盐酸米诺环素软膏治疗难治性窦道型根尖周炎的疗效分析

Analysis on curative effect of minocycline hydrochloride ointment in the treatment of refractory fistula type periapical periarthritis

目的探讨盐酸米诺环素软膏治疗难治性窦道型根尖周炎的临床效果。方法选取75例采用盐酸米诺环素软膏根管内封药治疗的难治性窦道型根尖周炎患者作为观察组,同时选取55例早期采用氢氧化钙根管封药治疗的患者作为对照组,观察比较两组患者临床治疗效果、不良反应发生率和窦道闭合时间。结果观察组显效21例,有效49例,无效5例,总有效率为93.3%,对照组显效18例,有效27例,无效10例,总有效率为81.8%;两组总有效率比较差异有统计学意义（P〈0.05）。观察组患者发生呕吐恶心1例,不良反应发生率为1.3%;对照组患者患者发生皮疹2例、呕吐恶心3例,不良反应发生率为9.1%;观察组不良反应发生率显著低于对照组,差异具有统计学意义（χ^2=4.3376,P=0.0373〈0.05）。观察组患者窦道闭合时间为（6.0±0.7）d,对照组窦道闭合时间为（9.0±1.1）d,观察组窦道闭合时间显著短于对照组,差异具有统计学意义（t=-18.9679,P=0.0000〈0.05）。结论与氢氧化钙根管封药比较,盐酸米诺环素软膏根管封药疗法有助于提高难治性窦道根尖周炎患者临床效果以及窦道闭合时间,且不良反应轻微,该方法值得推广应用。

Objective To explore clinical effect of minocycline hydrochloride ointment in the treatment of refractory fistula type periapical periarthritis. Methods A total of 75 refractory fistula type periapieal periarthritis patients treated with minocycline hydrochloride ointment for intracanal medication treatment were selected as observation group, and concurrent 55 patients treated with calcium hydroxide for early intracanal medication treatment were selected as control group. Observation were made on clinical treatment effect, adverse reaction rate and fistula closure time. Results The observation group had 21 excellent cases, 49 effective cases and 5 ineffective cases, with total effective rate as 93.3%. The control group had 18 excellent cases, 27 effective cases and 10 ineffective cases, with total effective rate as 81.8%. There was statistically significant difference in total effective rate in two groups （P〈0.05）. The observation group had 1 nausea and vomiting case, with incidence of adverse reaction as 1.3%, while the control group had 2 rash cases, 3 nausea and vomiting cases, with incidence of adverse reaction as 9.1%. The observation group had lower incidence of adverse reaction than the control group, and the difference had statistical significance （χ^2=4.3376, P=0.0373〈0.05）. The observation group had fistula closure time as （6.0 ±0.7）d, which was （9.0 ± 1.1）d in the control group. Ttle observation group had shorter fistula closure, time than the control group, and the difference had statistical significance （t=-18.9679, P=0.0000〈0.05）. Conclusion Compared with calcium hydroxide for intraeanal medication, minoeyeline hydrochloride ointment for intracanal medication treatment is helpful for improvement of clinical effect and fistula closure time in patients with refractory fistula type periapical periarthritis. This method also has light adverse reaction and is worth promotion and application.