【摘要】 目的 探讨铒，铬：钇-钪-镓-石榴石（erbium, chromium:yttrium-scandium gallium-garnet,Er,Cr∶YSGG）激光联合头孢拉定胶囊在慢性牙周炎中的治疗效果。方法 选择2018年8月至2021年5月，慢性牙周炎患者104例的临床资料，按照随机数字表法分成研究组和对照组，每组患者52例。两组均先进行牙周基础治疗后，对照组口服头孢拉定胶囊治疗，2粒/次，3次/d,5d为1个疗程，共用药5d；研究组采用Er,Cr∶YSGG激光联合头孢拉定胶囊治疗，激光治疗参数：频率为30～40 Hz，功率0.5～1.5 W，治疗1次。采用门诊随访的方式，患者于治疗后6周复查，评估两组临床疗效。记录治疗前及治疗后6周的牙菌斑指数（plaque index,PLI）、牙周探诊深度（probing depth,PD）、龈沟出血指数（sulcus bleeding index,SBI）、临床附着丧失（clinical attachment loss,CAL）、口气感官值（organoleptic score,OS）、挥发性硫化物（volatile sulfur compounds,VSCs）及龈沟液中基质金属蛋白酶-3(matrix metalloproteinase3,MMP-3)、基质金属蛋白酶-9(matrix metalloproteinase 9,MMP-9)、巨噬细胞移动抑制因子（mcrophoge migration inhibitory factor,MIF）、高迁移率族蛋白-1(high mobility group box-1,HMGB-1)水平。利用汉化Kayser-Jones简明口腔健康检查表（brief oral health status examination,BOHSE）评估患者口腔健康的相关生活质量，并记录两组患者不良反应发生率。结果 治疗后6周，研究组总有效率（94.2%）高于对照组（80.8%），两组比较差异具有统计学意义（P<0.05）。两组治疗后6周PLI、PD、SBI、CAL、OS、VSCs，龈沟液中MMP-3、MMP-9、MIF、HMGB-1水平以及BOHSE评分均低于治疗前，且研究组各项观察指标均低于对照组（P<0.05）。研究组和对照组不良反应发生率分别为15.4%、9.62%，两组比较差异无统计学意义（P>0.05）。结论 慢性牙周炎患者经Er,Cr∶YSGG激光联合头孢拉定治疗可减轻炎症，提升临床疗效，进一步改善了口腔健康状况，安全性高。更多还原

【Abstract】 Objective To investigate the therapeutic effect to treat chronic periodontitis jointly with erbium,chromium:yttrium-scandium gallium-garnet(Er,Cr:YSGG) laser and cefradine capsule.Methods Totally 104 patients with chronic periodontitis treated during the period from Aug.2018 to May 2021 were selected and divided randomly into a study group and control group,52 patients in each group.After basic periodontal treatment,the patients in the control group were given cefradine capsules orally for a course of treatment(5 days),2 capsules each time,3 times a day,and the patients in the study group were treated once with Er,Cr:YSGG laser in addition(power 0.5～1.5 W).The patients in both groups were followed up 6 weeks after the treatment to evaluate the clinical efficacy.Their plaque index(PLI),probing depth(PD),sulcus bleeding index(SBI),clinical attachment loss(CAL),organoleptic score(OS),volatile sulfur compounds(VSCs),matrix metalloproteinase 3(MMP-3),matrix metalloproteinase 9(MMP-9),marophage migration inhibitory factor(MIF) and high mobility group box-1(HMGB-1) levels were recorded respectively before and 6 weeks after the treatment.Their oral health quality of life was assessed with brief oral health status examination(BOHSE),and the incidence of adverse reactions of the two groups was recorded.Results Six weeks after the treatment,the total effective rate(94.2%) of the study group was higher than that(80.8%) of the control group,and the difference between the two groups was statistically significant(P<0.05).Moreover,the PLI,PD,SBI,CAL,OS and VSCs and the levels of MMP-3,MMP-9,MIF and HMGB-1 and the BOHSE score in gingival crevicular fluid were lower than those before the treatment in both groups,and all the observation indexes were lower in the study group than in the control group(P<0.05).The incidence of adverse reactions was 15.4% in the study group and 9.62% in the control group respectively,and there was no significant difference between the two groups(P>0.05).Conclusions Treating chronic periodontitis jointly with Er,Cr:YSGG laser and cefradine will reduce inflammation,improve clinical efficacy and further improve oral health while being fairly safe.更多还原