本文選題：慢性牙周炎 + 2型糖尿病　； 參考：《青島大學(xué)》2017年碩士論文

【摘要】：目的慢性牙周炎與2型糖尿病(T2DM)之間關(guān)系密切,備受世界矚目。牙周炎可增加T2DM等系統(tǒng)性疾病的易感性,而T2DM同時(shí)也是牙周病的重要危險(xiǎn)因素之一。T2DM與慢性牙周炎不僅在作用機(jī)制上相互聯(lián)系,在治療效果上也相互影響。本研究的目的在于觀察伴T2DM的牙周炎患者在不改變其原定的血糖控制方案的前提下,經(jīng)規(guī)范化牙周基礎(chǔ)治療后臨床牙周指數(shù)及空腹血糖水平的變化,分析其治療效果,為臨床該類患者的治療提供理論指導(dǎo)和實(shí)踐依據(jù)。方法1.按納入排除標(biāo)準(zhǔn),收集2014年到2016年在青島大學(xué)附屬醫(yī)院牙周科及內(nèi)分泌科就診伴2型糖尿病的慢性牙周炎患者30例,年齡分布45—60歲之間,分為兩組,對(duì)照組和實(shí)驗(yàn)組,每組15例。2.對(duì)照組:僅行原定血糖控制(飲食、降糖藥或胰島素注射等)方案,不進(jìn)行牙周基礎(chǔ)治療。實(shí)驗(yàn)組:采用原定血糖控制和規(guī)范的牙周基礎(chǔ)治療。牙周檢查和規(guī)范化牙周基礎(chǔ)治療由口腔科同一研究生大夫進(jìn)行,并且由牙周科同一老師指導(dǎo)。進(jìn)行一致性檢驗(yàn)。儀器使用法國(guó)賽特利P5超聲潔牙設(shè)備與美國(guó)Hu-Friedy、手工Gracey刮治器械進(jìn)行系統(tǒng)化牙周基礎(chǔ)治療,使用UNC-15牙周探針進(jìn)行常規(guī)臨床探診。3.觀察時(shí)間為3個(gè)月,測(cè)量?jī)山M治療前后的空腹血糖水平及牙周指數(shù)(PD、BI)的數(shù)值變化,使用SPSS17.0軟件處理數(shù)據(jù)。性別進(jìn)行卡方檢驗(yàn),年齡進(jìn)行t檢驗(yàn);實(shí)驗(yàn)組和對(duì)照組治療前的血糖水平、PD、BI的組間比較及兩組治療后的血糖水平、PD、BI的組間比較,用獨(dú)立樣本t檢驗(yàn)的統(tǒng)計(jì)學(xué)方法進(jìn)行比較。結(jié)果1.實(shí)驗(yàn)組和對(duì)照組年齡、性別比較,無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。2.臨床觀察,實(shí)驗(yàn)組牙周基礎(chǔ)治療前后,牙齦色形質(zhì)明顯改善,臨床牙周狀況顯著改善。治療前,實(shí)驗(yàn)組和對(duì)照組的PD、BI分別進(jìn)行組間比較,無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);治療3個(gè)月后,兩組PD、BI分別行組間比較,有統(tǒng)計(jì)學(xué)意義(P0.05)。3.治療前,兩組血糖水平比較,P=0.747,無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);牙周基礎(chǔ)治療3月后,兩組之間血糖水平比較,P=0.035,有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論本臨床研究中,實(shí)驗(yàn)組患者經(jīng)規(guī)范化系統(tǒng)化牙周基礎(chǔ)治療后,臨床牙周狀況明顯改善,說(shuō)明牙周基礎(chǔ)治療有助于T2DM患者牙周炎癥的控制。兩組治療3月后的血糖水平比較,說(shuō)明牙周基礎(chǔ)治療有助于伴T2DM的牙周炎患者的血糖控制及改善。提示臨床上對(duì)于T2DM患者的血糖控制,除常規(guī)血糖控制措施(如飲食、藥物、胰島素注射等)外,應(yīng)進(jìn)行口腔牙周檢查,對(duì)于確診聯(lián)合牙周炎的患者需采取積極地規(guī)范化牙周基礎(chǔ)治療,以改善患者的血糖水平。尤其對(duì)于血糖水平反復(fù)控制不佳的T2DM患者,更應(yīng)進(jìn)一步考慮進(jìn)行口腔檢查,必要時(shí)采取牙周治療。
[Abstract]:Objective to study the relationship between chronic periodontitis and type 2 diabetes mellitus (T 2 DM).Periodontitis can increase the susceptibility of T2DM and other systemic diseases, and T2DM is also one of the important risk factors of periodontal disease. T2DM and chronic periodontitis are not only related to each other in the mechanism of action, but also affect each other in the treatment of periodontitis.The purpose of this study was to observe the changes of clinical periodontal index and fasting blood glucose level in periodontitis patients with T2DM without changing their original blood glucose control program, and to analyze the therapeutic effect.To provide theoretical guidance and practical basis for the treatment of this kind of patients.Method 1.According to the exclusion criteria, 30 cases of chronic periodontitis with type 2 diabetes, aged 45-60 years, were collected from the periodontal Department and Endocrinology Department, affiliated Hospital of Qingdao University from 2014 to 2016. They were divided into two groups: control group and experimental group.There were 15 cases in each group.Control group: only the original blood glucose control (diet, hypoglycemic drugs or insulin injection, etc.), no periodontal basic treatment.Experimental group: blood glucose control and standard periodontal basic treatment.Periodontal examination and standardized periodontal basic treatment were conducted by the same graduate doctor in stomatology and directed by the same teacher in periodontal department.Check the conformance.The fasting blood glucose and periodontal index (PDBI) were measured before and after treatment, and the data were processed by SPSS17.0 software.Result 1.There was no significant difference in age and sex between the experimental group and the control group (P 0.05. 2).Clinical observation showed that the gingival chromophores and clinical periodontal status of the experimental group were significantly improved before and after basic periodontal treatment.Before treatment, the PDBI of the experimental group and the control group were compared between the groups without statistical significance (P0.05), and after 3 months of treatment, the PDBI of the two groups were compared with each other (P 0.05). 3.Before treatment, the blood glucose levels of the two groups were significantly higher than that of the control group (P = 0.747), no significant difference was found between the two groups (P 0.05), and the blood glucose level was significantly higher than that of the control group (P = 0.035) after three months of basic periodontal treatment.Conclusion in this clinical study, the clinical periodontal status of the patients in the experimental group was obviously improved after standardized systematic periodontal basic treatment, which indicated that the basic periodontal treatment was helpful to the control of periodontitis in patients with T2DM.The comparison of blood glucose levels between the two groups after 3 months showed that periodontal basic therapy was helpful to the control and improvement of blood glucose in patients with periodontitis with T2DM.It is suggested that oral periodontal examination should be carried out in addition to routine blood glucose control measures (such as diet, drugs, insulin injection, etc.) for the control of blood glucose in patients with T2DM.In order to improve the blood glucose level of patients with periodontitis, we should take active standardized periodontal basic treatment.Especially for patients with T2DM whose blood glucose level is not well controlled repeatedly, we should further consider oral examination and periodontal treatment if necessary.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R781.4;R587.1

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