摘要
目的 探讨复方甘菊利多卡因凝胶联合替硝唑局部用药对慢性牙周炎的应用效果及安全性.方法 前瞻性选取2021年1月至2024年1月延安大学附属医院收治的90例慢性牙周炎患者,依据随机数字表法将患者分为试验1组、试验2组与对照组,每组各30例.所有患者均保持口腔清洁,口腔洁治,刮治治疗或翻瓣治疗等牙周治疗,对照组口服替硝唑,试验1组在常规治疗基础上增加替硝唑局部用药,试验2组在常规治疗基础上增加复方甘菊利多卡因凝胶联合替硝唑局部用药,均治疗1周.比较3组临床疗效,治疗前、治疗1周后龈沟液炎症因子[白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、转化生长因子β(TGF-β)],牙周健康指标[菌斑指数(PLI),出血指数(BI)、探诊深度(PD)、临床附着丧失(CAL)],口气感官值(OS)、口腔挥发硫化物(VSCs)水平变化,并比较3组患者不良反应发生率.结果 试验2组治疗总有效率为96.67％,明显高于试验1组(80.00％)和对照组(53.33％),差异有统计学意义(P＜0.05).治疗1周后,3组患者IL-1β、IL-6水平均较治疗前降低,TGF-β水平较治疗前升高,且试验2组的IL-1β、IL-6 水平分别为(21.36±4.12)μg/L、(10.04±2.31)ng/mL,均低于试验 1 组[(26.40±5.12)μg/L、(13.23±3.38)ng/mL]与对照组[(31.49±3.19)μg/L、(16.57±2.23)ng/mL],试验 2 组 TGF-β 水平为(73.19±6.24)μg/mL,均高于试验1组[(63.48±5.17)μg/mL]与对照组[(57.07±8.68)μg/mL],差异均有统计学意义(P＜0.05).治疗1周后,3组患者CAL、PD、BI、PLI水平均较治疗前降低,且试验2组的CAL、PD、BI、PLI水平分别为(3.06±0.52)mm、(2.84±0.31)mm、1.01±0.24、0.82±0.24,均低于试验 1 组[(3.52±0.42)mm、(3.49±0.38)mm、1.28±0.17、1.16±0.24]与对照组[(4.18±1.29)mm、(4.31±1.43)mm、1.35±0.28、1.57±0.18],差异均有统计学意义(P＜0.05).治疗1周后,3组患者OS、VSCs水平均较治疗前降低,且试验2组OS、VSCs水平分别为1.38±0.12、(532.89±89.24)×10-9,低于试验 1 组[1.96±0.15、(604.32±87.44)×10-9]与对照组[2.19±0.21、(658.31±65.37)×10-9],差异均有统计学意义(P＜0.05).试验1组与试验2组全身不良反应发生率均为0,低于对照组(26.67％),差异有统计学意义(P＜0.05);3组患者局部不良反应发生率比较,差异无统计学意义(P＞0.05).结论 复方甘菊利多卡因凝胶联合替硝唑局部用药可改善慢性牙周炎临床疗效,提升牙周健康水平,降低牙龈炎症反应,改善口气情况,安全性较高.
Abstract
Objective To investigate the efficacy and safety of compound chamomile lidocaine gel combined with tinidazole in the treat-ment of chronic periodontitis.Methods Prospective selection of 90 patients with chronic periodontitis admitted to Yan'an University Affiliated Hospital from January 2021 to January 2024.According to the random number table method,the patients were divided into the experimental group 1,the experimental group 2,and the control group,with 30 cases in each group.All patients were treated with periodontal therapy such as oral cleaning,oral scaling,scraping or flap turning.The control group took tinidazole orally,the test group 1 added tinidazole local medication on the basis of conventional treatment,and the test group 2 added compound chamomile lidocaine gel combined with tinidazole local medication on the ba-sis of conventional treatment,all of which were treated for one week.The clinical efficacy of three groups,including changes in inflammatory fac-tors[interleukin(IL)-1 β,IL-6,and transforming growth factor β(TGF-β)]in gingival crevicular fluid,periodontal health indicators[plaque index(PLI),bleeding index(BI),depth of exploration(PD),and clinical attachment loss(CAL)],breath sensory values(OS),and levels of volatile sulfides(VSCs)in the oral cavity before and after 1 week of treatment were compared.Finally,the incidence of adverse reactions in the three groups of patients was compared.Results The total effective rate of treatment in the experimental group 2 was 96.67％,which was significantly higher than that in the experimental group 1(80.00％)and the control group(53.33％),and the difference was statistically signifi-cant(P＜0.05).After 1 week of treatment,the levels of IL-1 β and IL-6 in the three groups were lower than those before treatment,and the levels of TGF-β were higher than those before treatment.The levels of IL-1β and IL-6 in the experimental group 2 were(21.36±4.12)μg/L and(10.04±2.31)ng/mL,respectively,which were lower than those in the experimental group 1[(26.40±5.12)μg/L,(13.23±3.38)ng/mL]and the control group[(31.49±3.19)μg/L,(16.57±2.23)ng/mL].The level of TGF-β in the experimental group 2 was(73.19±6.24)μg/mL,which was higher than that in the experimental group 1[(63.48±5.17)μg/mL]and the control group[(57.07±8.68)μg/mL],and the differences were statistically significant(P＜0.05).After 1 week of treatment,the levels of CAL,PD,BI and PLI in the three groups were lower than those before treatment,and the levels of CAL,PD,BI and PLI in the experimental group 2 were(3.06±0.52)mm,(2.84±0.31)mm,1.01±0.24 and 0.82±0.24,respectively.They were lower than those in the experimental group 1[(3.52±0.42)mm,(3.49±0.38)mm,1.28±0.17,1.16±0.24]and the control group[(4.18±1.29)mm,(4.31±1.43)mm,1.35±0.28,1.57±0.18],and the differences were statistically significant(P＜0.05).After 1 week of treatment,the levels of OS and VSCs in the three groups were lower than those before treatment,and the levels of OS and VSCs in the experimental group 2 were 1.38±0.12 and(532.89±89.24)x 10-9,respectively,which were lower than those in the experimental group 1[1.96±0.15,(604.32±87.44)× 10-9]and the control group[2.19±0.21,(658.31±65.37)x 10-9],and the differences were statistically significant(P＜0.05).The incidence of systemic adverse re-actions in the experimental group 1 and the experimental group 2 was 0,which was lower than that in the control group(26.67％),and the differ-ence was statistically significant(P＜0.05).There was no statistically significant difference in the incidence of local adverse reactions among the three groups of patients(P＞0.05).Conclusion The combination of compound chamomile lidocaine gel and tinidazole can improve the clinical efficacy of chronic periodontitis,improve periodontal health,reduce gingival inflammatory reaction,improve breath conditions,and have high safety.
基金项目
陕西省科技厅社会发展领域项目(2021SF-082)
维普
万方数据