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目的观察抗生素联合牙周基础治疗对中重度慢性牙周炎合并2型糖尿病患者牙周指数和糖代谢的影响。方法60例中重度慢性牙周炎合并2型糖尿病患者随机分为观察组和对照组各30例。2组糖尿病治疗方案相同,对照组牙周病采取牙周基础治疗,观察组在对照组治疗基础上联合应用抗生素。记录并比较2组治疗前和治疗后3个月牙周探诊深度(probing depth,PD)、菌斑指数(plaque index,PLI)、临床附着丧失(clinic attachment loss,CAL)、出血指数(sulcus bleeding index,SBI)及空腹血糖(fasting plasma glucose,FPG)、糖化血红蛋白(glycosylated hemoglobin,HbA_1c)水平。结果 2组治疗前HbA_1c、FPG水平及PD、PLI、SBI、CAL比较差异均无统计学意义(P>0.05);对照组治疗后PD[(3.65±0.26)mm]、PLI(1.51±0.33)、SBI(1.79±0.16)及FPG[(7.85±1.25)mmol/L]、HbA1c[(6.96±1.46)%]水平均较治疗前[PD(6.38±0.50)mm、PLI为2.78±0.65、SBI为3.02±0.27、FPG(9.65±1.04)mmol/L、HbA_1c(7.93±1.75)%]降低(P<0.05),CAL[(4.43±0.72)mm]与治疗前[(5.09±0.55)mm]比较差异无统计学意义(P>0.05);观察组治疗后PD[(3.06±0.34)mm]、PLI(1.13±0.34)、SBI(1.37±0.32)、CAL[(3.73±0.57)mm]、FPG[(6.93±1.20)mmol/L]和HbA_1c[(6.16±1.24)%低于治疗前[PD(6.26±0.48)mm、PLI为2.86±0.61、SBI为3.20±0.39、CAL(4.99±0.48)mm、FPG(9.70±1.43)mmol/L、HbA_1c(7.96±0.97)%](P<0.05),且低于对照组治疗后,差异均有统计学意义(P<0.05)。结论牙周基础治疗联合抗生素应用可促进中重度慢性牙周炎合并2型糖尿病患者牙周健康,改善糖代谢水平。
Objective To observe the effect of antibiotic combined with periodontal therapy on periodontal index and glucose metabolism in patients with moderate-severe chronic periodontitis and type 2 diabetes mellitus. Methods Sixty patients with moderate-to-severe chronic periodontitis and type 2 diabetes mellitus were randomly divided into observation group (30 cases) and control group (30 cases). Two groups of diabetes treatment programs the same periodontal disease in the control group to take periodontal treatment, the observation group in the control group based on the combination of antibiotics. The probing depth (PD), plaque index (PLI), clinic attachment loss (CAL), sulcus index bleeding index (SBI), fasting plasma glucose (FPG), and glycosylated hemoglobin (HbA_1c) levels. Results The levels of HbA 1c, FPG, PD, PLI, SBI and CAL in the two groups before treatment were not significantly different (P> 0.05) , SBI (1.79 ± 0.16) and FPG [(7.85 ± 1.25) mmol / L] and HbA1c [(6.96 ± 1.46)%] were significantly higher than those before treatment (5.09 ± 0.55) mm] in CAL [(4.43 ± 0.72) mm] and before treatment (3.02 ± 0.27, 9.65 ± 1.04 mmol / L in FPG and 7.93 ± 1.75% in HbA_1c) (P <0.05). The PD [(3.06 ± 0.34) mm], PLI (1.13 ± 0.34), SBI (1.37 ± 0.32) and CAL [(3.73 ± 0.57) mm] The PLI was 2.86 ± 0.61, SBI was 3.20 ± 0.39, and CAL was 4.99 ± 0.48 (P <0.05). The mean FPG was (6.93 ± 1.20) mmol / L and HbA_1c (6.16 ± 1.24) ), FPG (9.70 ± 1.43) mmol / L, HbA_1c (7.96 ± 0.97)%] (P <0.05), and the differences were statistically significant (P <0.05) after treatment. Conclusion The application of periodontal therapy combined with antibiotics can promote periodontal health and improve glucose metabolism in patients with moderate-severe chronic periodontitis and type 2 diabetes mellitus.