[Influence of non-surgical periodontal treatment on the quality of life in chronic obstructive pulmonary disease patients with chronic periodontitis].

抄録

To evaluate the effects of periodontal therapy on the quality of life in chronic obstructive pulmonary disease (COPD) patients with chronic periodontitis (CP). In a randomized controlled pilot study, 60 COPD patients with CP were randomly assigned into three groups to receive scaling and root planing (SRP) treatment, supragingival scaling treatment and oral hygiene instructions only with no periodontal treatment, respectively. The scores of each patient's quality of life at baseline, 1 year and 2 years, respectively, were evaluated by using the standardized St George's respiratory questionnaire (SGRQ). The SGRQ was composed of three dimensions: symptoms, activity, and impact. A score was calculated for each section and a total summary score was also calculated. A high score indicated poor health and a decrease in the score indicates an improvement in quality of life. There were no statistically significant differences among the three groups for age, gender, body mass index, smoking status, lung funtion, periodontal parameters and the SGRQ scores (including total, symptoms, activity and impacts scores) among three groups at baseline (all 0.05). The SGRQ scores were all significantly correlated with major lung function parameters (=-0.54 --0.28). The result of ANCOVA analysis adjusted for the influence of baseline measurements showed that the total scores of two periodontal treatment groups were significantly lower (0.01) than that of control group at 2-year follow-up (SRP group: 31.1±12.1; scaling group: 28.9±9.8; control group: 46.5±24.9). The symptoms score of SRP group (45.4±19.7) was significantly lower (0.03) than that of control group (53.6±25.4) at 2-year follow-up. The impacts scores of two treatment groups were significantly lower (0.02) than that of control group at 2-year follow-up (SRP group: 15.2±8.3; scaling group: 14.9±7.7; control group: 34.8±18.8). Our preliminary results from this study suggest that non-surgical periodontal treatment in COPD patients with CP might improve the quality of life of the COPD patient.

观察牙周基础治疗对中重度慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）伴中重度慢性牙周炎患者生命质量的影响。 从首都医科大学附属北京朝阳医院呼吸科及口腔科2016年1至6月就诊的门诊患者中招募60例COPD伴慢性牙周炎患者。将受试者按计算机生成的随机数字表分为牙周刮治和根面平整（scaling and root planning，SRP）组、洁治组以及不做牙周治疗、仅接受口腔健康教育和口腔卫生指导的对照组，每组20例。在基线（治疗前）观察受试者肺功能参数，通过标准的圣乔治呼吸问卷（the St George′s respiratory questionnaire，SGRQ）调查，获得SGRQ各项得分，较高的得分代表较差的健康状况，得分下降代表生命质量的改善。SRP组和洁治组每6个月进行1次牙周维护治疗，1年及2年随访时观察3组SGRQ各项指标得分的变化。 SRP组[年龄（63.9±9.4）岁，男性16例，女性4例]、洁治组[年龄（65.3±7.5）岁，男性15例，女性5例]及对照组[年龄（68.0±7.6）岁，男性16例，女性4例]年龄、性别差异均无统计学意义（0.05）。在基线时，3组患者的体质量指数、吸烟状况、肺功能参数、SGRQ各项得分（总分、症状得分、活动得分、影响得分）、牙周各项临床指标在组间差异均无统计学意义（0.05）。基线时的SGRQ各项得分（包括总分、症状得分、活动得分、影响得分）与肺功能参数均呈显著负相关。SGRQ得分的协方差分析显示：2年随访时，SRP组和洁治组的SGRQ总分[分别为（31.1±12.1）和（28.9±9.8）分]均显著低于对照组[（46.5±24.9）分]（0.01），SRP组的症状得分[（45.4±19.7）分]显著低于对照组[（53.6±25.4）分]（0.03），SRP组和洁治组的影响得分[分别为（15.2±8.3）和（14.9±7.7）分]均显著低于对照组[（34.8±18.8）分]（0.02）。SRP组和洁治组的各项得分组间差异均无统计学意义（0.05）。 本研究结果证实牙周基础治疗有助于改善COPD患者的生命质量；可考虑将牙周基础治疗作为COPD慢病管理的一项辅助的治疗手段。.