清胃散加减联合一次性根管治疗急性牙髓炎的临床疗效观察及对血清TNF-α、IL-8、CD14水平影响  

The clinical observation of Qingwei Powder combined with disposable root canal in the treatment of acute pulpitis and its effect on serum TNF-α,IL-8 and CD14 levels

作　　者：郑建英 孙国峰 张霞 ZHENG Jian-ying;SUN Guo-Feng;ZHANG Xia(Hengshui Traditional Chinese Medicine Hospital Department of Stomatology,Hengshui 053000,China;不详)

机构地区：[1]衡水市中医医院口腔科,河北衡水053000 [2]衡水市中医医院治未病中心,河北衡水053000 [3]衡水市中医医院手术室,河北衡水053000

出　　处：《中国处方药》2024年第1期128-132,共5页Journal of China Prescription Drug

基　　金：2019年衡水市科技计划项目(2019014047Z);河北省自然科学基金(H2019206541)。

摘　　要：目的分析采用清胃散加减联合一次性根管治疗急性牙髓炎对患者疼痛、炎症改善情况,并观察其远期疗效。方法选取2020年1月~2022年12月78例因急性牙髓炎接受治疗的患者为研究对象,依据治疗方法的差异性将患者分为单一组(n=40,单纯的一次性根管治疗)和联合组(n=38,术后增加清胃散加减治疗),比较两组患者治疗前后疼痛评分、中医证候积分及血清C反应蛋白(C-reactive protein,CRP)、白介素-8(Interleukin-8,IL-8)、肿瘤坏死因子-α(tumor necrosis factorα,TNF-α)及白细胞分化抗原-14(Leukocyte differentiation antigen-14,CD14)等炎症因子指标改善情况,对所有患者进行为期半年的随访,对比分析两组患者牙周指数改善情况和治愈率。结果治疗前,两组患者疼痛评分及IL-8、TNF-α、CRP、CD14水平比较,差异无统计学意义(P>0.05);治疗2周后,与治疗前比较,两组患者疼痛评分及IL-8、TNF-α、CRP、CD14水平均降低,且与单一组比较,联合组患者疼痛评分及IL-8、TNF-α、CRP、CD14水平更低(P<0.05)。两组治疗后牙痛、舌象、脉象等中医症候评分与治疗前相比均明显降低(P<0.05),且治疗两周后联合组中医症候评分显著低于单一组,差异具有统计学意义(P<0.05)。治疗前,两组患者牙周袋探诊深度(Periodontal pocket probing depth,PD)、牙龈指数(gingival index,GI)、菌斑指数(plaque index,PLI)比较,差异无统计学意义(P>0.05);治疗6个月后,与治疗前比较,两组患者PD、GI、PLI均降低,且治疗6个月后与单一组比较,联合组患者PD、GI、PLI均降低(P<0.05)。与单一组比较,联合组治愈率明显升高(P<0.05)。结论与单一的一次性根管治疗比较,术后增加清胃散加减治疗急性牙髓炎患者可有效缓解疼痛,改善炎症反应,且能够促进术后牙周恢复,提升远期疗效。Objective To analyze the improvement of pain and inflammation in patients with acute pulpitis treated with modified Qingwei Powder combined with disposable root canal,and to observe its long-term effect.Methods 78 patients with acute pulpitis treated in a hospital from January 2020 to December 2022 were selected as the research object.According to the differences of treatment methods,the patients were divided into single group(n=40,simple one-time root canal treatment)and combined group(n=38,with addition and subtraction of Qingwei powder after operation).The improvement of pain scores,traditional Chinese medicine syndrome scores,serum C-reactive protein,interleukin-8,tumor necrosis factor-α,and leukocyte differentiation antigen-14 inflammatory factor indicators before and after treatment were compared between the two groups.All patients were followed up for half a year.The improvement of periodontal index,and cure rate were compared and analyzed between the two groups.Results Before treatment,there was no statistically significant difference in pain scores,IL-8,TNF-α,CRP,and CD14 levels between the two groups(P>0.05).After 2 weeks of treatment,compared with before treatment,the pain scores and levels of IL-8,TNF-α,CRP,and CD14 in both groups decreased,and compared with the single group,the combined group had lower pain scores and levels of IL-8,TNF-α,CRP,and CD14(P<0.05).The scores of traditional Chinese medicine symptoms such as toothache,tongue and pulse in the two groups were significantly lower than those before treatment(P<0.05),and the scores of traditional Chinese medicine symptoms in the combined group were significantly lower than those in the single group(P<0.05).Before treatment,there was no significant difference in PD,GI and PLI between the two groups(P>0.05);After 6 months of treatment,compared with before treatment,PD,GI and PLI in the two groups decreased,After 6 months of treatment,compared with the single group,PD,GI and PLI in the combined group decreased(P<0.05).Compared with the single g

关 键 词：急性牙髓炎 根管治疗术 中医症候 清胃散 炎症反应 牙周指数 

分 类 号：R781.31[医药卫生—口腔医学]