局部应用大环内酯类药物联合龈下刮治和根面平整治疗慢性牙周炎疗效的meta分析

doi:10.19439/j.sjos.2019.02.021

上海口腔医学 ›› 2019, Vol. 28 ›› Issue (2): 207-217.doi: 10.19439/j.sjos.2019.02.021

局部应用大环内酯类药物联合龈下刮治和根面平整治疗慢性牙周炎疗效的meta分析

刘秋月, 张奕, 李静, 向学熔

重庆医科大学附属口腔医院,口腔疾病与生物医学重庆市重点实验室, 重庆市高校市级口腔生物医学工程重点实验室,重庆 401120

收稿日期:2018-09-07 修回日期:2018-11-13 出版日期:2019-04-25 发布日期:2019-06-20
通讯作者: 向学熔,E-mail：500067@hospital.cqmu.edu.cn
作者简介:刘秋月（1992-）,女,在读硕士研究生,E-mail：2650047126@qq.com
基金资助:
重庆市科卫联合医学科研项目（2018ZDXM031）; 重庆高校创新团队建设计划资助项目（CXTDG201602006）; 重庆市高级市级口腔生物医学工程重点实验室资助项目

Locally delivered macrolides as an adjunct to non-surgical periodontal treatment of chronic periodontitis: a meta analysis

LIU Qiu-yue, ZHANG Yi, LI Jing, XIANG Xue-rong

Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education. Chongqing 401120, China

Received:2018-09-07 Revised:2018-11-13 Online:2019-04-25 Published:2019-06-20

摘要/Abstract

摘要： 目的系统评价龈下刮治及根面平整(scaling and root planing, SRP) 联合局部大环内酯类药物治疗慢性牙周炎的疗效。方法计算机检索PubMed、 Cochrane Library、Science Direct、Embase、中国知网、万方及维普等数据库中局部应用大环内酯类药物联合SRP对慢性牙周炎患者临床参数影响的随机对照试验（randomized controlled trials,RCTs）,检索时限从建库到2018年8月。由2名研究者按 Cochrane质量评分标准,对纳入文献进行质量评价,采用RevMan 5.3软件进行统计学分析。结果共纳入7篇质量较高的RCTs,包括439例患者。结果显示,与实施单纯SRP组比较,局部应用大环内酯类药物联合SRP组患者,随访3个月时的牙周探诊深度（probing depth, PD）减少[MD=0.77,95%CI(0.48-1.05),P<0.00001]、临床附着丧失（clinical attachment loss,CAL）获得[MD=0.74,95%CI(0.39-1.10),P<0.0001]、菌斑指数（plaque index,PI）降低[MD=0.30,95%CI(0.17-0.43),P<0.00001]、改良龈沟出血指数（modified sulcus bleeding index,mSBI）降低[MD=0.23,95%CI(0.15-0.32),P<0.00001],随访6个月时的PD减少[MD=1.15,95%CI(0.41-1.89),P=0.002]、CAL获得[MD=0.92,95%CI(0.43-1.40),P=0.0002],PI降低[MD=0.51,95%CI(0.07-0.95),P=0.02]、mSBI降低[MD=0.18,95%CI(0.07-0.29),P=0.002]更加显著(P<0.05)。结论实施SRP的同时,局部联合应用大环内酯类药物对减少PD和控制炎症有显著效果。

关键词: 大环内酯类药物, 慢性牙周炎, 龈下刮治及根面平整, Meta分析

Abstract: PURPOSE: The present meta analysis was designed to determine the effects of macrolides group of antibiotics as local drug delivery agents to scaling and root planing (SRP), compared with SRP alone or plus placebo. METHODS: Electronic and manual literature searches were conducted to select randomized controlled trials (RCTs) comparing SRP + macrolides versus SRP alone using the following databases: PubMed, Cochrane Library, Science Direct, EMbase, CNKI, Wanfang database and VIP data until August 2018. Two reviewers independently extracted the data and evaluated the methodological quality of the included studies. RevMan 5.3 was applied for meta analysis. RESULTS: Seven papers were obtained, which included 439 patients with chronic periodontitis.Meta analysis showed that in the two groups, the changes in probing depth（PD）[MD=0.77, 95%CI(0.48-1.05), P<0.00001], clinical attachment loss（CAL）[MD=0.74, 95%CI(0.39-1.10), P<0.0001],plaque index（PI）[MD=0.30, 95% CI(0.17-0.43), P<0.00001],modified sulcus bleeding index (mSBI)[MD=0.23, 95%CI(0.15-0.32), P<0.00001]at 3 month and 6 month of PD[MD=1.15, 95%CI(0.41-1.89), P=0.002] were significantly different, the difference of CAL[MD=0.92, 95%CI(0.43-1.40), P=0.0002], PI[MD=0.51, 95%CI(0.07-0.95), P=0.02] and mSBI[MD=0.18, 95%CI(0.07-0.29), P=0.002] was also significant (P<0.05). CONCLUSIONS: SRP combined with local macrolides adjuvant treatment for chronic periodontitis is effective in short-term observation.

Key words: Macrolides, Chronic periodontitis, Scaling and root planing, Meta analysis

中图分类号:

R781.4.2

刘秋月, 张奕, 李静, 向学熔. 局部应用大环内酯类药物联合龈下刮治和根面平整治疗慢性牙周炎疗效的meta分析[J]. 上海口腔医学, 2019, 28(2): 207-217.

LIU Qiu-yue, ZHANG Yi, LI Jing, XIANG Xue-rong. Locally delivered macrolides as an adjunct to non-surgical periodontal treatment of chronic periodontitis: a meta analysis[J]. Shanghai Journal of Stomatology, 2019, 28(2): 207-217.

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局部应用大环内酯类药物联合龈下刮治和根面平整治疗慢性牙周炎疗效的meta分析

Locally delivered macrolides as an adjunct to non-surgical periodontal treatment of chronic periodontitis: a meta analysis

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