局部應用派麗奧與牙康比較治療成人慢性牙周炎的Meta分析_《中國循證醫學雜志》

作者：

李思敏 ,  郭良微 , 丁玲

哈爾濱醫科大學附屬口腔醫院牙周病科（哈爾濱 150001）;

關鍵詞：

米諾環素甲硝唑牙周炎系統評價 Meta分析隨機對照試驗

DOI：

10.7507/1672-2531.20130038

視頻：

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目的　系統評價局部應用派麗奧（2%鹽酸米諾環素軟膏）與牙康（甲硝唑棒）比較治療成人慢性牙周炎的臨床療效。
方法　計算機檢索PubMed、The Cochrane Library、EMbase、CNKI、CBM和WanFang Data數據庫，查找派麗奧與牙康比較治療慢性牙周炎的隨機對照試驗（RCT），并追溯納入文獻的參考文獻，文獻檢索時限均從建庫至2012年7月。由2名評價員按照納入和排除標準獨立進行文獻篩選、資料提取和評價納入研究的方法學質量后，采用RevMan 5.0軟件進行Meta分析。
結果　最終納入7個RCT，737例受試者。Meta分析結果顯示：治療后兩組在探診深度［MD=0.26，95%CI（–0.35，0.87），P=0.40］、臨床附著水平［MD=–0.10，95%CI（–0.75，0.54），P=0.75］、齦溝出血指數［MD=0.12，95%CI（–0.30，0.53），P=0.59］和菌斑指數［MD=0.07，95%CI（–0.09，0.22），P=0.41］的改變方面，差異均無統計學意義。
結論　現有研究證據表明，在牙周基礎治療后，局部應用派麗奧和牙康治療慢性牙周炎的療效無顯著差異。但由于納入研究的方法學質量均欠佳，且樣本量有限，因此本系統評價結論尚需開展更多設計嚴謹的高質量、大樣本RCT進一步驗證，并盡可能延長隨訪時間以觀察長期療效。

引用本文： 李思敏,郭良微,丁玲. 局部應用派麗奧與牙康比較治療成人慢性牙周炎的Meta分析. 中國循證醫學雜志, 2013, 13(2): 224-230. doi: 10.7507/1672-2531.20130038 復制

