盐酸米诺环素软膏联合光动力抗菌疗法治疗慢性重度牙周炎的疗效及对龈沟液炎性因子、MMPs/TIMPs水平的影响  

Effect of minocycline hydrochloride ointment combined with photodynamic antibacterial therapy in the treatment of severe chronic periodontitis and its influence on the levels of inflammatory factors and MMPs/TIMPs in gingival crevicular fluid

作　　者：姚丽慧 李轩 栾岁端 孙晓燕 YAO Li-hui;LI Xuan;LUAN Sui-duan;SUN Xiao-yan(Center of Stomatology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA)

机构地区：[1]郑州大学第一附属医院口腔医学中心,河南郑州450000

出　　处：《海南医学》2024年第23期3400-3405,共6页Hainan Medical Journal

基　　金：2022年度河南省医学科技攻关计划软科学项目及联合共建项目(编号:LHGJ20220361)。

摘　　要：目的观察盐酸米诺环素与光动力疗法联合治疗慢性重度牙周炎的疗效,并探讨其对患者炎性因子和基质金属蛋白酶/组织金属蛋白酶抑制剂(MMPs/TIMPs)水平的影响。方法选取2022年9月至2024年1月郑州大学第一附属医院口腔医学中心收治的102例慢性重度牙周炎患者纳入研究,按随机数表法分为研究组和对照组各51例。两组患者均给予常规治疗,在此基础上,对照组患者采用光动力抗菌疗法,研究组患者采用盐酸米诺环素软膏联合光动力抗菌疗法。治疗8周后,比较两组患者的治疗效果,治疗前后牙周致病菌检出率、牙周袋深度(PD)、C反应蛋白(CRP)、附着水平(AL)、白细胞介素-8(IL-8)、龈沟出血指数(SBI)、基质金属蛋白酶(MMP-2)、菌斑指数(PLI)、肿瘤坏死因子-α(TNF-α)、转化生长因子β1(TGF-β1)、基质金属蛋白酶(MMP)-13、MMP-8、基质金属蛋白酶抑制剂-1(TIMP-1)水平,同时比较两组治疗期间的不良反应发生情况。结果研究组患者的治疗总有效率为94.12%,明显高于对照组的80.39%,差异有统计学意义(P<0.05);治疗后研究组患者的牙龈卟啉单胞菌、齿垢密螺旋体、福赛坦氏菌检出率分别为13.73%、9.80%、11.76%,明显低于对照组的31.37%、25.49%、27.45%,差异均有统计学意义(P<0.05);治疗后研究组患者的PD、SBI、AL、PLI水平分别为(2.36±0.43)mm、1.48±0.29、(2.21±0.60)mm、0.95±0.25,明显低于对照组的(3.01±0.57)mm、1.96±0.35、(2.84±0.66)mm、1.38±0.31,差异均有统计学意义(P<0.05);治疗后研究组患者的龈沟液CRP、TGF-β1、TNF-α、IL-8水平分别为(4.12±1.13)mg/L、(12.18±2.24)pg/mL、(11.80±2.09)pg/mL、(7.51±1.64)ng/L,明显低于对照组的(6.26±1.55)mg/L、(15.83±3.05)pg/mL、(15.49±3.15)pg/mL、(9.26±1.91)ng/L,差异均有统计学意义(P<0.05);治疗后研究组患者的龈沟液MMP-2、MMP-8、MMP-13、TIMP-1水平分别为(115.29±16.82)ng/mL、(100.35±10.31)ng/mL、(70.15±8.55)ng/mL�Objective To observe the efficacy of minocycline hydrochloride ointment combined with photody-namic antibacterial therapy in the treatment of severe chronic periodontitis,and to explore its effect on the levels of in-flammatory factors and matrix metalloproteinases/tissue inhibitor of metalloproteinases(MMPs/TIMPs)in gingival cre-vicular fluid.Methods A total of 102 patients with severe chronic periodontitis admitted to Center of Stomatology,the First Affiliated Hospital of Zhengzhou University from September 2022 to January 2024 were selected and randomly di-vided into a study group and a control group,with 51 patients in each group.Both groups of patients were given conven-tional treatment.On this basis,patients in the control group received photodynamic antibacterial therapy,while those in the study group received minocycline hydrochloride ointment combined with photodynamic antibacterial therapy.After 8 weeks of treatment,the therapeutic effects between the two groups of patients were compared,as well as the detection rate of periodontal pathogens,periodontal pocket depth(PD),C-reactive protein(CRP),attachment level(AL),interleu-kin-8(IL-8),sulcus bleeding index(SBI),matrix metalloproteinase 2(MMP-2),plaque index(PLI),tumor necrosis fac-tor-α(TNF-α),transforming growth factorβ1(TGF-β1),MMP-13,MMP-8,and matrix metalloproteinase inhibitor-1(TIMP-1)levels before and after treatment.At the same time,the incidence of adverse reactions during treatment was al-so compared between the two groups.Results The total effective rate of treatment in the study group was 94.12%,which was significantly higher than 80.39%in the control group(P<0.05).After treatment,the detection rates of Porphy-romonas gingivalis,Treponema denticola,and Fusobacterium nucleatum in the study group were 13.73%,9.80%,and 11.76%,respectively,which were significantly lower than 31.37%,25.49%,and 27.45%in the control group(P<0.05).Af-ter treatment,the levels of PD,SBI,AL,and PLI in the study group were(2.36±0.43)mm,1.48±0.29,(2.21±0.60)mm,and

关 键 词：慢性牙周炎 盐酸米诺环素软膏 光动力 疗效 致病菌 炎性因子 

分 类 号：R781.42[医药卫生—口腔医学]