| 雷飞,倪菁,白丹,等.牙周干预对 2型糖尿病病人牙周炎控制及血糖水平的影响[J].安徽医药,2020,24(10):2013-2017. |
| 牙周干预对 2型糖尿病病人牙周炎控制及血糖水平的影响 |
| Effects of periodontal intervention on periodontal inflammation and blood glucose levels in patients with type 2 diabetes mellitus |
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| DOI：10.3969/j.issn.1009?6469.2020.10.025 |
| 中文关键词: 糖尿病， 2型/并发症 牙周炎 牙周指数 健康教育，牙科 牙科刮治术 牙菌斑指数 |
| 英文关键词: Diabetes mellitus,type 2/complications Periodontitis Periodontal index Health education,dental Dental scal? ing Dental plaque index |
| 基金项目:陕西省教育厅基金项目(18JK0679) |
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| 中文摘要: |
| 目的探讨牙周干预对 2型糖尿病病人牙周炎控制及血糖代谢的影响。方法选取 2015年 11月至 2017年 6月西安医学院第二附属医院收治的 120例 2型糖尿病伴牙周炎病人，按随机数字表法分为 A组、 B组、对照组，每组 40例。对照组仅在 24 h内进行口腔卫生宣教。 A组在进行卫生宣教基础上，进行牙周非手术治疗。 B组在上述治疗基础上， 3个月时进行牙周维护干预治疗。记录并比较各组基线、 3个月、 12个月时的牙周探诊深度(PD)、探诊出血指数(BOP)、附着丧失(AL)、菌斑指数(PLI)、空腹血糖、糖化血红蛋白水平。结果 A组、 B组治疗 3个月、 12个月后 PD、AL、PLI、BOP值均明显低于基线值(P＜0.01)而对照组治疗期间 PD、AL、PLI、BOP值差异无统计学意义(P＞0.05)。 A组治疗后 3个月、 12个月时的 PD、AL、PLI、BOP改善别为(0.40±0.03)比(0.45±0.05)mm、(0.30±0.02)比(0.25±0.03)mm、(0.49±0.05)比(0.39±0.04)、(23.51±2.11)%比值分，(13.22±1.36)%；B组治疗后 3个月、 12个月时的 PD、AL、PLI、BOP改善值分别为(0.44±0.05)比(0.47±0.06)mm、(0.66±0.07)比(0.61±0.06)mm、(0.48±0.05)比(0.36±0.04)mm、(22.81±2.11)%比(12.06±1.13)%；均明显高于对照组(P＜0.01)。 B组治疗后各时间点的 PD、AL的改善值明显高于 A组(P＜0.01)。对照组空腹血糖、糖化血红蛋白随时间变化无差异(P＞0.05)。 A组、 B组治疗 3个月、 12个月的空腹血糖及糖化血红蛋白改善程度均明显高于对照组及基线(P＜0.01)。 B组治疗期间的空腹血糖的改善程度优于 A组(P＜0.01)，但糖化血红蛋白的改善程度两组间差异无统计学意义(P＞0.05)。 A组、 B组 PD改善＞ 0.5 mm病人的空腹血糖分别为(0.65±0.04)mmol/L、(0.69±0.10)mmol/L，明显高于 PD改善 ≤0.5 mm的病人(P＜0.01)。 A组、 B组 PD改善＞0.5 mm病人的糖化血红蛋白水平分别为(0.74±0.11)%、(0.84±0.12)%明显高于 PD改善 ≤0.5 mm的病人(P＜0.01)。结论口腔卫生宣教结合牙周非手术治疗对于改善牙周炎状态有明显的优势，治疗 3个月时再进行牙周维护干预的效果更佳。牙周干预能够明显控制 2型糖尿病伴牙周炎病人的牙周炎症，并改善糖代谢状况。 |
| 英文摘要: |
| Objective To explore the effects of periodontal intervention on periodontal inflammation and blood glucose levels in pa?tients with type 2 diabetes mellitus.Methods A total of 120 patients with type 2 diabetes and periodontitiswho were admitted to the Second Affiliated Hospital of Xi’an Medical University from November 2015 to June 2017 were selected and assigned into group A，Group B and control group according to the random number table method，with 40 patients in each group.The controlgroup received oral health education within 24 hours.Group A performed periodontal nonsurgical treatment on the basis of healtheducation.Group B underwent periodontal maintenance intervention for 3 months based on the above treatment.The periodontal prob?ing depth(PD)，explore clinical bleeding index(BOP)attachment loss(AL)，plaque index(PLI)，fasting blood glucose，glycosyl? ated hemoglobin levels at baseline，3 months，12months，were recorded and compared.Results PD，AL，PLI and BOP values of group A and group B were significantly lower than the baseline values after 3 months and 12 months of treatment(P＜0.01)，while PD，AL，PLI and BOP values of the control group were not significantly different during the treatment(P＞0.05).The improvement values of PD，AL，PLI and BOP after 3 months in group A was(0.40±0.03)mm，(0.30±0.02)mm，(0.49±0.05)，and(23.51±2.11)%， respectively，the improvement values of PD，AL，PLI and BOP after 12 months in group A was(0.45±0.05)mm，(0.25±0.03)mm，(0.39±0.04)，and(13.22±1.36)%，respectively；the improvement values of PD，AL，PLI and BOP after 3 months in group Bwas(0.44±0.05)mm，(0.66±0.07)mm，(0.48±0.05)，and(22.81±2.11)%，respectively；the improvement values of PD，AL，PLI and BOP after 12 months in group B was(0.47±0.06)mm，(0.61±0.06)mm，(0.36±0.04)，and(12.06±1.13)%，and the improvement values of PD，AL，PLI and BOPin group B were significantly higher than those in the control group(P＜0.01).The improvement values ofPD and AL in group B at each time point after treatment were significantly higher than those in group A(P＜0.01).The fastingblood glucose and glycosylated hemoglobin of group A and group B all showed a decreasing trend with the progress of treatmenttime(P＜0.01).The fasting blood glucose and glycosylated hemoglobin in the control group showed no difference with the progressof treatment time(P＞0.05).The improvement of fasting blood glucose and glycosylated hemoglobin in group A and group B at 3months and 12 months after treatment was significantly higher than those in the control group and baseline(P＜0.01).The improve? ment degree of fasting blood glucose in group B was superior to that in group A during the treatment(P＜0.01)，but there was no statistically significant difference in the improvement degree of glycosylated hemoglobin(P＞0.05).Fasting blood glucose of pa? tients with PD improvement＞0.5mm in group A and group B was(0.65±0.04)mmol/L and(0.69±0.10)mmol/L，respectively， which was significantly higher than that of patients with PD improvement ≤0.5mm(P＜0.01).The glycosylated hemoglobin levels of patients with PD improvement＞0.5mm in group A and group B were(0.74±0.11)% and(0.84±0.12)%，respectively，which were significantly higher than those that of patients with PD improvement ≤0.5mm(P＜0.01).Conclusion Oral health education com? bined with periodontal non?surgical treatment has obvious advantages in improving periodontal inflammation，and the effect of peri?odontal maintenance intervention after 3 months of treatment is better.Periodontal intervention can significantly control periodontalin flammation，control periodontal inflammation in patients with type 2 diabetes and periodontitis，and improve glucose metabolism. |
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