| 张莹,康晓瑞,刘景平.布洛芬缓释凝胶联合聚维酮碘含漱液治疗慢性牙周炎的临床效果及对病儿龈沟液核因子 κB受体激活蛋白配体、骨碱性磷酸酶、基质金属蛋白酶 -8水平的影响[J].安徽医药,2026,30(9):1886-1891. |
| 布洛芬缓释凝胶联合聚维酮碘含漱液治疗慢性牙周炎的临床效果及对病儿龈沟液核因子 κB受体激活蛋白配体、骨碱性磷酸酶、基质金属蛋白酶 -8水平的影响 |
| The curative effect of ibuprofen sustained-release gel combined with povidone iodine gargle in treating children with chronic periodontitis and its impacts on serum receptor activator of nuclear factor κB ligand, bone alkaline phosphatase and matrix metalloproteinase-8 in gingival crevicular fluid of children |
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| DOI：10.3969/j.issn.1009-6469.2026.09.035 |
| 中文关键词: 慢性牙周炎 布洛芬缓释凝胶 聚维酮碘含漱液 龈沟液 核因子 κB受体激活蛋白配体 骨碱性磷酸酶 基质金属蛋白酶 -8 |
| 英文关键词: Chronic periodontitis Ibuprofen sustained-release gel Povidone iodine gargle Gingival crevicular fluid Receptor activator of nuclear factor κB ligand Bone alkaline phosphatase Matrix metalloproteinase-8 |
| 基金项目:呼和浩特市卫生健康领域科技项目(呼卫健医疗 -2023038) |
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| 中文摘要: |
| 目的探讨布洛芬缓释凝胶联合聚维酮碘含漱液治疗慢性牙周炎病儿的临床效果，以及对病儿龈沟液核因子 κB受体激活蛋白配体( RANKL)、骨碱性磷酸酶( BALP)、基质金属蛋白酶 -8(MMP-8)水平的影响。方法前瞻性研究。选择 84例 2022年 3月至 2024年 5月至呼和浩特市口腔医院治疗的慢性牙周炎病儿，以随机数字表法分为对照组和研究组，每组 42例。对照组使用常规治疗结合聚维酮碘含漱液治疗，每次 10 mL温水稀释或直接含漱 15 s，每日 4次；研究组在对照组治疗的基础上，使用注射器经牙周袋注射布洛芬凝胶治疗，每次使用剂量以注满病儿牙周袋，在牙龈边缘处观察到药物为准，每周 1次，治疗后 24 h内不可漱口刷牙。均治疗 4周。对比治疗后两组的总有效率、牙周指标、牙周组织吸收相关因子、骨标志物、炎症因子、疼痛评分和不良反应发生情况。结果研究组病人总有效率［90.48%(38/42)］显著高于对照组［71.43%(30/42)］(P<0.05)；治疗后研究组和对照组的牙周指标附着丧失( AL)、龈沟出血指数( SBI)、菌斑指数( PLI)相比于治疗前显著下降( P<0.05)研究组治疗后 AL、SBI、PLI低于对照组( P<0.05)；治疗后两组 MMP-8、RANKL、可溶性细胞间黏附分子 1(sICAM-1)水平相较于治疗前显著下降( P<0.05)；治疗后研究组 MMP-8［(15.59±4.76)μg/L］、 RANKL［( 30.18±8.66)ng/L］和 sICAM-1［( 76.15±18.03)μg/L］水平显著低于对照组［(20.37±5.10)μg/L、(36.12±8.15)ng/L、(92.08±15.55)μg/L］(P<0.05)；治疗后两组 BALP、Ⅰ型前胶原 N端前肽( PINP)水平显著高于治疗前( P<0.05)Ⅰ型胶原交联 C端肽( CTX-1)低于治疗前( P<0.05)；治疗后研究组 BALP［( 50.25±6.72)U/L］、 PINP［( 81.26±6.25)μg/L］水平于对照组［( 44.36±4.20)U/L，(68.19±7.64)μg/L］(P<0.05)，CTX-1低高，于对照组( P<0.05)；与治疗前比较，治疗后两组转化生长因子 -β(TGF-β)水平升高，白细胞介素( IL)-6、超敏 C反应蛋白(hs-CRP)、单核细胞趋化蛋白 -1(MCP-1)水平降低( P<0.05)；治疗后研究组 TGF-β水平高于对照组， IL-6、hs-CRP、MCP-1水平低于对照组(P<0.05)；治疗后，两组视觉模拟评分法( VAS)评分显著低于治疗前( P<0.05)，研究组 VAS评分显著低于对照组( P<0.05)；治疗期间两组不良反应发生率差异无统计学意义( P>0.05)。结论布洛芬缓释凝胶联合聚维酮碘含漱液治疗慢性牙周炎病儿的治疗效果较好，可以提高病儿龈沟液中 BALP水平，降低 MMP-8、RANKL。 |
| 英文摘要: |
| Objective To investigate the curative effect of ibuprofen sustained-release gel combined with povidone iodine gargle inchildren with treating chronic periodontitis, as well as its impacts on the serum receptor activator of nuclear factor κB ligand (RANKL), bone alkaline phosphatase (BALP), matrix metalloproteinase-8 (MMP-8) in gingival crevicular fluid of children.Methods A prospec.tive study was conducted. 