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目的评价0.12%氯已定对已应用复合树脂充填患牙的糖尿病患者行牙周维护治疗的临床效果。方法选择20例有牙周炎病的糖尿病患者,对其前牙区龋齿进行复合树脂充填治疗后,分为研究组(n=10)和对照组(n=10)。在进行基础牙周治疗之前预防性应用抗生素,在牙周维护治疗阶段给予研究组患者0.12%氯已定15 d,对照组患者不应用氯已定。分别在治疗前和治疗后90 d检测所有患者的菌斑指数、牙龈指数和牙周探诊深度,记录并应用方差分析和Tukey检验对数据进行统计。并对研究组患者进行糖化血红蛋白等血清生化指标的检测,比较治疗前后的差异。结果经过90 d的治疗,研究组患者的菌斑指数、牙龈指数和牙周探诊深度均明显低于对照组,差异有统计学意义(P<0.01)。研究组患者经0.12%氯已定治疗后较治疗前比较,糖化血红蛋白降低,差异有统计学意义(P<0.05);血清总胆红素水平较之前升高(P<0.05);血清磷水平升高(P<0.01);血清钙磷比下降(P<0.01);甘油三酯的水平下降(P<0.05);载脂蛋白A1升高(P<0.01)。结论在牙周维护治疗中,应用0.12%氯已定能够有效改善糖尿病患者已行树脂修复患牙的牙周健康和糖化血红蛋白,此外还可能影响钙、磷、血脂等其他生化指标。
Objective To evaluate the clinical effect of 0.12% chlorhexidine on the periodontal maintenance treatment of diabetic patients who have applied the composite resin to fill the tooth. Methods Twenty patients with diabetes mellitus with periodontitis were selected and divided into two groups: study group (n = 10) and control group (n = 10). Prophylactic antibiotics were administered prior to periodontal treatment and 0.12% chlorhexidine was administered to the study group during the period of periodontal maintenance therapy. Chlorhexidine was not used in the control group. The plaque index, gingival index and periodontal exploration depth of all patients were detected before treatment and 90 days after treatment. The data were recorded and analyzed by analysis of variance and Tukey’s test. The patients in the study group were tested for serum biochemical indexes such as HbA1c and the differences between before and after treatment were compared. Results After 90 days of treatment, the plaque index, gingival index and periodontal exploration depth in the study group were significantly lower than those in the control group (P <0.01). The study group patients treated with 0.12% chlorhexidine after treatment compared with before treatment, HbA1c decreased, the difference was statistically significant (P <0.05); serum total bilirubin levels were higher than before (P <0.05); serum phosphorus levels (P <0.01); serum calcium and phosphorus ratio decreased (P <0.01); triglyceride level decreased (P <0.05); apolipoprotein A1 increased (P <0.01). Conclusion In periodontal maintenance treatment, application of 0.12% chlorhexidine can effectively improve the periodontal health and glycosylated hemoglobin in patients with diabetes mellitus, and may also affect other biochemical indexes such as calcium, phosphorus and blood lipid.