慢性牙周炎的基础治疗和牙周支持治疗疗效与位点特异性研究

目的评价慢性牙周炎基础治疗（Initial Therapy）和牙周支持治疗（Supportive Periodontal Therapy，SPT）的疗效以及慢性牙周炎全口牙不同位点间病情的特异性。方法选择102例慢性牙周炎患者进行牙周基础治疗，检测患者在治疗前，第一次SPT时和第2次SPT时的探诊深度（Probing Depth，PD）、探诊出血情况（Bleedingon Probing，BOP）和牙齿松动度（Tooth Mobility，TM）。检测位点为患者所有天然牙的4个位点。将全口牙分成前牙组、前磨牙组、磨牙组和所有牙组四组。比较四组间以及PD〈5mm和PD≥5mm的位点间两次治疗前后PD、BOP和TM的变化。结果四组受试牙两次治疗后PD、BOP和TM与治疗前相比均有明显改善（P〈0．01）。PD〈5mm和PD≥5mm的牙周位点间PD的降低有统计学差异（P〈0．05），深PD的牙周位点改善更明显。结论牙周基础治疗和牙周支持治疗对慢性牙周炎具有良好的治疗效果。牙周炎不同位点的病情和对治疗的反应不一致。牙周支持治疗对慢性牙周炎治疗的远期疗效具有重要意义。

The effects on lung function and quality of life of Tiotropium combined salmeterol and fluticasone propionate in treatment of patients with stable COPD

Objective To investigate the effect on the lung function and quality of life in COPD patients with stable therapeutic treated with tiotropium combined salmeterol fluticasone propionate. Methods A total of 119 cases with sta- ble COPD patients collected from January 2013 to January 2014 in our hospital were retrospective analyzed,all of them were divided into two groups, the control group had 60 patients and used salmeterol fluticasone treatment, the observation group had 59 cases and used tiotropium combined salmeterol and flutieasone propionate therapy,patients of two groups were treated 6 months and the effect of two groups were compared. Results （1）the frequency of acute exacerbation of the observation group was significantly lower than the control group,there was a significant difference between two groups （P〈0.05）. （2）FEV1, FEV1/FVC, FEV1/expected values of the observation group and the control group post- treatment were significantly higher than before treatment, the observation group after treatment were significantly higher than the control group, there was a significant difference between two groups （P〈0.05）. （3）SGRQ symptom, activity, impact on daily life and total scores of the observation group and control group post-treatment were significantly lower than before treatment, the observation group after treatment were significantly lower than the control group, there was a significant difference between two groups （P〈0.05）. Conclusion Stable COPD patients with tiotropium combined salmeterol and flutieasone propionate therapy significantly, with higher security, can clinical applications.