盐酸米诺环素联合翻瓣术辅助治疗慢性牙周炎疗效的Meta分析

doi:10.7518/hxkq.2018.04.013

华西口腔医学杂志 ›› 2018, Vol. 36 ›› Issue (4): 421-427.doi: 10.7518/hxkq.2018.04.013

盐酸米诺环素联合翻瓣术辅助治疗慢性牙周炎疗效的Meta分析

白远亮^1,²(), 郑苔菁^2,³, 张芷玮^1,⁴, 甘祎^2,⁴, 黄姣^1,²()

1.重庆医科大学附属口腔医院牙周科
2.口腔疾病与生物医学重庆市重点实验室,重庆 400015
3.重庆医科大学附属第一医院口腔科,重庆 400016
4.重庆医科大学重庆市高校市级口腔生物医学工程重点实验室,重庆 400015

收稿日期:2018-03-05 修回日期:2018-05-13 出版日期:2018-08-01 发布日期:2018-08-01
作者简介:
白远亮,住院医师,硕士,E-mail：444588059@qq.com
基金资助:
重庆市卫计委重点资助课题（2015ZDXM018）;重庆高校创新团队建设计划资助课题（CXTDG201602006）

Efficacy of minocycline hydrochloride combined with flap surgery for chronic periodontitis: a Meta-analysis

Yuanliang Bai^1,²(), Taijing Zheng^2,³, Zhiwei Zhang^1,⁴, Yi Gan^2,⁴, Jiao Huang^1,²()

1. Dept. of Periodontics, Affiliated Stomatology Hospital, Chongqing Medical University, Chongqing 400015, China
2. Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 400015, China
3. Dept. of Stomatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
4. Chongqing Medical University, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 400015, China

Received:2018-03-05 Revised:2018-05-13 Online:2018-08-01 Published:2018-08-01
Supported by:
Key Funding Projects of Chongqing Municipal Health Planning Commission (2015ZDXM018);Project Support Project of Innovation Team Construction in Chongqing University (CXTDG201602006)

摘要/Abstract

摘要：

目的系统评价牙周翻瓣术中使用2%盐酸米诺环素处理根面的疗效,为其治疗慢性牙周炎提供循证医学证据。方法检索中国期刊全文数据库、维普、万方、中国生物医学文献数据库、PubMed、ScienceDirect和Embase等数据库,检索时限为从建库到2017年7月。由2名评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3对数据进行Meta分析。结果最终纳入7个随机对照实验,共217例受试者。Meta分析结果显示,与单纯翻瓣术（FO）组比较,盐酸米诺环素联合翻瓣术（FM）组患者随访3个月时的探诊深度减少[MD=-0.55,95%CI（-0.84,-0.26）,P=0.000 2],菌斑指数降低[MD=-0.08,95%CI（-0.15,-0.01）,P=0.03],随访6个月时探诊深度减少[MD=-0.62,95%CI（-1.04,-0.21）,P=0.003]方面更加明显,组间比较差异有统计学意义（P<0.05）。FM组患者随访3个月时在临床附着丧失获得[MD=-0.21,95%CI（-0.47,0.04）,P=0.10]方面改变的差异无统计学意义（P>0.05）。结论在翻瓣下机械清创治疗慢性牙周炎中,使用2%盐酸米诺环素处理根面减少探诊深度和炎症控制方面有明显的效果。

关键词: 盐酸米诺环素, 慢性牙周炎, 翻瓣术, 根面处理, Meta分析

Abstract:

Objective This study aimed to evaluate the efficacy of 2% minocycline hydrochloride combined with flap surgery in the treatment of chronic periodontitis. The superiority of this therapy to simple flap surgery was also explored. Methods We searched the databases of CNKI, VIP, Wanfang, Chinese Biomedical Literature, PubMed, ScienceDirect, and Embase from inception to July 2017. Two reviewers independently screened literature, extracted data, and evaluated the bias risk of included studies. Then, Meta-analysis was performed using RevMan 5.3 software. Results A total of seven randomized controlled trials involving 217 patients were included. Meta-analysis showed that, in two groups, the changes in probing depth (PD) [MD=-0.55, 95%CI (-0.84, -0.26), P=0.000 2] and plaque index [MD=-0.08, 95%CI (-0.15, -0.01), P=0.03] at 3 and 6 months of PD [MD=-0.62, 95%CI (-1.04, -0.21), P=0.003] had statistically significant difference (P<0.05). The clinical attachment loss (CAL) [MD=-0.21, 95%CI (-0.47, 0.04), P=0.10] had no statistically significant difference after 3 months (P>0.05), but the improvement in CAL was significantly improved by minocycline hydrochloride combined with flap therapy. Conclusion Periodontal flap combined with minocycline adjuvant therapy for chronic periodontitis is effective in short-term observations.

Key words: minocycline hydrochloride, chronic periodontitis, flap surgery, Meta-analysis

中图分类号:

R782

白远亮, 郑苔菁, 张芷玮, 甘祎, 黄姣. 盐酸米诺环素联合翻瓣术辅助治疗慢性牙周炎疗效的Meta分析[J]. 华西口腔医学杂志, 2018, 36(4): 421-427.

Yuanliang Bai, Taijing Zheng, Zhiwei Zhang, Yi Gan, Jiao Huang. Efficacy of minocycline hydrochloride combined with flap surgery for chronic periodontitis: a Meta-analysis[J]. West China Journal of Stomatology, 2018, 36(4): 421-427.

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参考文献 34

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纳入研究	例数（T/C）	年龄/岁	干预措施		随访时间/月	纳入时PD/mm	主要结局指标
纳入研究	例数（T/C）	年龄/岁	T	C	随访时间/月	纳入时PD/mm	主要结局指标
王岩等^[23]	8/7	35~72	FM+SRP	FO+SRP	3	≥5	PD+CAL+PI
李启艳等^[19]	13/13	40~56	FM+SRP	FO+SRP	6	≥5	PD+CAL
赵曼等^[21]	8/7	35~72	FM+SRP	FO+SRP	3	≥5	PD+CAL+PI
葛少华等^[22]	23/23	36~64	FM+SRP	FO+SRP	3	5≤PD≤10	PD +PI
粟立平^[18]	8/7	35~72	FM+SRP	FO+SRP	3	≥5	PD+CAL+PI
Abbas等^[20]	30/30	30~50	FM+SRP	FO+SRP	6	≥6	PD+CAL+PI
Jung等^[24]	20/20	43~69	FM+SRP	FO+SRP	6	≥6	PD+CAL+PI

纳入研究	随机方法	盲法	分配隐藏	结果数据的完整性	选择性报告研究结果	其他偏倚来源
王岩等^[23]	随机数字	不清楚	是	完整	否	不清楚
李启艳等^[19]	随机数字	不清楚	是	完整	否	不清楚
赵曼等^[21]	随机数字	不清楚	是	完整	否	不清楚
葛少华等^[22]	不清楚	双盲	是	完整	否	不清楚
粟立平^[18]	随机数字	不清楚	不清楚	完整	否	不清楚
Abbas等^[20]	丢硬币	是	是	完整	否	不清楚
Jung等^[24]	不清楚	双盲	是	完整	否	不清楚

盐酸米诺环素联合翻瓣术辅助治疗慢性牙周炎疗效的Meta分析

Efficacy of minocycline hydrochloride combined with flap surgery for chronic periodontitis: a Meta-analysis

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