牙周治療對牙周病人生活品質的影響

背景：台灣成人99.2%有不同程度之牙周病、20 歲以上成年人糖尿病盛行率為12.3%，牙周病和控制不良的糖尿病相互影響，高血糖會增加牙周病的風險和嚴重程度，可能導致高血糖控制不良和糖尿病併發症。過去較少關於牙周病及糖尿病病人健康相關生活品質的研究。故本研究旨在於牙周病的糖尿病病人經牙周統合照護計畫對生活品質之差異。目的：本研究旨在於比較接受牙周病介入治療的糖尿病病人與一般門診牙周病病人的口腔困擾及生活品質之變化差異。研究對象符合牙周病統合照護計畫且排除下列條件：定期服用抗生素及骨質疏鬆症等藥物治療、有抽菸或嚼食檳榔、戒除菸檳榔未達半年、罹患全身系統性疾病、精神疾病病史。方法：為比較性的量性研究，採立意取樣，在牙周病門診由醫師轉介收案。研究對象共兩組，糖尿病組給予「牙周病治療及口腔衛生指導」及糖尿病管理衛教，共22 位；非糖尿病組為22 位，接受常規的「牙周病治療及口腔衛生指導」，共44 位。三次評估時間分別為治療前(T1)、治療後第一個月(T2)及第三個月(T3)。研究工具包括口腔衛生影響量表(OHIP-14)和世界衛生組織生活質量台灣簡明版(WHOQOL-BREF)。統計分析方法包括T 檢定、卡方檢定、單因子變異數分析等。結果：牙周病人經牙周病治療後，一般的牙周病人經牙周病治療後，口腔困擾程度有顯著改善 (P＜.05)，整體生活品質的平均數有提升，但無統計上顯著成效(P >.05)。具糖尿病的牙周病人接受介入治療之後，其T2 及T3 的飯前血糖比T1 的血糖有顯著降低(P＜.05)，糖化血色素(HbA1C)經接受介入治療之後，其T2 比T1 的糖化血色素有顯著降低(P＜.05)，但T3 的糖化血色素相較於T1 的糖化血色素，則無顯著降低(P >.05)。結論和臨床應用：本研究發現牙周病介入治療能改善牙周病人的生活品質及糖尿病人疾病血糖管理成效。提供護理人員關於病人牙周病照護治療並間接影響血糖管理，減輕牙齒困擾，進而提升其健康生活品質。

關鍵字

牙周病；糖尿病；牙周病治療；口腔衛生；生活品質

並列摘要

Background: About 99.2% of adults in Taiwan have different degrees of periodontal disease, and the prevalence of diabetes in adults over 20 years old is 12.3%. Periodontal disease and poorly controlled diabetes affect each other. Hyperglycemia increases the risk and severity of periodontal disease, which may result in Hyperglycemia control and complications of diabetes. In the past, there have been few studies on the health-related quality of life of periodontal disease and diabetes patients. This study aimed to determine the difference in quality of life between patients with periodontal disease and diabetes through periodontal integration care. Objective: This study compared the differences in oral distress and quality of life between diabetic patients undergoing periodontal disease intervention and general outpatient periodontal disease. The subjects met the periodontal disease integrated care plan and excluded the following conditions: taking antibiotics regularly and rerug treatment such as osteoporosis, have smoking or chewing betel nuts, quit smoking betel nut for less than half a year, suffering from systemic diseases, history of mental Methods: For comparative quantitative research, a sampling was taken and a referral was made by a physician at the periodontal disease clinic. The study group consisted of two groups. The diabetes group gave 22 patients with "periodonial disease treatment and oral hygiene guidance" and diabetes management and education, and 22 patients in the non-diabetic group. They received routine "periodonal disease treatment and oral hygiene guidance". A total of 44. The three evaluation times were pre-treatment (T1), first month (T2) after treatment, and third month (T3). Research tools include the Oral Health Impact Scale (OHIP-14) and the World Health Organization Quality of Life Taiwan Concise Edition (WHOQOL-BREF). Statistical analysis methods include T-test, chi-square test, and single-factor variance analysis. Results: After periodontal disease treatment in periodontal patients, the degree of oral distress was significantly improved in patients with periodontal disease after general periodontal disease treatment (P<.05), and the average quality of life improved, but no statistically significant results (P >.05). After periodontal treatment of diabetic patients, T2 and T3 had significantly lower pre-prandial blood glucose than T1 (P < .05), and glycosylated hemoglobin (HbA1C) was T2 saccharified after T1 intervention. Hemoglobin was significantly reduced (P < .05), but T3 glycated hemoglobin was not significantly reduced compared to T1 glycated hemoglobin (P> .05). Conclusions: This study found that interventional therapy for periodontal disease can improve the quality of life of patients with periodontal disease and the effectiveness of blood glucose management in patients with diabetes. Provide caregivers on the treatment of patients with periodontal disease and indirectly affect blood sugar management, reduce dental problems, and improve their healthy living quality.

並列關鍵字

Periodontal Disease ； Diabetes ； Periodontal Disease Treatment ； Oral Hygiene ； Quality of Life

參考文獻

Chang, T. J., Jiang, Y. D., Chang, C. H., Chung, C. H., Yu, N. C., & Chuang, L. M. (2012). Accountability, utilization and providers for diabetes management in Taiwan, 2000–2009: An analysis of the National Health Insurance database. Journal of the Formosan Medical Association, 111(11), 605–616. doi:10.1016/j.jfma2012.09.011

Shrivastava, S. R., Shrivastava, P. S., & Ramasamy, J. (2013). Role of self-care in management of diabetes mellitus. Journal of Diabetes & Metabolic Disorders, 12(1), 14. doi:10.1186/2251-6581-12-14

一、中文文獻部分