本文選題：牙周炎 + 基礎(chǔ)治療��； 參考：《大連醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：分析比較慢性牙周炎患者牙周基礎(chǔ)治療前后,齦溝液中彈性蛋白酶(EA)和前列腺素E2(PGE2)水平的變化,以及鹽酸米諾環(huán)素藥物輔助治療對齦溝液中兩種因子水平的影響。 方法：選擇25個牙周炎患者,選擇標(biāo)準(zhǔn)為左右半口各有超過5個位點(diǎn)有3毫米(mm)以上的牙周袋深度以及1mm以上的附著喪失,在左半口和右半口各選擇3個符合標(biāo)準(zhǔn)的位點(diǎn),對所選擇的位點(diǎn)進(jìn)行牙周臨床檢查,記錄探診深度(PD),附著喪失(AL),牙齦指數(shù)(GI),用濾紙收集兩側(cè)所選位點(diǎn)的等量的齦溝液,并記錄收集齦溝液所需的時(shí)間(GCFtime),于室溫下,將收集到齦溝液的濾紙置于PBS緩沖液中震蕩一個小時(shí),后于1000r/min的離心機(jī)中離心5分鐘(min),取上清液于EP管中,放置于-70度冰箱中保存。取完齦溝液的患者進(jìn)行牙周基礎(chǔ)治療,即超聲波潔治和齦下刮治根面平整,選擇每一個患者的右側(cè)位點(diǎn)在基礎(chǔ)治療后使用鹽酸米諾環(huán)素(派力奧)藥物局部輔助治療,左側(cè)不用藥,每周用藥一次,共用藥四次�；A(chǔ)治療后約6周后,對患者進(jìn)行同樣位點(diǎn)的牙周臨床檢查,記錄所需牙周指標(biāo),和同樣方法的治療后取樣。約半年后,收集完畢所有患者治療前后的齦溝液,取出所有保存樣品,于室溫下升溫至室溫。采用酶聯(lián)免疫法(ELISA法)測量樣品PGE2和EA的濃度,用spss13.0配對樣品T檢驗(yàn)對實(shí)驗(yàn)結(jié)果進(jìn)行數(shù)據(jù)分析。 結(jié)果：治療后的PD, AL,GI均較治療前明顯降低,結(jié)果有統(tǒng)計(jì)學(xué)意義(P0.01)；治療后的GCFtime較治療前明顯延長,結(jié)果有統(tǒng)計(jì)學(xué)意義(P0.01)；而治療前后的PD, AL, GI, GCFtime的用藥側(cè)治療前后的差值和非用藥側(cè)治療前后的差值對比則無明顯差別(P0.05)；對于齦溝液EA,牙周基礎(chǔ)治療后,用藥側(cè)和非用藥側(cè)水平均較治療前明顯降低,結(jié)果有統(tǒng)計(jì)學(xué)意義(P0.01)；但用藥側(cè)在治療前后的差值與非用藥側(cè)在治療前后的差值對比無明顯差異,經(jīng)統(tǒng)計(jì)學(xué)分析,結(jié)果無統(tǒng)計(jì)學(xué)意義(P0.05)；對于PGE2,牙周基礎(chǔ)治療后,用藥側(cè)和非用藥側(cè)水平也分別較治療前明顯降低,結(jié)果有統(tǒng)計(jì)學(xué)意義(P0.01)；但用藥側(cè)在治療前后的差值與非用藥側(cè)在治療前后的差值對比無明顯差異,經(jīng)統(tǒng)計(jì)學(xué)分析,結(jié)果無統(tǒng)計(jì)學(xué)意義(P0.05)。 結(jié)論：對于慢性牙周炎患者,牙周基礎(chǔ)治療可有效降低齦溝液中PGE2和EA的濃度水平,這兩種因子也可以作為評價(jià)牙周病嚴(yán)重程度和基礎(chǔ)治療效果的參考標(biāo)準(zhǔn),然而鹽酸米諾環(huán)素對牙周臨床指標(biāo)和兩種因子在齦溝液中濃度無明顯影響,對牙周炎的治療為輔助作用。
[Abstract]:Objective: to compare the changes of the levels of elastase EAA and PGE2 in gingival crevicular fluid before and after basic periodontal treatment in patients with chronic periodontitis and the effect of minocycline hydrochloride drug adjuvant therapy on the two factors in gingival crevicular fluid.Methods: Twenty-five patients with periodontitis were selected according to the criteria of periodontal bag depth and loss of attachment above 1mm if there were more than 5 loci in the left and right halves, and 3 sites in the left and right halves, respectively.Periodontal clinical examination was performed on the selected sites, the depth of probing was recorded, the attachment loss of ALP, the gingival index (GI), the equivalent amount of gingival crevicular fluid at the selected sites were collected with filter paper, and the time required to collect gingival crevicular fluid was recorded, and at room temperature, the time required to collect gingival crevicular fluid was recorded.The filter paper collected from gingival crevicular fluid was placed in PBS buffer for one hour, then centrifuged in 1000r/min centrifuge for 5 minutes. The supernatant was collected in EP tube and stored in -70 degree refrigerator.Patients with gingival crevicular fluid were treated with basic periodontal therapy, namely ultrasonic scaling and subgingival curettage, and the right side of each patient was selected to receive local adjuvant therapy with minocycline hydrochloride (pariac) after basic treatment.The left side did not use drugs, once a week, a total of four times.After 6 weeks of basic treatment, periodontal clinical examination at the same site was performed, the required periodontal indexes were recorded, and samples were taken after the same treatment.After about half a year, the gingival crevicular fluid was collected from all patients before and after treatment, and all preserved samples were taken out and heated to room temperature at room temperature.The concentrations of PGE2 and EA were measured by Elisa. The experimental data were analyzed by spss13.0 paired sample T test.Results: after treatment, the PDand Algai were significantly lower than those before treatment, the results were statistically significant (P 0.01), and the GCFtime after treatment was significantly longer than that before treatment.The results showed that there was no significant difference in the difference between the two sides before and after treatment (P 0.05), and in the gingival crevicular fluid (EAA), after basic periodontal treatment, there was no significant difference between the difference before and after the treatment and the difference between the two sides before and after treatment (P 0.05), while the difference between the two sides before and after treatment was not significant (P 0.05).The level of drug side and non drug side were significantly lower than those before and after treatment, the results were statistically significant (P 0.01), but there was no significant difference between the drug side before and after treatment and the non-medication side before and after treatment.Results there was no statistical significance (P 0.05). For PGE2, the levels of the drug side and the non-medication side were significantly lower than those before the treatment.Results there was no significant difference in the difference between the drug side before and after treatment and that of the non-medication side before and after treatment, but there was no significant difference in the difference between the drug side and the non-medication side before and after treatment. The results showed that there was no significant difference in the difference between the drug side and the non-medication side before and after treatment.Conclusion: for patients with chronic periodontitis, periodontal basic therapy can effectively reduce the concentration of PGE2 and EA in gingival crevicular fluid. These two factors can also be used as reference criteria for evaluating the severity of periodontal disease and the effect of basic treatment.However, minocycline hydrochloride has no effect on periodontal clinical indexes and two factors in gingival crevicular fluid.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R781.4

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