米诺环素联合甲硝唑治疗广泛型侵袭性牙周炎的临床研究

Clinical trial of minocycline combined with metronidazole in treatment of generalized aggressive periodontitis

目的观察米诺环素联合甲硝唑治疗广泛型侵袭性牙周炎(GAgP)的临床疗效与安全性。方法将82例GAgP患者随机分为对照组和试验组,每组41例。对照组口服甲硝唑片0. 6 g,qd,持续治疗7 d;牙周袋内注入甲硝唑凝胶10mg,每周1次,持续治疗4周。试验组在对照组的基础上,于牙周袋内注入盐酸米诺环素软膏0. 5 g,每周1次,持续治疗4周。比较2组临床疗效,牙周状态,基质金属蛋白酶(MMP)-1,MMP-8,白细胞介素(IL)-17水平,及药物不良反应发生情况。结果治疗后,试验组和对照组总有效率分别为90. 24%(37例/41例)和70. 73%(29例/41例),差异有统计学意义(P <0. 05)。治疗后,试验组和对照组附着丧失(AL)分别为(2. 63±0. 49)和(3. 22±0. 52) mm;牙周袋深度(PD)分别为(2. 93±0. 47)和(3. 95±0. 71) mm;出血指数(BI)分别为(1. 02±0. 16)和(2. 02±0. 16)分;菌斑指数(PLI)分别为(1. 05±0. 22)和(1. 15±0. 36)分; MMP-1分别为(1466. 16±185. 13)和(1767. 40±233. 57)ng·L^(-1); MMP-8分别为(1334. 23±173. 38)和(1726. 00±168. 84) ng·L^(-1);IL-17分别为(6. 04±0. 65)和(9. 01±1. 29) pg·μL^(-1),差异均有统计学意义(均P <0. 05)。2组均出现消化道反应、神经系统症状、皮疹,试验组和对照组药物不良反应发生率分别为17. 07%(7例/41例)和12. 19%(5例/41例),差异无统计学意义(P> 0. 05)。结论米诺环素联合甲硝唑治疗GAgP的临床疗效优于甲硝唑单用,临床效果显著。

Objective To analyze the clinical efficacy and safety of minocycline combined with metronidazole in the treatment of extensive aggressive periodontitis.Methods A total of 82 generalized aggressive periodontitis(GAgP)patients were randomly assigned in control group(41 patients)and treatment group(41 patients).Control group received oral metronidazole tablet(0.6 g)once daily for 7 days and injected with metronidazole gel(10 mg)metronidazole in the periodontal pocket once a week for 4 weeks.Treatment group were injected with 0.5 g of minocycline ointment in the periodontal pouch,once a week for 4 weeks,on the basis of control group.The clinical efficacy,periodontal states,matrix metalloproteinase(MMP)-1,MMP-8,interleukin-17(IL-17)and adverse reactions in both group were compared.Results After treatment,the total effective rates of the treatment group and the control group were 90.24%(37 cases/41 cases)and 70.73%(29 cases/41 cases),the difference was statistically significant(P<0.05).After treatment,there were significant differences between the treatment group and the control group in the attachment loss(AL)[(2.63±0.49)mm vs(3.22±0.52)mm],the periodontal pocket depth(PD)[(2.93±0.47)mm vs(3.95±0.71)mm],the bleeding index(BI)[(1.02±0.16)vs(2.02±0.16)],the plaque index(PLI)[(1.05±0.22)vs(1.15±0.36)],MMP-1[(1466.16±185.13)ng·L-1 vs(1767.40±233.57)ng·L-1],MMP-8[(1334.23±173.38)ng·L-1 vs(1726.00±168.84)ng·L-1],IL-17[(6.04±0.65)pg·L-1 vs(9.01±1.29)pg·μL-1](P<0.05).Both treatment group and control group had digestive tract reactions,neurological symptoms and rash,and the adverse drug reaction rates were 17.07%(7 cases/41 cases)and 12.19%(5 cases/41 cases),respectively(P>0.05).Conclusion The clinical efficacy of minocycline combined with metronidazole in the treatment of GAgP is superior to metronidazole alone.The clinical effect is significant and the safety is better.