盐酸米诺环素软膏对轻中度慢性牙周炎正畸患者的疗效及安全性的影响  

Effect of minocycline hydrochloride ointment on the efficacy and safety of orthodontic patients with mild to moderate chronic periodontitis

作　　者：蔡齐 任昊天 王彦蒽 蔚一博 徐晓刚 Cai Qi;Ren Haotian;Wang Yanen(Department of Stomatology,the First Affiliated Hospital of Naval Medical University,Shanghai 200433,China)

机构地区：[1]海军军医大学第一附属医院口腔科,上海200433

出　　处：《中华保健医学杂志》2024年第4期495-498,共4页Chinese Journal of Health Care and Medicine

基　　金：国家自然科学基金(81800988)。

摘　　要：目的 探究轻中度慢性牙周炎正畸患者应用盐酸米诺环素软膏治疗的临床疗效。方法 选取2020年1月~2023年4月海军军医大学第一附属医院收治的70例轻中度慢性牙周炎正畸患者,根据随机数表法分为对照组(牙周基础治疗+西帕依固龈液含漱,n=35)和观察组(牙周基础+盐酸米诺环素软膏,n=35)。连续6个月随访观察,对比两组临床疗效、首次疗程后两组患者牙周指标[龈沟出血指数(SBI)、牙周探针深度(PD)、临床附着丧失(CAL)、龈沟液量(GCF)]、牙周致病菌[福塞斯坦纳菌(Tf)、中间普氏菌(Pi)、卟啉单胞菌(Pg)、齿垢密螺旋体(Td)]及血清炎性因子[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、γ-干扰素(IFN-γ)、白细胞介素-6(IL-6)]表达水平的变化,统计两组用药期间不良反应发生情况。结果 观察组总有效率为85.71%、临床治愈率为60.00%,对照组分别为71.43%、40.00%,观察组临床疗效较对照组良好,差异有统计学意义(Z=-2.065,P<0.05)。治疗后,观察组的牙周指标(SBI、PD、CAL、GCF)水平低于对照组[(2.02±0.29)分vs.(2.36±0.34)分、(4.09±0.42)mm vs.(4.39±0.46)mm、(2.11±0.31)mm vs.(2.65±0.42)mm、(1.18±0.32)μl vs.(1.47±0.45)μl],差异有统计学意义(t=4.501、2.849、6.120、3.107,P<0.05)。观察组血清炎性因子(CRP、TNF-α、IFN-γ、IL-6)水平低于对照组[(1.76±0.77)mg/L vs.(2.88±0.83)mg/L、(2.79±0.73)pg/ml vs.(4.14±0.97)pg/ml、(1.27±0.29)ng/L vs.(1.97±0.36)ng/L、(1.75±0.15)ng/L vs.(2.14±0.27)ng/L],差异有统计学意义(t=5.853、6.579、8.958、7.470,P<0.05)。观察组牙周致病菌(Tf、Pi、Pg、Td)水平低于对照组[(2.24±0.26)CFU/ml vs.(2.73±0.32)CFU/ml、(2.93±0.31)CFU/ml vs.(3.39±0.38)CFU/ml、(3.85±0.41)CFU/ml vs.(4.32±0.47)CFU/ml、(2.38±0.28)CFU/ml vs.(2.74±0.31)CFU/ml],差异有统计学意义(t=7.031、5.549、4.458、5.098,P<0.05)。观察组不良反应总发生率为5.71%,对照组为17.14%,差异无统计学意义(χ^(2)=2.258,P> 0.05)Objective This study aimed to investigate the clinical effect of minocycline hydrochloride ointment on patients with mild to moderate chronic periodontitis.Methods A total of 70 orthodontic patients with mild to moderate chronic periodontitis admitted to our hospital from January 2020 to April 2023 were randomly divided into two groups:the control group(periodontal basic treatment+Xipayi mouth rinse,n=35)and the observation group(periodontal basic treatment+minocycline hydrochloride cream,n=35).The clinical efficacy,periodontal indexes,periodontal pathogens,and expression levels of serum inflammatory factors were compared between the two groups after the first course of treatment.Additionally,the occurrence of adverse reactions during the treatment was analyzed.Results The total effective rate and clinical cure rate in the observation group were 85.71%and 60.00%,while the control group was 71.43%and 40.00%,respectively.The clinical curative effect of the observation group was superior to that of control group(Z=-2.065,P<0.05).After treatment,the levels of SBI,PD,Cal and GCF in the observation group were lower than those in the control group,the difference was significant(t=4.501,2.849,6.120,3.107,P<0.05).The levels of serum inflammatory factors(CRP,TNF-α,IFN-γ,IL-6)in the observation group were lower than those in the control group,the difference was significant(t=5.853,6.579,8.958,7.470,P<0.05).The levels of periodontal pathogens(TF,PI,PG,TD)in the observation group were lower than those in the control group,the difference was statistically significant(t=7.031,5.549,4.458,5.098,P<0.05).The total incidence of adverse reactions was 5.71%in the observation group and 17.14%in the control group,with no significant difference(χ^(2)=2.258,P>0.05).Conclusion The use of minocycline hydrochloride ointment in orthodontic treatment for mild to moderate chronic periodontitis can improve periodontal condition and reduce inflammatory factors and periodontal pathogens,thus demonstrating significant clinical effectiveness.

关 键 词：慢性牙周炎 正畸 盐酸米诺环素软膏 西帕依固龈液 

分 类 号：R781[医药卫生—口腔医学]