克拉霉素辅助治疗慢性牙周炎疗效的Meta分析

doi:10.7518/hxkq.2020.03.011

摘要/Abstract

摘要：

目的系统评价克拉霉素（CLM）辅助治疗慢性牙周炎的临床疗效,通过循证医学的方法得出合理的结论,为临床合理用药提供指导。方法计算机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等数据库有关CLM辅助治疗慢性牙周炎的文献,检索时间为从建库到2019年2月。由2名评价者独立筛选文献、评价文献质量、提取数据并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果最终纳入6个随机对照试验（RCT）,共316例受试者。Meta分析结果显示:与单纯龈下刮治和根面平整术（SRP）组相比,CLM联合SRP组患者探诊深度减少[MD=-1.00,95%CI（-1.55,-0.45）,P=0.000 04],临床附着丧失获得[MD=-0.03,95%CI（0.43,0.65）,P<0.000 01],组间相比差异有统计学意义。改良龈沟出血指数（mSBI）减少[MD=-0.01,95%CI（-0.14,0.19）,P=0.66] ,组间相比差异无统计学意义,但是SRP联合CLM组mSBI减少更显著。结论 CLM联合SRP在治疗慢性牙周炎中能够取得更好的效果。

关键词: 克拉霉素, 牙周非手术治疗, 慢性牙周炎, Meta分析

Abstract:

Objective To evaluate the clinical efficacy of clarithromycin (CLM) in the adjuvant treatment of chronic periodontitis systematically, obtain reasonable conclusions through evidence-based medicine, and provide guidance for clinical rational drug use. Methods Literature about CLM in the adjuvant treatment of chronic periodontitis was searched in CNKI, VIP, Wanfang, Chinese Biomedical Literature Database, PubMed, ScienceDirect, and Embase databases from inception to February 2019 using a computer. Meta-analysis was performed on the homogeneous study using RevMan 5.3 software after two independent reviewers screened the literature, evaluated the quality of the study, extracted the data, and evaluated the risk of bias in the included studies. Results Six randomized controlled trials were included in 316 subjects. The meta-analysis showed that compared with the scaling and root planning (SRP) group, the probing depth (PD) was reduced in patients with CLM and SRP [MD=-1.00, 95%CI (-1.55, -0.45), P=0.000 04]. Clinical attachment loss was obtained [MD=-0.03, 95%CI (0.43, 0.65), P<0.000 01], and the difference between the groups was statistically significant. The modified sulcus bleeding index (mSBI) was reduced [MD=-0.01, 95%CI (-0.14, 0.19), P=0.66]. No significant difference was observed between the groups, but the decrease in mSBI was more significant in CLM combined with SRP group. Conclusion CLM combined with subgingival SRP can achieve remarkable results in treating chronic periodontitist.

Key words: clarithromycin, non-surgical periodontal therapy, chronic periodontitis, Meta-analysis

中图分类号:

R781.4

柏银, 白远亮, 赖静, 黄姣. 克拉霉素辅助治疗慢性牙周炎疗效的Meta分析[J]. 华西口腔医学杂志, 2020, 38(3): 290-296.

Bai Yin, Bai Yuanliang, Lai Jing, Huang Jiao. Efficacy of clarithromycin in the adjuvant treatment of chronic periodontitis: a Meta-analysis[J]. West China Journal of Stomatology, 2020, 38(3): 290-296.

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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
Arora等^[16]	15/15	25~40	CLM+SRP	SRP	1	≥4	PD、CAL、PI、GI
Andere等^[17]	20/20	<35	CLM+SRP	SRP	6	>5	PD、CAL、BOP、FMPI
Bajaj等^[18]	29/27	30~50	CLM+SRP	SRP	6	≥5	PD、PAL、PI、GI、mSBI
Agarwal等^[19]	28/27	30~50	CLM+SRP	SRP	6	≥5	PD、CAL、PI、GI、mSBI
Kathariya等^[20]	50/48	25~50	CLM+SRP	SRP	3	≥5	PD、PAL、PI、GI、mSBI
Pradeep等^[21]	18/19	25~50	CLM+SRP	SRP	9	≥5	PD、CAL、GI

纳入研究	随机分组方法	分配隐藏	盲法	不完整结果数据	选择性报告结果	其他偏倚
Arora等^[16]	不清楚	是	双盲	否	否	不清楚
Andere等^[17]	随机数字	是	双盲	否	否	不清楚
Bajaj等^[18]	随机数字	是	双盲	否	否	不清楚
Agarwal等^[19]	随机数字	是	双盲	否	否	不清楚
Kathariya等^[20]	随机数字	是	双盲	否	否	不清楚
Pradeep等^[21]	随机数字	是	双盲	否	否	不清楚