云南白药对下颌阻生第三磨牙拔除术后面部肿胀的影响

Facial swelling after administration of Yunnan Baiyao following extraction of the mandibular impacted third molar

目的:应用逆向工程技术、随机对照双盲多中心临床实验评价口服云南白药胶囊对下颌阻生第三磨牙拔除术后面部肿胀程度的影响。方法:拔除下颌近中阻生第三磨牙患者按区组随机方法分为实验组和对照组,于术前3d至术后第4天连续口服云南白药胶囊或安慰剂胶囊,4次/d,0.5g/次。于术前、术后第1、3、5天行面部三维扫描,重建面部三维模型。利用逆向工程软件将术后各个观察时间模型与术前模型重叠配准,测量面部肿胀厚度、体积和肿胀度作为评价指标。结果:187例患者完成了各个观察期面部三维数据扫描,其中实验组93例,对照组94例。两组人口学构成无统计学差异,手术时间无统计学差异,实验组各个观察时间点的肿胀厚度的平均值均小于对照组,实验组和对照组术后24h、第3天肿胀厚度、肿胀体积、肿胀度差异有统计学意义(P<0.01)。结论:下颌阻生第三磨牙拔除围手术期口服云南白药胶囊可有效预防和促进拔牙术后面颊肿胀的吸收。

Abstract： Objective： To evaluate the effects of perioperative oral administration of Yuan Baiyao reduction of postoperative facial swelling following extraction of the mandibular impacted third molar. Methods： 187 patients scheduled for extraction of the mesially impacted mandibular third molar were enrolled in the prospective, randomized, double-blind, placebo- controlled clinical study. Patients were orally administrated with Yunnan Baiyao Capsules or Placebo Capsules 2g per day for 8 days from 3 days before operation. Three-dimensional facial image were recorded with OKIO-SC-400 Scanning System in patients at pre-operation, 1st day, 3rd and 5th day after operation. Facial scans from different time periods were performed with reverse engineering software to compare the differences between each two models and to quantitatively determine the reductions in facial swelling. Results： After unblinding, there were 93 patients in Yunnan Baiyao group and 94 patients in control group. The severe swelling region was in the cheek, followed by submandibular region. The swelling thicknesses in Yunnan Baiyao group were thinner than that in control group. There were significant changes in magnitude of swelling between the two groups on 1st and 3rd days after operation. Conclusion： Perioperative oral administration of Yunnan Baiyao Capsules can reduce the magnitude of facial swelling following extraction of the mandibular impacted third molar effectly.