刘小龙

【摘要】 目的 探讨替硝唑联合米诺环素软膏辅助根管治疗牙周牙髓联合病变的临床疗效。方法 186例牙周牙髓联合病变患者， 随机分为观察组和对照组， 每组93例。对照组患者在接受常规治疗的基础上给予替硝唑片治疗， 观察组患者在常规治疗的基础上给予盐酸米诺环素软膏与替硝唑片联合治疗。比较两组的临床治疗效果；干预前后菌斑指数（PLI）、牙周探诊深度（PD）、 出血指数（BI）、牙龈指数（GI）；不良反应发生情况。结果 观察组治疗总有效率93.5%高于对照组的71.0%， 差异具有统计学意义（P<0.05）。干预后两组PLI、PD、BI、GI均优于本组干预前， 且观察组均优于对照组， 差异均具有统计学意义（P<0.05）。观察组皮肤瘙痒、胃肠不适发生率分别为2.15%、3.23%， 均低于对照组的9.68%、10.75%， 差异均具有统计学意义（P<0.05）；两组头晕发生率比较差异无统计学意义（P>0.05）。结论 替硝唑联合米诺环素软膏辅助根管治疗牙周牙髓联合病变的临床效果较好， 值得推广应用。

【关键词】 盐酸米诺环素软膏；替硝唑片；牙周牙髓联合病变

DOI：10.14163/j.cnki.11-5547/r.2018.11.049

【Abstract】 Objective To discuss the clinical efficacy of tinidazole combined with minocycline ointment and root canal therapy in the treatment of periodontal-endodontic combined lesions. Methods A total of 186 patients with periodontal-endodontic combined lesions were randomly divided into observation group and control group， with 93 cases in each group. The control group received tinidazole tablets on the basis of conventional therapy， and the observation group received minocycline hydrochloride ointment combined with tinidazole tablets on the basis of conventional therapy. Comparison were made on clinical treatment effect， plaque index （PLI）， periodontal probing depth （PD）， bleeding index （BI）， and gingival index （GI） before and after intervention and occurrence of adverse reactions between the two groups. Results The research group had higher total treatment effective rate as 93.5% than 71.0% in the control group， and the difference was statistically significant （P<0.05）. After intervention， both groups had better PLI， PD， BI and GI than before intervention， and the observation group was better than the control group. Their difference was statistically significant （P<0.05）. The observation group had lower incidence of skin pruritus and gastrointestinal discomfort respectively as 2.15% and 3.23% than 9.68% and 10.75% in the control group， and their difference was statistically significant （P<0.05）. Both groups had no statistically significant difference in incidence of dizziness （P>0.05）. Conclusion Combination of tinidazole， minocycline ointment and root canal therapy shows good clinical effect in treating periodontal-endodontic combined lesions， and it is worthy of promotion and application.

【Key words】 Minocycline hydrochloride ointment； Tinidazole tablets； Periodontal-endodontic combined lesions

牙周牙髓聯合病变（periodontal-endodontic combined lesions）是口腔科收治的常见病种， 具体是指患者在患有牙髓炎症性病变的同时伴有牙周组织的破坏， 主要原因是在解剖学方面牙髓与牙周是相互联通的， 牙髓病变与牙周病变可相互扩散和影响， 形成恶性循环[1]。有数据显示， 牙周牙髓联合病变的发病率呈逐年上升趋势， 且与年龄成正相关[2]。替硝唑和米诺环素软膏是治疗牙周牙髓联合病变的主要药物， 但其临床疗效如何尚未可知， 本课题组通过随机对照研究对186例牙周牙髓联合病变的患者进行干预， 拟探讨替硝唑联合米诺环素软膏辅助根管治疗该病的临床疗效， 现报告如下。

1 资料与方法

1. 1 一般资料 于2015年6月～2017年10月期间， 通过发放招募广告、由主治医师介绍等方式根据纳入标准和排除标准， 选择186例在本院口腔科接受治疗的牙周牙髓联合病变患者为研究对象。……