克林霉素联合碘甘油对慢性牙周炎β-catenin、IL-35和IL-37表达水平的影响研究

Effect of clindamycin combined with iodoglycerol on the expression levels ofβ-catenin,IL-35 and IL-37 in chronic periodontitis

目的探讨克林霉素联合碘甘油对慢性牙周炎β-连环蛋白(β-catenin)、白细胞介素(IL)-35和IL-37表达水平的影响。方法前瞻性选取2021年1月至2022年12月华中科技大学同济医学院附属梨园医院收治的110例慢性牙周炎患者为研究对象,采用随机数字表法分为对照组(n=55)和观察组(n=55),对照组采用碘甘油治疗,观察组采用克林霉素+碘甘油治疗。比较两组的临床疗效、牙周健康[出血指数、探诊出血、牙周袋深度、附着水平]、症状及致病菌好转情况、血清指标[β-catenin、IL-35、IL-37]及不良反应情况。结果治疗7 d后,观察组临床总有效率为98.18%,高于对照组(83.64%),差异有统计学意义(P<0.05)。治疗后,两组的出血指数、探诊出血、牙周袋深度、附着水平、厌氧菌数、β-catenin水平、IL-35水平较治疗前均显著下降,IL-37水平较治疗前上升,且观察组治疗后的出血指数、探诊出血、牙周袋深度、附着水平、厌氧菌数、β-catenin水平、IL-35水平分别为(0.66±0.39)分、(1.31±0.28)个、(2.94±0.31)mm、(3.77±0.41)mm、(4.11±0.41)lg(CFU/mL)、(1.68±0.32)g/L、(122.85±13.14)ng/L,均明显低于对照组[(1.29±0.47)分、(2.11±0.47)个、(4.11±0.12)mm、(4.35±0.53)mm、(5.05±0.63)lg(CFU/mL)、(2.27±0.61)g/L、(161.02±15.64)ng/L],IL-37水平为(131.25±18.01)ng/L,高于对照组[(124.21±17.92)ng/L],差异均有统计学意义(P<0.05)。观察组治疗后所需牙齿松动、咀嚼疼痛、牙龈水肿、口腔异味好转时间分别为(9.78±1.01)、(9.34±0.97)、(10.31±1.25)、(8.49±0.95)d,均短于对照组[(12.48±2.13)、(11.62±1.89)、(13.39±2.26)、(10.84±1.24)d],差异均有统计学意义(P<0.05)。治疗7 d内,观察组与对照组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论在慢性牙周炎的临床治疗中,采用克林霉素联合碘甘油治疗方式,能提升临床治疗效果,促进牙龈肿痛、出血等症状的恢复,抑制杀灭厌氧菌,减轻炎症反应,促进口腔健康的恢复,且有一定用药安全性,值得推广应用。

Objective To investigate the effects of clindamycin combined with iodoglycerol on the expression levels ofβ-catenin,interleukin(IL)-35 and IL-37 in chronic periodontitis.Methods A total of 110 patients with chronic periodontitis admitted to Liyuan Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2021 to December 2022 were prospectively selected as the study objects,and were divided into the control group(n=55)and the observation group(n=55)by the random number table method.The control group was treated with iodoglycerin,and the observation group was treated with clindamycin+iodoglycerin.The clinical efficacy,periodontal health[bleeding index,probing bleeding,periodontal pocket depth,adhesion level],symptoms and improvement of pathogenic bacteria,serum indexes(β-catenin,IL-35,IL-37)and adverse reactions of the two groups were compared.Results After 7 days of treatment,the total clinical effective rate of the observation group was 98.18%,which was higher than that of the control group(83.64%),the difference was statistically significant(P<0.05).After treatment,the bleeding index,probing bleeding,periodontal pocket depth,attachment level,anaerobic bacteria count,β-catenin level and IL-35 level in two groups were significantly lower than those before treatment,while IL-37 levels were higher than those before treatment,and the bleeding index,probing bleeding,periodontal pocket depth,attachment level,anaerobic bacteria count,β-catenin level and IL-35 level in observation group were(0.66±0.39)points,(1.31±0.28)points,(2.94±0.31)mm,(3.77±0.41)mm,(4.11±0.41)lg(CFU/mL),(1.68±0.32)g/L,and(122.85±13.14)ng/L,respectively,which were significantly lower than those in the control group[(1.29±0.47)points,(2.11±0.47)points,(4.11±0.12)mm,(4.35±0.53)mm,(5.05±0.63)lg(CFU/mL),(2.27±0.61)g/L.(161.02±15.64)ng/L],the level of IL-37 was(131.25±18.01)ng/L,which was higher than that in the control group[(124.21±17.92)ng/L],the differences were statistically significant(P<0.05).The improvement time of tooth loosening,chewing pain,gingival edema and bad breath in the observation group after treatment were(9.78±1.01),(9.34±0.97),(10.31±1.25),and(8.49±0.95)days,respectively,which were shorter than those in the control group[(12.48±2.13),(11.62±1.89),(13.39±2.26),and(10.84±1.24)days],the differences were statistically significant(P<0.05).Within 7 days of treatment,there was no statistically significant difference in the total incidence of adverse reactions between the observation group and the control group(P>0.05).Conclusion In the clinical treatment of chronic periodontitis,clindamycin combined with iodoglycerin can improve the clinical treatment effect,promote the recovery of symptoms such as gum swelling,pain and bleeding,inhibit and kill anaerobic bacteria,reduce inflammatory response,and promote the recovery of oral health,and has certain drug safety,worthy of promotion and application.