全程牙周基础治疗联合抗生素对慢性牙周炎合并2型糖尿病患者的影响

Effect of Whole Course Periodontal Basic Treatment Combined with Antibiotics on Patients with Chronic Periodontitis Complicated with Type 2 Diabetes Mellitus

目的:探讨全程牙周基础治疗联合抗生素对慢性牙周炎合并2型糖尿病(T2DM)患者的影响。方法:选取2021年6月-2023年4月在阳江雅博口腔门诊部接受治疗的82例慢性牙周炎合并T2DM患者作为研究对象。根据随机数表法将其分为全程联合组(28例),单程联合组(27例),基础治疗组(27例)。三组均给予T2DM治疗。基础治疗组给予牙周基础治疗,单程联合组给予牙周基础治疗联合抗生素,全程联合组给予全程牙周基础治疗联合抗生素。比较三组治疗前后血糖指标、炎症因子、牙周指数及临床疗效。结果:治疗后,全程联合组空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)水平均低于单程联合组与基础治疗组,单程联合组FPG、2 h PG、HbA1c水平均低于基础治疗组,差异有统计学意义(P<0.05)。治疗后,全程联合组C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)与白细胞介素-6(IL-6)水平均低于单程联合组与基础治疗组,单程联合组CRP、TNF-α、IL-6水平均低于基础治疗组,差异有统计学意义(P<0.05)。治疗后,全程联合组菌斑指数(PLI)、龈沟出血指数(SBI)、牙周探诊深度(PD)、附着丧失量(AL)均低于单程联合组与基础治疗组,单程联合组PLI、SBI、PD、AL均低于基础治疗组,差异有统计学意义(P<0.05)。全程联合组总有效率高于单程联合组与基础治疗组,差异有统计学意义(P<0.05)。三组治疗期间均未发生严重不良反应。结论:全程牙周基础治疗联合抗生素用于慢性牙周炎合并T2DM患者效果显著,能够改善患者血糖代谢、炎症因子水平及牙周指数,且无严重不良反应。

Objective:To explore the effect of whole course periodontal basic treatment combined with antibiotics on patients with chronic periodontitis complicated with type 2 diabetes mellitus(T2DM).Method:A total of 82 patients with chronic periodontitis complicated with T2DM who received treatment at Yangjiang Yabo Dental Clinic from June 2021 to April 2023 were selected as the study objects.According to the random number table method,the patients were divided into whole course combination group(28 cases),one-way combination group(27 cases)and basic treatment group(27 cases).All three groups were given the T2DM treatment.The basic treatment group was given periodontal basic treatment,the one-way combination group was given periodontal basic treatment combined with antibiotics,and the whole course combination group was given whole course periodontal basic treatment combined with antibiotics.Blood glucose index,inflammatory factors,periodontal index before and after treatment and clinical efficacy of the three groups were compared.Result:After treatment,the levels of fasting plasma glucose(FPG),2 h postprandial blood glucose(2 h PG)and glycosylated hemoglobin(HbA1c)in the whole course combination group were lower than those in the one-way combination group and the basic treatment group,and the levels of FPG,2 h PG and HbA1c in the one-way combination group were lower than those in the basic treatment group,the differences were statistically significant(P<0.05).After treatment,the levels of C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in the whole course combination group were lower than those in the one-way combination group and the basic treatment group,and the levels of CRP,TNF-αand IL-6 in the one-way combination group were lower than those in the basic treatment group,the differences were statistically significant(P<0.05).After treatment,the plaque index(PLI),sulcus bleeding index(SBI),periodontal probing depth(PD)and attachment loss(AL)in the whole course combination group were lower than those in the one-way combination group and the basic treatment group,and the PLI,SBI,PD and AL in the one-way combination group were lower than those in the basic treatment group,the differences were statistically significant(P<0.05).The total effective rate of the whole course combination group was higher than that of the one-way combination group and the basic treatment group,and the difference was statistically significant(P<0.05).No serious adverse reactions occurred in the three groups during treatment.Conclusion:The whole course periodontal basic treatment combined with antibiotics is effective in the application of patients with chronic periodontitis complicated with T2DM.It can improve blood glucose metabolism,inflammatory factor levels,and periodontal index in patients without serious adverse reactions.