摘要
目的:探讨酪酸梭菌肠球菌三联活菌片联合新癀片对牙周病患者牙龈组织内炎症反应和骨密度的影响。方法:选取2021年1月至2022年1月该院收治的慢性牙周病患者219例进行前瞻性盲法研究,根据就诊序号以随机数字表法分为A、B和C组,各73例。所有患者均给予基础治疗+盐酸米诺环素软膏+抗菌药物治疗,在此基础上,A组患者加用酪酸梭菌肠球菌三联活菌片治疗1个月,B组患者加用新癀片治疗5 d,C组患者加用新癀片治疗5 d+酪酸梭菌肠球菌三联活菌片治疗1个月。对比三组患者的疗效、不同时间牙周指数指标[出血指数(BI)、探诊深度(PD)和附着丧失(AL)]、组织炎症因子(CD3^(+)T细胞、CD4^(+)T细胞和CD68+巨噬细胞)、牙槽骨骨密度及唾液菌群[梭杆菌(Fn)、牙龈卟啉单胞菌(Pg)、中间普氏菌(Pi)和伴放线放线杆菌(Aa)]。结果:C组患者的总有效率为97.26%(71/73),高于A组(78.08%,57/73)、B组(86.30%,63/73),差异有统计学意义(P<0.05);A、B组的差异无统计学意义(P>0.05)。治疗5 d后和治疗1个月后,C组患者的BI、PD和AL,CD4^(+)T细胞、CD3^(+)T细胞和CD68+巨噬细胞水平及各唾液菌群检出率均低于A、B组,牙槽骨骨密度高于A、B组,复发率低于B组,差异均有统计学意义(P<0.05)。治疗5 d后,B组患者的BI、PD和AL,CD4^(+)T细胞、CD3^(+)T细胞和CD68+巨噬细胞水平均低于A组;治疗1个月后,A组患者复发率低于B组,BI、PD和AL,CD68+巨噬细胞、CD3^(+)T细胞及各唾液菌群检出率低于B组,差异均有统计学意义(P<0.05)。A、B组患者治疗1个月后的牙槽骨骨密度、CD4^(+)T细胞水平比较,差异无统计学意义(P>0.05)。结论:酪酸梭菌肠球菌三联活菌片、新癀片在慢性牙周病治疗中各有优势,二者联合治疗能进一步提高临床疗效,减轻炎症反应,促进牙周恢复,降低复发率,且在改善压槽骨密度方面也有重要意义。
OBJECTIVE:To probe into the effects of Clostridium butyricum enterococcus triple viable bacterial tablets combined with Neotzehuang tablets on tissue inflammatory response and bone density in patients with periodontal disease.METHODS:A total of 219 patients with chronic periodontal disease admitted into the hospital from Jan.2021 to Jan.2022 were extracted as the research objects for a prospective blinded study.Seventy-three cases each were grouped by random number table method according to the consultation serial number.All patients were given basic treatment+minocycline hydrochloride ointment+antibiotic treatment,group A was treated with Clostridium butyricum enterococcus triple viable bacterial tablets for 1 month on top of this,group B received Nezhuang tablets for 5 d on top of this,group C was treated with Nezhuang tablets for 5 d+Clostridium butyricum enterococcus triple viable bacterial tablets for 1 month on top of this.Efficacy,periodontal indicators at different time points[bleeding index(BI),probing depth(PD)and attachment loss(AL)],tissue inflammatory factors(CD3^(+)T cells,CD4^(+)T cells and CD68+macrophages),alveolar bone mineral density and salivary flora[Fusobacterium nucleatum(Fn),Porphyromonas gingivalis(Pg),Proteus intermedius(Pi)and Actinobacillus actinomycetemcomitans(Aa)]in three groups were compared.RESULTS:The total effective rate of group C was 97.26%(71/73),higher than that of group A(78.08%,57/73)and group B(86.30%,63/73),with statistically significant differences(P<0.05);however,there was no significant difference between group A and group B(P>0.05).After 5 d and 1 month of treatment,the levels of BI,PD and AL,CD4^(+)T cells,CD3^(+)T cells and CD68+macrophages and the detection rate of each salivary flora in group C were lower than those in group A and group B,the alveolar bone density was higher than that in group A and group B,and the recurrence rate was lower than that in group B,with statistically significant differences(P<0.05).After 5 d of treatment,the levels of BI,PD and AL,CD4^(+)T cells,CD3^(+)T cells and CD68+macrophages in group B were lower than those in group A;after 1 month of treatment,the recurrence rate of group A was lower than that of group B,the detection rates of BI,PD and AL,CD68+macrophages,CD3^(+)T cells and salivary flora were lower than those of group B,the differences were statistically significant(P<0.05).There was no significant difference in alveolar bone mineral density and CD4^(+)T cells between group A and group B after 1 month of treatment(P>0.05).CONCLUSIONS:Clostridium butyricum enterococcus triple viable bacterial tablets and Neotzehuang tablets have their own advantages in the treatment of patients with periodontal disease,and the combined treatment can further improve the clinical efficacy,reduce the inflammatory reaction,promote periodontal recovery and reduce the recurrence rate,which also has important significance in improving the density of pressure alveolar bone.
作者
徐欢
崔二辉
贾情
张坤锋
穆楠楠
赵素倩
XU Huan;CUI Erhui;JIA Qing;ZHANG Kunfeng;MU Nannan;ZHAO Suqian(Dept.of Stomatology,Shijiazhuang People’s Hospital,Shijiazhuang 050000,China)
出处
《中国医院用药评价与分析》
2023年第5期575-579,共5页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
石家庄市科学技术研究与发展计划项目(No.211460783)。
关键词
酪酸梭菌肠球菌三联活菌片
新癀片
复发
骨密度
牙周病
炎症
Clostridium butyricum enterococcus triple viable bacterial tablets
Neotzehuang tabletst
Recurrence
Bone density
Periodontal disease
Inflammation
