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目的探讨盐酸米诺环素缓释剂联合Vitapex治疗老年慢性牙周炎合并牙髓病变的临床疗效。方法选取2014年7月至2015年12月在佛山市禅城区向阳医院口腔综合科就诊的130例老年慢性牙周炎合并牙髓病变患者,采用随机数字表法分为观察组和对照组,每组各65例。对照组采用碘甘油联合常规根管治疗,观察组采用盐酸米诺环素软膏联合Vitapex治疗,比较两组牙周相关指标、龈沟液炎性因子和临床疗效等。结果观察组有效率90.77%,明显高于对照组的75.38%(P<0.05);牙周袋探诊深度(PD)、牙龈指数(GI)、龈沟出血指数(SBI)、菌斑指数(PLI)、牙齿松动度(TM)均明显低于对照组(均P<0.05);龈沟液肿瘤坏死因子-α(TNF-α)、高敏C反应蛋白(hs-CRP)、白细胞介素-4(IL-4)含量均明显低于对照组(均P<0.05)。结论盐酸米诺环素缓释剂联合Vitapex治疗有助于提高老年慢性牙周炎合并牙髓病变患者临床疗效,可能与改善牙周症状、下调龈沟液中炎性因子水平有关。
Objective To investigate the clinical efficacy of minocycline hydrochloride in combination with Vitapex in the treatment of elderly patients with chronic periodontitis and endodontic diseases. Methods From July 2014 to December 2015, 130 elderly patients with chronic periodontitis complicated with endodontic disease who were treated in Department of Stomatology, Xiangyang Hospital, Chancheng District, Foshan City were randomly divided into observation group and control group by random number table. Each group of 65 cases. The control group was treated with iodoglycerin combined with conventional root canal therapy. The observation group was treated with minocycline hydrochloride combined with Vitapex. The periodontal related indicators, gingival crevicular fluid inflammatory factors and clinical efficacy were compared. Results The observation group had an effective rate of 90.77%, which was significantly higher than that of the control group (75.38%, P <0.05). The PD, GI, SBI, PLI) and tooth mobility (TM) were significantly lower than those in the control group (all P <0.05). The levels of tumor necrosis factor-α (TNF-α), high sensitivity C reactive protein (hs-CRP), interleukin- 4 (IL-4) were significantly lower than the control group (P <0.05). Conclusion Minocycline hydrochloride combined with Vitapex may be helpful to improve the clinical efficacy of elderly patients with chronic periodontitis and endodontic disease. It may be related to the improvement of periodontal symptoms and down-regulation of inflammatory cytokines in gingival crevicular fluid.