目的 利用鹽酸米諾環(huán)素對(duì)2型糖尿病牙周病進(jìn)行輔助治療，以探討其臨床療效和作用機(jī)制。方法 選取2012年3月-2014年3月中國人民解放軍空軍總醫(yī)院口腔科就診的2型糖尿病合并牙周炎患者86例隨機(jī)分組，其中，治療組43例（91牙），對(duì)照組43例（87牙）。對(duì)照組進(jìn)行口腔齦上潔治術(shù)后使用濃替硝唑含漱液5 mL，保留2 min后吐出，并進(jìn)行齦下刮治術(shù)。治療組在對(duì)照組基礎(chǔ)上，刮治完畢后將鹽酸米諾環(huán)素?cái)D入牙周袋內(nèi)至溢出為止，1次/周，連續(xù)治療4周。治療結(jié)束后，比較兩組的臨床療效，并檢測兩組治療前后牙周指數(shù)、IL-Iβ和MMP-3的變化情況。結(jié)果 治療組和對(duì)照組的總有效率分別為85.71%、66.67%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.01）。治療后兩組患者菌斑指數(shù)、出血指數(shù)、牙周袋深度和附著喪失均較治療前明顯改善，同組治療前后差異有統(tǒng)計(jì)學(xué)意義（P<0.01）；治療后，治療組各指標(biāo)均優(yōu)于對(duì)照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05，0.01）。治療后兩組患者齦溝液量、IL-Iβ、MMP-3水平均較治療前明顯減少，同組治療前后差異有統(tǒng)計(jì)學(xué)意義（P<0.01）；治療后，治療組齦溝液量、IL-Iβ與對(duì)照組相比差異有統(tǒng)計(jì)學(xué)意義（P<0.01）。結(jié)論 鹽酸米諾環(huán)素能夠改善2型糖尿病合并牙周病患者的炎性因子水平，提高臨床治療效果，值得臨床推廣應(yīng)用。

Objective To investigate the clinical effect and mechanism of action of minocycline as an auxiliary therapy on type 2 diabetes with periodontal disease. Methods Eighty six patients with diabetes with periodontal disease picked up from Stomatological Department of Air Force General Hospital of PLA during March 2012 to March 2013 were randomly divided into two groups, 43 cases (91 teeth) as experimental group, 43 cases (87 teeth) as control group. The patients in the control group was using 5 mL tinidazole gargles after dental subgingval scaling, spited after 2 min, and then given subgingival scaling. The patients in the experimental group were put minocycliene hydrochloride in periodontal pockets till overflow after scaling, 1 time/week for 4 weeks. Periodontal index, IL-I β, and MMP-3 and clinical curative effect were compared before and after the treatment. Results Efficiency to the patients of the experimental and control groups were 85.71% and 66.67%, there was significant difference between the two groups (P<0.01). Plaque index, bleeding index, probing depth, and attachment loss of the patients in the experimental group after the treatment was better than those in the control group, the difference has statistical significance (P<0.01). The indexes of the patients in the experimental group were better than those in the control group, the difference had statistical significance (P<0.05, 0.01). The content of the gingival crevicular fluid, IL-I β, and MMP-3 levels in the two groups after the treatment reduced significantly, and there was a significant difference before and after the treatment on the same group (P<0.01). The contents of the gingival crevicular fluid and IL-I β had the significant difference to those in the control group after the treatment (P<0.01). Conclusion Minocycline hydrochloride can improve the levels of inflammatory factors in the patients with type 2 diabetes mellitus and periodontal disease, improve the clinical therapeutic effect, worthy of clinical popularization and application.