1.	Miani PK, do Nascimento C, Sato S, et al. In vivo evaluation of a metronidazole-containing gel for the adjuvant treatment of chronic periodontitis: preliminary results. Eur J Clin Microbiol Infect Dis, 2012, 31(7): 1611-1618.
2.	Ribeiro Edel P, Bittencourt S, Zanin IC, et al. Full-mouth ultrasonic debridement associated with amoxicillin and metronidazole in the treatment of severe chronic periodontitis. J Periodontol, 2009, 80(8):1254-1264.
3.	Sedlacek MJ, Walker C. Antibiotic resistence in an in vitro subgingival biofilm model. Oral Microbiol Immunol, 2007, 22(5): 333-339.
4.	Zandbergen D, Slot DE, Cobb CM, et al. The clinical effect of scaling and root planing and the concomitant administration of systemic amoxicillin and metronidazole: a systematic review. J Periodontal, 2012, 83(5): 1-29.
5.	Bogren A, Teles RP, Torresyap G, et al. Locally delivered doxycycline during supportive periodontal therapy: a 3-year study. J Periodontal, 2008, 79(5): 827-835.
6.	Paolantonio M, D’ Ercole S, Pilloni A, et al. Clinical, microbiologic, and biochemical effects of subgingival administration of a Xanthan-based chlorhexidine gel in the treatment of periodontitis: a randomized multicenter trial. J Periodontol, 2009, 80(9): 1479-1492.
7.	Singh S, Roy S, Chumber SK. Evaluation of two local drug delivery systems as adjuncts to mechanotherapy as compared to mechanotherapy alone in management of chronic periodontitis: A clinical, microbiological, and molecular study. J Indian Soc Periodontol, 2009, 13(3): 126-132.
8.	Colombo AP, Bennet S, Cotton SL, et al. Impact of periodontal therapy on the subgingival microbiota of severe periodontitis: comparison between good responders and individuals with refractory periodontitis using the human oral microbe identification microarray. J Periodontol, 2012, 83(10): 1279-1287.
9.	Rizzo A, Paolillo R, Guida L, et al. Effect of metronidazole and modulation of cytokine production on human periodontal ligament cells. Int Immunopharmacol, 2010, 10(7): 744-750.
10.	Reise M, Wyrwa R, Müller U, et al. Release of metronidazole from electrospun poly (L-lactide-co-D/L-lactide) fibers for local periodontitis treatment. Dental Mater, 2012, 28(2): 179-188.
11.	Bruschi ML, Jones DS, Panzeri H, et al. Semisolid systems containing propolis for the treatment of periodontal disease: in vitro release kinetics, syringeability, rheological, textural, and mucoadhesive properties. J Pharm Sci, 2007, 96(8): 2074-2089.
12.	Sato S, Fonseca MJ, Ciampo JO, et al. Metronidazole-containing gel for the treatment of periodontitis: an in vivo evaluation. Braz Oral Res, 2008, 22(2): 145-150.
13.	Tiwari G, Tiwari R, Rai AK. Studies on development of controlled delivery of combination drug(s) to periodontal pocket. Indian J Dent Res, 2010, 21(1): 72-83.
14.	歐陽翔英. 牙周病的藥物治療. 見: 曹采方, 主編. 臨床牙周病學. 第1版. 北京: 北京大學醫學出版社, 2006: 280.
15.	孫穎, 吳亞菲. 米諾環素在牙周治療中的應用. 牙體牙髓牙周病學雜志, 2003, 13(11): 659-661.
16.	Yilmaz S, Kut B, Gursoy H, et al. Er: YAG laser versus systemic metronidazole as an adjunct to nonsurgical periodontal therapy: a clinical and microbiological study. Photomed Laser Surg, 2012, 30(6): 325-330.
17.	Silva MP, Feres M, Sirotto TA, et al. Clinical and microbiological benefits of metronidazole alone or with amoxicillin as adjuncts in the treatment of chronic periodontitis: a randomized placebo-controlled clinical trial. J Clin Periodontol, 2011, 38(9): 828-837.
18.	傅曉幼, 李國峰. 三種藥物對牙周炎的臨床療效研究. 南方醫科大學學報, 2010, 30(3): 611-613.
19.	張俊羽. 鹽酸米諾環素軟膏和甲硝唑棒治療慢性牙周病58例的療效比較. 廣西醫學, 2008, 30(2): 238-239.
20.	李綺文. 米諾環素輔助治療慢性牙周炎療效觀察. 中國現代藥物應用, 2008, 2(23): 67.
21.	梅雪. 鹽酸米諾環素軟膏、甲硝唑、碘甘油對牙周炎的效果觀察. 中國衛生產業, 2012, (6): 54-55.
22.	胡燕. 鹽酸米諾環素局部治療慢性牙周炎的臨床效果評價. 中國醫藥指南, 2011, 9(15): 228-230.
23.	鄒紅. 鹽酸米諾環素軟膏、甲硝唑、碘甘油對牙周炎的臨床效果觀察. 中國醫藥導報, 2011, 8(19): 67-68.
24.	陳家歡, 陳金萍, 張楠. 鹽酸米諾環素軟膏治療中重度慢性牙周炎臨床療效評價. 廣州醫藥, 2010, 41(2): 32-34.
25.	韓寧, 楊圣輝. 牙周病緩釋治療的進展. 北京口腔醫學, 2000, 8(2): 98-107.
26.	羅杰, 肖曉蓉, 劉琴, 等. 派麗奧局部應用治療牙周炎的療效評價. 西部醫學, 2008, 20(5): 1057-1059.
27.	李湘明. 甲硝唑聯合鹽酸米諾環素治療牙周炎的臨床觀察. 中國現代醫生, 2010, 48(21): 56-57.
28.	王聃, 鄧嘉胤. 牙周局部緩釋型制劑的研究現狀及應用進展. 中國組織工程研究與臨床康復. 2010, 14(8): 1437-1441.
29.	吳昊, 牛薇. 派麗奧與牙康局部治療牙周炎效果的Meta分析. 口腔醫學研究, 2012, 28(6): 563-569.

