口腔洁含漱液联合牙周基础治疗对慢性牙周炎伴2型糖尿病患者牙周状态及龈沟液炎症因子水平的影响

Effect of Kouqiangjie Gargle Combined with Periodontal Basic Therapy on Periodontal Status and Gingival Crevicular Fluid Inflammatory Cytokines in Patients with Chronic Periodontitis Complicated with Type 2 Diabetes Mellitus

目的探讨口腔洁含漱液(清热解毒利湿,和血益气养阴为法)联合牙周基础治疗对慢性牙周炎(chronic periodontitis,CP)伴2型糖尿病(type 2 diabetes mellitus,T2DM)患者牙周状态及患牙龈沟液中炎症因子水平的影响。方法将60例CP伴T2DM患者随机分为观察组和对照组,每组各30例。患者在接受牙周基础治疗的基础上,对照组予以生理盐水含漱,观察组用口腔洁含漱液含漱。比较两组患者治疗前和治疗2周后的中医证候积分(牙龈肿痛、牙龈萎缩、口干舌燥、口臭、便秘),牙周状态相关指标[牙龈指数(GI)、改良龈沟出血指数(mSBI)、牙周探诊深度(PD)、改良菌斑指数(mPLI)、临床附着丧失(CAL)、牙齿松动度(TM)]以及龈沟液炎症因子[肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、基质金属蛋白酶9(MMP-9)]水平,同时观察治疗期间的不良反应。结果两组患者受检牙齿治疗后牙龈肿痛、牙龈萎缩、口干舌燥、口臭、便秘各项积分显著降低(P<0.05);牙周状态相关指标GI、mSBI、PPD、mPLI、CAL、TM和龈沟液中TNF-α、IL-1β和MMP-9水平较治疗前均下降(P<0.05),而且,治疗后除两组间PD和CAL比较差异无统计学意义外(P>0.05),观察组较对照组下降更明显(P<0.05);两组不良反应发生率差异无统计学意义(P>0.05);观察组总有效率显著高于对照组(P<0.05)。结论口腔洁含漱液联合牙周基础治疗可显著缓解CP伴T2DM患者症状,改善患者牙周状况,降低龈沟液炎症因子水平,从而控制疾病进展。

Objective To explore the effects of Kouqiangjie Gargle(KQJG,therapeutic principle of clearing heat,removing toxin,harmonizing blood,nourishing yin and tonifying qi)combined with periodontal basic therapy on periodontal status and levels of gingival crevicular fluid(GCF)inflammatory cytokines in patients with chronic periodontitis(CP)complicated with type 2 diabetes mellitus(T2DM).Methods Sixty patients with CP complicated with T2DM were randomly divided into observation group and control group(n=30).All the patients received the basic periodontal treatment.Meanwhile,patients in observation group received KQJG,and those in control group were treated with saline.The traditional Chinese medicine(TCM)syndrome scores(gingival pain and swelling,gingival atrophy,dry mouth,bad breath,and constipation),periodontal status-related indicators[gingival index(GI),modified sulcus bleeding index(mSBI),probing depth(PD),modified plaque index(mPLI),clinical attachment loss(CAL),tooth mobility(TM)],and inflammatory cytokines(TNF-α,IL-1β,and MMP-9)in GCF before and after 2-week treatment in each group,as well as between the two groups,were measured and compared.The adverse reactions during treatment were observed and recorded.Results After treatment,the TCM syndrome scores in the two groups,including gingival pain and swelling,gingival atrophy,dry mouth,bad breath,and constipation,were significantly decreased(P<0.05).Periodontal status-related indicators(GI,mSBI,PPD,mPLI,CAL and TM)and inflammatory cytokines(TNF-α,IL-1β,and MMP-9)in GCF were all significantly decreased in the two groups(P<0.05).There was no statistically significant difference in PD and CAL between the two groups after treatment(P>0.05).Other indicators in observation group after treatment were significantly decreased compared with those in control group(P<0.05).Moreover,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).Conclusion KQJG combined with periodontal basic therapy treatment can significantly relieve the symptoms of patients with CP complicated with T2DM,improve the periodontal status,reduce the levels of inflammatory cytokines in GCF,and control disease progression.