牙周非手术治疗对2型糖尿病伴慢性牙周炎患者血糖代谢水平的影响  

Effect of Non-surgical Therapy on Control of Metabolic Level in Type 2 Diabetes Mellitus with Chronic Periodontitis

作　　者：李婧[1] 陈蕾[1] 刘芳[1] 章锦才[1] 

机构地区：[1]广东省口腔医院.南方医科大学附属口腔医院牙周科,广东广州510280

出　　处：《广东牙病防治》2011年第6期305-308,共4页Journal of Dental Prevention and Treatment

基　　金：广东省科技计划项目(2010B031600117)

摘　　要：目的探讨牙周非手术治疗对2型糖尿病伴慢性牙周炎患者牙周状况和血糖代谢水平的影响。方法 2型糖尿病伴慢性牙周炎患者135例,糖化血红蛋白(glycosylated hemoglobin,HbA1c)平均值(7.33±1.42)%,随机分为治疗组和对照组。治疗组接受牙周非手术治疗,对照组暂不接受治疗,只接受口腔卫生宣教。观察2组干预前及干预后3个月、干预后6个月的牙周临床指标,包括探诊深度(probing depth,PD)、菌斑指数(plaque index,PLI)、探诊出血(bleeding on probing,BOP)和血糖代谢指标,包括空腹血糖(fasting plasma glucose,FPG)、HbA1c的变化情况。结果同治疗前相比,治疗组全口平均PD(F=89.956,P=0.000)、PLI(F=82.399,P=0.000)、BOP(F=169.535,P=0.000)随时间推移下降,差异有统计学意义。对照组全口平均PD随时间推移差异无统计学意义(F=3.002,P=0.076);PLI(F=11.443,P=0.001)、BOP(F=6.537,P=0.008)下降有统计学意义。干预后6个月,组间比较PD(t=-3.318,P=0.001)、PLI(t=-4.354,P=0.000)、BOP(t=-5.868,P=0.000)差异有统计学意义。治疗组FPG(F=4.325,P=0.015)和HbA1c(F=6.654,P=0.003)随时间推移下降,差异有统计学意义;对照组FPG(F=0.215,P=0.756)和HbA1c(F=1.767,P=0.184)随时间推移变化无统计学意义;干预后6个月,两组间FPG(t=-1.386,P=0.171)和HbA1c(t=-1.065,P=0.289)差异无统计学意义。结论牙周非手术治疗能有效控制2型糖尿病伴牙周炎患者的牙周炎症;尚不能认为牙周非手术治疗可以改善糖尿病患者的血糖代谢。Objective To investigate the effect of non-surgical therapy on periodontitis control and metabolic level in type 2 diabetes mellitus with chronic periodontitis.Methods One hundred and fifty-four type 2 diabetes mellitus（DM） patients with chronic periodontitis were randomly assigned into two groups.Clinical index including probing depth（PD）,plaque index（PLI）,bleeding on probing（BOP） and metabolic level including fasting plasma glucose（FPG） and glycosylated hemoglobin（HbA1c） were examined in both groups before and after periodontal therapy.Results Periodontal treatment significantly improved periodontal status of the treatment group.In the control group,no significant change was observed in PD,except for significant reduction in PLI,BOP.After 6-month,the levels of metabolic of two groups were lower than before,but the difference between groups did not reach significance.Conclusion The periodontal therapy was helpful in improving periodontal status,but the evidence is not enough to support non-surgical periodontal treatment can improve glycemic control in patients with type 2 diabetes.

关 键 词：2型糖尿病伴慢性牙周炎 牙周非手术治疗 牙周指数 糖化血红蛋白 

分 类 号：R781.4[医药卫生—口腔医学]