84 children with chronic periodontitis treated at Hohhot Stomatological Hospital from March 2022 to May2024 were enrolled and stochastically grouped into control group and research group by the random number method, each had 42 cases.The control group was treated with conventional treatment combined with povidone iodine gargle, diluted with 10 mL of warm watereach time or directly rinsed for 15 seconds, 4 times a day. On the basis of the treatment of the control group, the research group used asyringe to inject ibuprofen gel through the periodontal pocket for treatment. The dosage of each use was subject to the filling of the pa.tient's periodontal pocket, and the drug was observed at the edge of the gingiva, once a week. Rinsing and brushing were not allowedwithin 24 hours after treatment. All treatments lasted for 4 weeks. The total effective rate, periodontal indicators, periodontal tissue ab.sorption related factors, bone markers, inflammatory factors, pain scores, and bad reactions were compared between the two groups aftertreatment.Results The research group [90.48% (38/42)] had a unusually higher total effective rate than control group [71.43% (30/ 42)] (P<0.05). The attachment loss (AL), gingival bleeding index (SBI), and plaque index (PLI) in both groups obviously decreased aftertreatment (P<0.05). The AL, SBI, and PLI in research group were lower than those in control group after treatment (P<0.05). The MMP-8, RANKL, and soluble intercellular adhesion molecule-1 (sICAM-1) in both groups obviously decreased after treatment (P<0.05). After treatment, the levels of MMP-8 [(15.59±4.76) μg/L], RANKL [(30.18±8.66) ng/L], and sICAM-1 [(76.15±18.03) μg/L] in the researchgroup were significantly lower than those in the control group [(20.37±5.10) μg/L, (36.12±8.15) ng/L, (92.08±15.55) μg/L] (P<0.05). The BALP and procollagen type Ⅰ N-terminal propeptide (PINP) in both groups unusually raised after treatment (P<0.05), while type Ⅰ collagen cross-linked C-terminal peptide (CTX-1) reduced (P<0.05). After treatment, the levels of BALP [(50.25±6.72) U/L] andPINP [(81.26±6.25) μg/L] in the research group were higher than those in the control group [(44.36±4.20) U/L, (68.19±7.64) μg/L] (P< 0.05), and CTX-1 was lower than that in the control group (P<0.05). Both groups had increased transforming growth factor-β (TGF-β), and decreased interleukin (IL)-6, high-sensitivity C-reactive protein (hs-CRP), and monocyte chemoattractant protein-1 (MCP-1) after treatment (P<0.05). After treatment, these indexes in the research group were higher than those in the control group (P<0.05). Both groups had obviously reduced visual analogue scale (VAS) score after treatment (P<0.05), and with obviously lower VAS scores in re. search group (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groupsduring the treatment period (P>0.05).Conclusions Ibuprofen sustained-release gel combined with povidone iodine gargle is effectivein treating children with chronic periodontitis. It can increase BALP and reduce MMP-8 and RANKL in gingival crevicular fluid of chil. dren. |
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