牙周基础治疗对伴2型糖尿病牙周炎患者的临床疗效及血糖水平的观察研究

发布时间：2018-04-10 13:25

本文选题：慢性牙周炎 + 2型糖尿病　；参考：《青岛大学》2017年硕士论文

【摘要】：目的慢性牙周炎与2型糖尿病(T2DM)之间关系密切,备受世界瞩目。牙周炎可增加T2DM等系统性疾病的易感性,而T2DM同时也是牙周病的重要危险因素之一。T2DM与慢性牙周炎不仅在作用机制上相互联系,在治疗效果上也相互影响。本研究的目的在于观察伴T2DM的牙周炎患者在不改变其原定的血糖控制方案的前提下,经规范化牙周基础治疗后临床牙周指数及空腹血糖水平的变化,分析其治疗效果,为临床该类患者的治疗提供理论指导和实践依据。方法1.按纳入排除标准,收集2014年到2016年在青岛大学附属医院牙周科及内分泌科就诊伴2型糖尿病的慢性牙周炎患者30例,年龄分布45—60岁之间,分为两组,对照组和实验组,每组15例。2.对照组:仅行原定血糖控制(饮食、降糖药或胰岛素注射等)方案,不进行牙周基础治疗。实验组:采用原定血糖控制和规范的牙周基础治疗。牙周检查和规范化牙周基础治疗由口腔科同一研究生大夫进行,并且由牙周科同一老师指导。进行一致性检验。仪器使用法国赛特利P5超声洁牙设备与美国Hu-Friedy、手工Gracey刮治器械进行系统化牙周基础治疗,使用UNC-15牙周探针进行常规临床探诊。3.观察时间为3个月,测量两组治疗前后的空腹血糖水平及牙周指数(PD、BI)的数值变化,使用SPSS17.0软件处理数据。性别进行卡方检验,年龄进行t检验;实验组和对照组治疗前的血糖水平、PD、BI的组间比较及两组治疗后的血糖水平、PD、BI的组间比较,用独立样本t检验的统计学方法进行比较。结果1.实验组和对照组年龄、性别比较,无统计学意义(P0.05)。2.临床观察,实验组牙周基础治疗前后,牙龈色形质明显改善,临床牙周状况显著改善。治疗前,实验组和对照组的PD、BI分别进行组间比较,无统计学意义(P0.05);治疗3个月后,两组PD、BI分别行组间比较,有统计学意义(P0.05)。3.治疗前,两组血糖水平比较,P=0.747,无统计学意义(P0.05);牙周基础治疗3月后,两组之间血糖水平比较,P=0.035,有统计学意义(P0.05)。结论本临床研究中,实验组患者经规范化系统化牙周基础治疗后,临床牙周状况明显改善,说明牙周基础治疗有助于T2DM患者牙周炎症的控制。两组治疗3月后的血糖水平比较,说明牙周基础治疗有助于伴T2DM的牙周炎患者的血糖控制及改善。提示临床上对于T2DM患者的血糖控制,除常规血糖控制措施(如饮食、药物、胰岛素注射等)外,应进行口腔牙周检查,对于确诊联合牙周炎的患者需采取积极地规范化牙周基础治疗,以改善患者的血糖水平。尤其对于血糖水平反复控制不佳的T2DM患者,更应进一步考虑进行口腔检查,必要时采取牙周治疗。
[Abstract]:Objective to study the relationship between chronic periodontitis and type 2 diabetes mellitus (T 2 DM).Periodontitis can increase the susceptibility of T2DM and other systemic diseases, and T2DM is also one of the important risk factors of periodontal disease. T2DM and chronic periodontitis are not only related to each other in the mechanism of action, but also affect each other in the treatment of periodontitis.The purpose of this study was to observe the changes of clinical periodontal index and fasting blood glucose level in periodontitis patients with T2DM without changing their original blood glucose control program, and to analyze the therapeutic effect.To provide theoretical guidance and practical basis for the treatment of this kind of patients.Method 1.According to the exclusion criteria, 30 cases of chronic periodontitis with type 2 diabetes, aged 45-60 years, were collected from the periodontal Department and Endocrinology Department, affiliated Hospital of Qingdao University from 2014 to 2016. They were divided into two groups: control group and experimental group.There were 15 cases in each group.Control group: only the original blood glucose control (diet, hypoglycemic drugs or insulin injection, etc.), no periodontal basic treatment.Experimental group: blood glucose control and standard periodontal basic treatment.Periodontal examination and standardized periodontal basic treatment were conducted by the same graduate doctor in stomatology and directed by the same teacher in periodontal department.Check the conformance.The fasting blood glucose and periodontal index (PDBI) were measured before and after treatment, and the data were processed by SPSS17.0 software.Result 1.There was no significant difference in age and sex between the experimental group and the control group (P 0.05. 2).Clinical observation showed that the gingival chromophores and clinical periodontal status of the experimental group were significantly improved before and after basic periodontal treatment.Before treatment, the PDBI of the experimental group and the control group were compared between the groups without statistical significance (P0.05), and after 3 months of treatment, the PDBI of the two groups were compared with each other (P 0.05). 3.Before treatment, the blood glucose levels of the two groups were significantly higher than that of the control group (P = 0.747), no significant difference was found between the two groups (P 0.05), and the blood glucose level was significantly higher than that of the control group (P = 0.035) after three months of basic periodontal treatment.Conclusion in this clinical study, the clinical periodontal status of the patients in the experimental group was obviously improved after standardized systematic periodontal basic treatment, which indicated that the basic periodontal treatment was helpful to the control of periodontitis in patients with T2DM.The comparison of blood glucose levels between the two groups after 3 months showed that periodontal basic therapy was helpful to the control and improvement of blood glucose in patients with periodontitis with T2DM.It is suggested that oral periodontal examination should be carried out in addition to routine blood glucose control measures (such as diet, drugs, insulin injection, etc.) for the control of blood glucose in patients with T2DM.In order to improve the blood glucose level of patients with periodontitis, we should take active standardized periodontal basic treatment.Especially for patients with T2DM whose blood glucose level is not well controlled repeatedly, we should further consider oral examination and periodontal treatment if necessary.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R781.4;R587.1

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