盐酸米诺环素结合超声龈下刮治术治疗老年牙周炎的临床分析  

Clinical analysis of minocycline hydrochloride combined with ultrasonic subgingival scaling in the treatment of periodontitis in elderly patients

作　　者：张菁[1] 王俊敏 马丽琼 李午丽[1] Zhang Jing;Wang Junmin;Ma Liqiong;Li Wuli(Department of Stomatology,Affiliated Stomatological Hospital of Anhui Medical University/Key Laboratory of Oral Disease Research of Anhui Province),Hefei,Anhui,230000,P.R.China)

机构地区：[1]安徽医科大学附属口腔医院口腔内科安徽省口腔疾病研究重点实验室,安徽合肥230000

出　　处：《老年医学与保健》2022年第5期1119-1125,共7页Geriatrics & Health Care

基　　金：安徽省自然科学基金面上项目(2008085MH255);2021安徽医科大学口腔医学院学科建设项目(2021kqxkFY09)。

摘　　要：目的 观察老年牙周炎患者使用盐酸米诺环素结合超声龈下刮治术方案的治疗效果。方法 回顾性分析2019年7月—2022年1月于安徽医科大学附属口腔医院收治的100例老年牙周炎患者的临床资料,根据患者不同治疗方式分为观察组(n=50)和对照组(n=50)。观察组行盐酸米诺环素结合超声龈下刮治术方案治疗,对照组行超声龈下刮治术治疗。观察并比较2组治疗前后牙周状况、牙菌斑生物膜活性、牙周菌落数、牙周炎症分子、疼痛程度、生活质量和临床疗效,并在治疗后进行6个月的随访,统计远期复发率,以综合分析盐酸米诺环素结合超声龈下刮治术方案治疗老年牙周炎的可行性。结果 治疗后观察组牙周状况指标值均低于对照组[PLI:1.37±0.28 vs 1.71±0.35、 PD:(3.21±0.51) mm vs(4.12±0.62) mm、 GBI:1.12±0.39 vs 1.48±0.38、 CAL:(2.34±0.26) mm vs(3.98±0.28) mm](t=5.364、 8.015、 4.675、 30.350,均P<0.05)。治疗后观察组牙菌斑生物膜活性和牙周菌落数均低于对照组[内层面牙菌斑生物膜活性:(10.57±2.24)%vs(25.27±2.97)%、中层面牙菌斑生物膜活性:(12.47±1.57)%vs(28.08±3.68)%、外层面牙菌斑生物膜活性:(9.05±1.08)%vs(29.18±5.51)%、 G+厌氧菌菌落数:(2.10±0.67) CFU vs(3.45±0.89) CFU、 G-厌氧菌菌落数:(2.31±0.38) CFU vs(3.14±0.86) CFU](t=27.940、 27.590、 23.250、 8.569、 6.242,均P<0.05)。治疗后观察组牙周局部炎症反应程度低于对照组[IL-17:(4.98±1.66) pg/mL vs(7.61±2.19) pg/mL、 TNF-α:(2.35±1.01) ng/mL vs(3.24±1.03) ng/mL、 CRP:(1.55±0.52) mg/L vs(2.42±0.93) mg/L、 IL-1β:(23.49±5.16)μg/L vs(34.57±5.72)μg/L、 MCP-1:(27.36±6.45) ng/L vs(37.52±6.84) ng/L](t=6.767、 4.363、 5.774、 10.170、 7.642,均P<0.05)。治疗后观察组疼痛程度低于对照组[VAS:(1.38±0.81)分vs(2.97±1.01)分、 SP:(1.13±0.14) pg/mL vs(2.52±0.31) pg/mL、 NPY:(124.16±19.14) pg/mL vs(154.31±21.05) pg/mL、 5-HT:(5.00±0.34) pg/mL vs(5.59±0.51Objective To explore the therapeutic effects of minocycline hydrochloride combined with ultrasonic subgingival scaling in the treatment of periodontitis in elderly patients.Methods The clinical data of 100 elderly patients with periodontitis admitted to Affiliated Stomatological Hospital of Anhui Medical University from July 2019 to January 2022 were retrospectively analyzed.They were divided into observation group(n=50) and control group(n=50) according to different treatment methods.The observation group was treated with minocycline hydrochloride combined with ultrasonic subgingival scaling,while the control group was treated with ultrasonic subgingival scaling.The periodontal status,plaque biofilm activity,periodontal colony count,periodontal inflammatory molecules,degree of pain and quality of life before and after treatment,as well as the clinical efficacy were observed and compared between the two groups.After 6 months of follow-up,the long-term recurrence rate was calculated so as to comprehensively analyze the feasibility of minocycline hydrochloride combined with ultrasonic subgingival scaling in the treatment of periodontitis in elderly patients.Results After treatment,the periodontal status indicators of the observation group were lower than those of the control group [PLI:1.37±0.28 vs 1.71±0.35,PD:3.21±0.51 mm vs 4.12±0.62 mm,GBI:1.12±0.39 vs 1.48±0.38,CAL:2.34±2.34±0.26 mm vs 3.98±0.28 mm](t=5.364,8.015,4.675,30.350,all P<0.05);the degree of periodontal local inflammatory reaction in the observation group was lower than that in the control group [IL-17:(4.98±1.66) pg/mL vs(7.61±2.19) pg/mL,TNF-α:(2.35±1.01) ng/mL vs(3.24±1.03) ng/mL,CRP:(1.55±0.52) mg/L vs(2.42±0.93) mg/L,IL-1β:(23.49±5.16) μg/L vs(34.57±5.72) μg/L,MCP-1:(27.36±6.45) ng/L vs(37.52±6.84) ng/L](t=6.767,4.363,5.774,10.170,7.642,all P<0.05);the pain degree of the observation group were lower than those of the control group [VAS:1.38±0.81 points vs 2.97±1.01 points,SP:1.13±0.14 pg/mL vs 2.52±0.31 pg/mL,NPY:124.1

关 键 词：老年 牙周炎 盐酸米诺环素 超声龈下刮治术 疼痛 复发 

分 类 号：R781.42[医药卫生—口腔医学]