1. Miani PK, do Nascimento C, Sato S, et al. In vivo evaluation of a metronidazole-containing gel for the adjuvant treatment of chronic periodontitis: preliminary results. Eur J Clin Microbiol Infect Dis, 2012, 31(7): 1611-1618.
2. Ribeiro Edel P, Bittencourt S, Zanin IC, et al. Full-mouth ultrasonic debridement associated with amoxicillin and metronidazole in the treatment of severe chronic periodontitis. J Periodontol, 2009, 80(8):1254-1264.
3. Sedlacek MJ, Walker C. Antibiotic resistence in an in vitro subgingival biofilm model. Oral Microbiol Immunol, 2007, 22(5): 333-339.
4. Zandbergen D, Slot DE, Cobb CM, et al. The clinical effect of scaling and root planing and the concomitant administration of systemic amoxicillin and metronidazole: a systematic review. J Periodontal, 2012, 83(5): 1-29.
5. Bogren A, Teles RP, Torresyap G, et al. Locally delivered doxycycline during supportive periodontal therapy: a 3-year study. J Periodontal, 2008, 79(5): 827-835.
6. Paolantonio M, D’ Ercole S, Pilloni A, et al. Clinical, microbiologic, and biochemical effects of subgingival administration of a Xanthan-based chlorhexidine gel in the treatment of periodontitis: a randomized multicenter trial. J Periodontol, 2009, 80(9): 1479-1492.
7. Singh S, Roy S, Chumber SK. Evaluation of two local drug delivery systems as adjuncts to mechanotherapy as compared to mechanotherapy alone in management of chronic periodontitis: A clinical, microbiological, and molecular study. J Indian Soc Periodontol, 2009, 13(3): 126-132.
8. Colombo AP, Bennet S, Cotton SL, et al. Impact of periodontal therapy on the subgingival microbiota of severe periodontitis: comparison between good responders and individuals with refractory periodontitis using the human oral microbe identification microarray. J Periodontol, 2012, 83(10): 1279-1287.
9. Rizzo A, Paolillo R, Guida L, et al. Effect of metronidazole and modulation of cytokine production on human periodontal ligament cells. Int Immunopharmacol, 2010, 10(7): 744-750.
10. Reise M, Wyrwa R, Müller U, et al. Release of metronidazole from electrospun poly (L-lactide-co-D/L-lactide) fibers for local periodontitis treatment. Dental Mater, 2012, 28(2): 179-188.
11. Bruschi ML, Jones DS, Panzeri H, et al. Semisolid systems containing propolis for the treatment of periodontal disease: in vitro release kinetics, syringeability, rheological, textural, and mucoadhesive properties. J Pharm Sci, 2007, 96(8): 2074-2089.
12. Sato S, Fonseca MJ, Ciampo JO, et al. Metronidazole-containing gel for the treatment of periodontitis: an in vivo evaluation. Braz Oral Res, 2008, 22(2): 145-150.
13. Tiwari G, Tiwari R, Rai AK. Studies on development of controlled delivery of combination drug(s) to periodontal pocket. Indian J Dent Res, 2010, 21(1): 72-83.
14. 歐陽翔英. 牙周病的藥物治療. 見: 曹采方, 主編. 臨床牙周病學. 第1版. 北京: 北京大學醫學出版社, 2006: 280.
15. 孫穎, 吳亞菲. 米諾環素在牙周治療中的應用. 牙體牙髓牙周病學雜志, 2003, 13(11): 659-661.
16. Yilmaz S, Kut B, Gursoy H, et al. Er: YAG laser versus systemic metronidazole as an adjunct to nonsurgical periodontal therapy: a clinical and microbiological study. Photomed Laser Surg, 2012, 30(6): 325-330.
17. Silva MP, Feres M, Sirotto TA, et al. Clinical and microbiological benefits of metronidazole alone or with amoxicillin as adjuncts in the treatment of chronic periodontitis: a randomized placebo-controlled clinical trial. J Clin Periodontol, 2011, 38(9): 828-837.
18. 傅曉幼, 李國峰. 三種藥物對牙周炎的臨床療效研究. 南方醫科大學學報, 2010, 30(3): 611-613.
19. 張俊羽. 鹽酸米諾環素軟膏和甲硝唑棒治療慢性牙周病58例的療效比較. 廣西醫學, 2008, 30(2): 238-239.
20. 李綺文. 米諾環素輔助治療慢性牙周炎療效觀察. 中國現代藥物應用, 2008, 2(23): 67.
21. 梅雪. 鹽酸米諾環素軟膏、甲硝唑、碘甘油對牙周炎的效果觀察. 中國衛生產業, 2012, (6): 54-55.
22. 胡燕. 鹽酸米諾環素局部治療慢性牙周炎的臨床效果評價. 中國醫藥指南, 2011, 9(15): 228-230.
23. 鄒紅. 鹽酸米諾環素軟膏、甲硝唑、碘甘油對牙周炎的臨床效果觀察. 中國醫藥導報, 2011, 8(19): 67-68.
24. 陳家歡, 陳金萍, 張楠. 鹽酸米諾環素軟膏治療中重度慢性牙周炎臨床療效評價. 廣州醫藥, 2010, 41(2): 32-34.
25. 韓寧, 楊圣輝. 牙周病緩釋治療的進展. 北京口腔醫學, 2000, 8(2): 98-107.
26. 羅杰, 肖曉蓉, 劉琴, 等. 派麗奧局部應用治療牙周炎的療效評價. 西部醫學, 2008, 20(5): 1057-1059.
27. 李湘明. 甲硝唑聯合鹽酸米諾環素治療牙周炎的臨床觀察. 中國現代醫生, 2010, 48(21): 56-57.
28. 王聃, 鄧嘉胤. 牙周局部緩釋型制劑的研究現狀及應用進展. 中國組織工程研究與臨床康復. 2010, 14(8): 1437-1441.
29. 吳昊, 牛薇. 派麗奧與牙康局部治療牙周炎效果的Meta分析. 口腔醫學研究, 2012, 28(6): 563-569.

《中國循證醫學雜志》

局部應用派麗奧與牙康比較治療成人慢性牙周炎的Meta分析

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《中國循證醫學雜志》

局部應用派麗奧與牙康比較治療成人慢性牙周炎的Meta分析

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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