光动力疗法联合牙周基础疗法治疗老年糖尿病慢性牙周炎患者的效果观察  

Observation on the effect of photodynamic therapy combined with periodontal basic treatment on elderly patients with diabetic chronic periodontitis

作　　者：李娜 周晌辉 黄忠亮 陈明华 刘海珍 LI Na;ZHOU Shang-hui;HUANG Zhong-liang(Stomatological Center,Hainan West Central Hospital,Danzhou Hainan 571700,China)

机构地区：[1]海南西部中心医院口腔医学中心,海南儋州571700

出　　处：《临床和实验医学杂志》2025年第5期502-507,共6页Journal of Clinical and Experimental Medicine

基　　金：海南省自然科学基金项目(编号:823MS158);儋州市科技和工业信息发展局项目(编号:儋科工信〔2024〕72号)。

摘　　要：目的探究光动力疗法(PDT)与牙周基础疗法联合应用治疗老年患者糖尿病慢性牙周炎的效果。方法前瞻性纳入2021年8月至2024年1月海南西部中心医院收治的98例老年糖尿病慢性牙周炎患者为研究对象,按照随机数字表法将其分为对照组(n=49)和研究组(n=49)。对照组行牙周基础疗法治疗,研究组行PDT联合牙周基础疗法治疗。记录两组患者治疗前、治疗12周后的临床症状(口腔异味、牙周袋形成、疼痛及牙龈出血或溢脓)改善情况,比较两组患者治疗前及治疗12周后的牙周状况[龈沟出血指数(SBI)、临床附着丧失(CAL)、牙周探诊深度(PD)]、菌群(乳酸菌、梭杆菌、拟杆菌)数量、牙周致病菌[牙龈卟啉单胞菌(P.g)、伴放线共生杆菌(A.a)、福赛斯坦纳菌(T.f)]菌量、菌斑活性[螺旋体占比、胰蛋白酶样酶(TLE)活性]、龈沟液[可溶性CD40配体(sCD40L)、可溶性CXC趋化因子配体16(sCXCL-16)]水平变化情况。结果治疗12周后,两组间各项临床症状评分均较治疗前降低,且研究组患者的各项临床症状均低于对照组,差异均有统计学意义(P<0.05)。治疗12周后,两组SBI、CAL、PD均较治疗前降低,且研究组SBI、CAL、PD均低于对照组,差异均有统计学意义(P<0.05)。治疗12周后,两组患者的龈下乳酸菌、梭杆菌、拟杆菌数量均较治疗前降低,且研究组龈下乳酸菌、梭杆菌、拟杆菌数量均低于对照组,差异均有统计学意义(P<0.05)。治疗12周后,两组P.g、A.a、T.f菌量均较治疗前降低,且研究组P.g、A.a、T.f菌量均低于对照组,差异均有统计学意义(P<0.05)。治疗12周后,两组患者的菌斑活性螺旋体占比、TLE活性均较治疗前降低,且研究组菌斑活性螺旋体占比、TLE活性均低于对照组,差异均有统计学意义(P<0.05)。治疗12周后,两组患者的龈沟液sCD40L及sCXCL-16水平均较治疗前降低,且研究组的龈沟液sCD40L及sCXCL-16水平均低于对照组,差异均�Objective To explore the effect of photodynamic therapy(PDT)combined with periodontal basic therapy in the treatment of elderly patients with diabetic chronic periodontitis.Methods A total of 98 elderly patients with diabetic chronic periodontitis admitted to Hainan West Central Hospital from August 2021 to January 2024 were enrolled prospectively.They were divided into the control group(n=49)and the study group(n=49)according to the random number table method.The control group received basic periodontal treatment,and the study group received PDT combined with periodontal basic treatment.The improvement of clinical symptoms(oral odor,periodontal pocket formation,pain and gingival bleeding or pus overflow)in the two groups was recorded and compared before and after 12 weeks of treatment.The periodontal status[sulcus bleeding index(SBI),clinical attachment loss(CAL),periodontal probing depth(PD)],the number of flora(lactic acid bacteria,Fusobacterium,Bacteroides),periodontal pathogens[Porphyromonas gingivalis(P.g),Actinobacillus actinomycetemcomitans(A.a),Tannerella forsythia(T.f)],plaque activity[proportion of spirochete,trypsin-like enzyme(TLE)activity],gingival crevicular fluid[soluble CD40 ligand(sCD40L),soluble CXC chemokine ligand 16(sCXCL-16)]were compared between the two groups before and after 12 weeks of treatment.Results After 12 weeks of treatment,the clinical symptom scores of the two groups were lower than those before treatment,and the clinical symptoms of the study group were lower than those of the control group,the differences were statistically significant(P<0.05).After 12 weeks of treatment,the SBI,CAL and PD of the two groups were lower than those before treatment,and the SBI,CAL and PD of the study group were lower than those of the control group,the differences were statistically significant(P<0.05).After 12 weeks of treatment,the levels of subgingival lactic acid bacteria,fusobacterium and bacteroides in the two groups were lower than those before treatment,and the levels of subgingival lact

关 键 词：光动力疗法 牙周基础疗法 老年人 糖尿病 慢性牙周炎 龈下菌群 可溶性CD40配体 可溶性CXC趋化因子配体16 

分 类 号：R781.4[医药卫生—口腔医学]