| 摘要: |
| ［摘要］ 目的 探讨牙周干预对2型糖尿病伴牙周病患者口腔健康状况和血糖控制的影响。方法 将146例糖尿病伴牙周病患者随机分为实验组（75例）和对照组（71例）。对照组进行口腔卫生宣教、正确刷牙方法指导及发放口腔保健用品。实验组在对照组的基础上还进行龈上洁治术和（或）龈下刮治术等牙周干预治疗。比较两组干预前后牙周指数、龈下菌斑中牙龈卟啉单胞菌含量、空腹血糖（FBG）和糖化血红蛋白（HbA1c）水平变化情况。结果 （1）两组不同阶段牙周指数的比较：3个月及6个月时实验组牙周指数均较前一阶段下降，对照组均较前一阶段上升，两组差异有统计学意义（P<0.05）；12个月时两组牙周指数均较6个月时上升，差异有统计学意义（P<0.05)。（2）两组不同阶段龈下菌斑Pg检出量比较:3个月时实验组龈下菌斑中Pg检出量较基线值下降,对照组较基线值上升,两组差异有统计学意义（P<0.05）；6个月及12个月时两组龈下菌斑Pg检出量均较前一阶段上升，但差异无统计学意义（P>0.05)。（3）两组不同阶段FBG比较：3个月时实验组FBG较基线值下降，对照组较基线值上升，差异无统计学意义（P>0.05)；6个月时两组FBG均较3个月时上升，差异无统计学意义（P>0.05)；12个月时实验组FBG较6个月时下降，对照组较6个月时上升，但两组差异无统计学意义（P>0.05)。（4）两组不同阶段HbA1c比较：3个月时两组HbA1c均较基线值下降，差异无统计学意义（P>0.05)；6个月时实验组HbA1c较3个月时下降，对照组较3个月时上升，两组差异有统计学意义（P<0.05)；12个月时实验组HbA1c较6个月时上升，对照组无明显变化，两组差异无统计学意义（P>0.05)。结论 牙周干预不仅可改善Ⅱ型糖尿病伴牙周病患者的牙周状况，在糖尿病病情控制方面也起积极的作用;Ⅱ型糖尿病伴牙周病患者牙周基础治疗需长期坚持,建议每半年定期进行一次口腔健康检查，应积极配合医师进行牙周综合干预。 |
| 关键词: 糖尿病 牙周病 牙周指数 牙龈卟啉单胞菌 糖化血红蛋白 |
| DOI：10.3969/j.issn.1674-3806.2018.01.02 |
| 分类号:R 781.4 |
| 基金项目:广西自然科学基金资助项目（编号：2010GXNSFA013229） |
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| Clinical effect of oral comprehensive intervention on patients with type 2 diabetes mellitus complicated with periodontal disease |
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LU Yan, ZHOU Yan, LIU Hong-yan, et al.
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Youjiang Medical University for Nationalities, Guangxi 533000, China
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| Abstract: |
| ［Abstract］ Objective To observe the effect of oral comprehensive intervention on oral health status and blood glucose control in the patients with type 2 diabetes mellitus complicated with periodontal disease.Methods 146 patients with type 2 diabetes mellitus complicated with periodontal disease were divided into the experimental group(n=75) and the control group(n=71). Both groups were given oral hygiene education and effective tooth brushing. In addition, the experimental group was given supragingival scaling and(or) subgingival curettage of periodontal intervention. The periodontal indexes, subgingival plaque of porphyromonas gingivalis in content, glycosylated hemoglobin, fasting blood glucose were compared between the two groups.Results Comparison of the periodontal index between the two groups at different stages: 3 and 6 months after the treatment, the periodontal indexes in the experimental group were declined while they were increased in the control group compared with those at the previous stage, with significant differences between the two groups(P<0.05). 12 months after the treatment, the periodontal indexes were increased in both of the two groups compared with those at 6 months(P<0.05). Comparison of the subgingival plaque Pg detection between the two groups at different stages: 3 months after the treatment, the subgingival plaque of Pg in the experimental group was decreased compared with the baseline value while it was increased in the control group, with a significant difference between the two groups(P<0.05). 6 and 12 months after the treatment, it was increased in both groups compared with the previous stage increased, without significant differences between the two groups(P>0.05). Comparison of the fasting blood glucose between the two groups at different stages: 3 months after the treatment, FBG in the experimental group decreased while it increased in the control group, without significant differences between the two groups(P>0.05). 6 months after the treatment, FBG increased in both of the two groups, without a significant difference(P>0.05); 12 months after the treatment, FBG in the experimental group decreased while it increased in the control group, without a significant difference(P>0.05). Comparison of hemoglobin between the two groups at different stages: 3 months after the treatment, HbA1c was lower than that of the baseline value, without a significant difference between the two groups(P>0.05). 6 months after the treatment, HbA1c in the experimental group decreased compared with that of the baseline value while it increased in the control group, with significant differences between the two groups(P<0.05); 12 months after the treatment, HbA1c in the experimental group increased compared with that 6 months after the treatment, while HbA1c was unchanged in the control group, without a significant difference between the two groups(P>0.05).Conclusion Periodontal intervention can not only improve the periodontal status in the patients with type 2 diabetes mellitus complicated with periodontal disease, but also play a positive role in the control of diabetes mellitus. It is suggested that oral health examination should be carried out once every six months and the patients should cooperate with the doctors to carry out the periodontal comprehensive intervention actively. |
| Key words: Diabetes mellitus Periodontal disease Periodontal index Porphyromonas gingivalis Glycosylated hemoglobin |
