论文部分内容阅读
目的系统评价抗生素辅助牙周非手术治疗对侵袭性牙周炎患者的临床疗效。方法计算机检索PubMed、EMbase、The Cochrane Library(2016年1期)、WanFang Data、CBM、VIP和CNKI数据库,搜集抗生素辅助牙周非手术治疗侵袭性牙周炎的相关随机对照试验(RCT),检索时限均为建库至2016年1月。由2位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软件进行Meta分析。结果最终纳入8个RCT,共236名侵袭性牙周炎患者。Meta分析结果显示:抗生素辅助牙周非手术治疗相较于单纯牙周非手术治疗,不仅能改善患者3个月、6个月和12个月的牙周探诊深度[3个月:MD=0.33,95%CI(0.25,0.41),P<0.000 01;6个月:MD=0.53,95%CI(0.44,0.62),P<0.000 01;12个月:MD=0.52,95%CI(0.23,0.81),P=0.000 4],还能改善患者3个月、6个月和12个月的临床附着丧失[3个月:MD=0.43,95%CI(0.30,0.56),P<0.000 01;6个月:MD=0.44,95%CI(0.33,0.55),P<0.000 01;12个月:MD=0.43,95%CI(0.20,0.65),P=0.000 2]。结论现有证据表明,牙周非手术治疗辅助使用抗生素(甲硝唑和阿莫西林)治疗侵袭性牙周炎可获得更好的临床疗效。但受纳入研究数量和质量的限制,上述结论可能存在偏倚,需开展更多高质量研究予以验证。
Objective To evaluate the clinical efficacy of antibiotic-assisted periodontal non-surgical treatment of patients with aggressive periodontitis. Methods The databases of PubMed, EMbase, The Cochrane Library (2016 1), WanFang Data, CBM, VIP and CNKI were searched by computer. Randomized controlled trials (RCTs) were conducted to investigate the effect of antibiotic-assisted periodontal non-surgical therapy on aggressive periodontitis. The time limit is to build the library until January 2016. After two independent reviewers screened the literature, extracted data and assessed the risk of being included in the study, Meta-analysis was performed using RevMan 5.3 software. The results eventually included 8 RCTs, a total of 236 patients with aggressive periodontitis. Meta-analysis showed that antibiotic-assisted periodontal non-surgical treatment compared with simple periodontal non-surgical treatment not only improved the periodontal exploration depth of patients at 3 months, 6 months and 12 months [3 months: MD = P <0.000 01; 6 months: MD = 0.53, 95% CI (0.44, 0.62), P <0.000 01; 12 months: MD = 0.52, 95% CI (0.25, 0.41) 0.23, 0.81), P = 0.0004], and also improved the patients with clinical attachment loss at 3 months, 6 months and 12 months [3 months: MD = 0.43,95% CI 0.30,0.56, P < 0.000 01; 6 months: MD = 0.44, 95% CI (0.33, 0.55), P <0.000 01; 12 months: MD = 0.43, 95% CI (0.20, 0.65), P = 0.0002]. CONCLUSIONS Current evidence suggests that periodontal non-surgical adjuvant antibiotics (metronidazole and amoxicillin) may achieve better clinical outcomes in the treatment of aggressive periodontitis. However, due to the limited number and quality of studies involved, the above conclusions may be biased and more high-quality studies are needed to verify them.