function and periodontal status.