盐酸米诺环素联合替硝唑治疗2型糖尿病合并牙周病的临床研究

目的 利用盐酸米诺环素对2型糖尿病牙周病进行辅助治疗，以探讨其临床疗效和作用机制。方法 选取2012年3月-2014年3月中国人民解放军空军总医院口腔科就诊的2型糖尿病合并牙周炎患者86例随机分组，其中，治疗组43例（91牙），对照组43例（87牙）。对照组进行口腔龈上洁治术后使用浓替硝唑含漱液5 mL，保留2 min后吐出，并进行龈下刮治术。治疗组在对照组基础上，刮治完毕后将盐酸米诺环素挤入牙周袋内至溢出为止，1次/周，连续治疗4周。治疗结束后，比较两组的临床疗效，并检测两组治疗前后牙周指数、IL-Iβ和MMP-3的变化情况。结果 治疗组和对照组的总有效率分别为85.71%、66.67%，两组比较差异有统计学意义（P〈0.01）。治疗后两组患者菌斑指数、出血指数、牙周袋深度和附着丧失均较治疗前明显改善，同组治疗前后差异有统计学意义（P〈0.01）；治疗后，治疗组各指标均优于对照组，两组比较差异有统计学意义（P〈0.05，0.01）。治疗后两组患者龈沟液量、IL-Iβ、MMP-3水平均较治疗前明显减少，同组治疗前后差异有统计学意义（P〈0.01）；治疗后，治疗组龈沟液量、IL-Iβ与对照组相比差异有统计学意义（P〈0.01）。结论 盐酸米诺环素能够改善2型糖尿病合并牙周病患者的炎性因子水平，提高临床治疗效果，值得临床推广应用。

Clinical study on minocycline combined with tinidazole in the treatment of type 2 diabetes with periodontal disease

Objective To investigate the clinical effect and mechanism of action of minocycline as an auxiliary therapy on type 2 diabetes with periodontal disease. Methods Eighty six patients with diabetes with periodontal disease picked up from Stomatological Department of Air Force General Hospital of PLA during March 2012 to March 2013 were randomly divided into two groups, 43 cases （91 teeth） as experimental group, 43 cases （87 teeth） as control group. The patients in the control group was using 5 mL tinidazole gargles after dental subgingval scaling, spited after 2 min, and then given subgingival scaling. The patients in the experimental group were put minocycliene hydrochloride in periodontal pockets till overflow after scaling, 1 time/week for 4 weeks. Periodontal index, IL-Iβ, and MMP-3 and clinical curative effect were compared before and after the treatment. Results Efficiency to the patients of the experimental and control groups were 85.71% and 66.67%, there was significant difference between the two groups （P〈0.01）. Plaque index, bleeding index, probing depth, and attachment loss of the patients in the experimental group after the treatment was better than those in the control group, the difference has statistical significance （P〈0.01）. The indexes of the patients in the experimental group were better than those in the control group, the difference had statistical significance （P〈0.05, 0.01）. The content of the gingival crevicular fluid, IL-I ~, and MMP-3 levels in the two groups after the treatment reduced significantly, and there was a significant difference before and after the treatment on the same group （P〈0.01）. The contents of the gingival crevicular fluid and IL-I β had the significant difference to those in the control group after the treatment （P〈0.01）. Conclusion Minocycline hydrochloride can improve the levels of inflammatory factors in the patients with type 2 diabetes mellitus and periodontal disease, improve the clinical therapeutic effect, worthy of clinical popularization and application.