塞来昔布用于下颌阻生牙拔除术后镇痛的疗效评价

Application of celecoxib in analgesia for patients who underwent extraction of impacted tooth

目的:评价塞来昔布对下颌阻生牙拔除术后急性疼痛的镇痛效果。方法 :90例拔除下颌阻生第三磨牙的患者按随机双盲法分为塞来昔布组、布洛芬组、安慰剂组,每组30例。拔牙4 h后,分别给予塞来昔布400 mg、布洛芬400 mg、维生素C 100 mg。采用视觉模拟评分法(visual analogue scale,VAS),记录患者拔牙4 h后、服药24 h内的疼痛情况及不良反应,利用SPSS 13.0软件包,通过χ2检验和方差分析,比较2种药物的镇痛效果有无显著差异。结果:塞来昔布组、布洛芬组与安慰剂组相比,在镇痛药起效时间、疼痛强度差值(PID)、疼痛缓解程度(PAR)、总疼痛强度差(SPID)、疼痛缓解总和(TOPPAR)、整体评价方面具有显著差异(P<0.05)。塞来昔布组与布洛芬组相比,镇痛效果基本相同,仅服药12 h后两者的PID有显著差异(P<0.05)。服药24 h内,在镇痛起效时间、PAR、SPID、TOPPAR、整体评价方面的差异无显著性(P>0.05)。结论:塞来昔布对下颌阻生牙拔除术后中、重度急性疼痛有明显的镇痛作用。

PURPOSE： To evaluate the effect of celecoxib in acute pain relief after extraction of impacted tooth. METHODS： In the randomized, double-blind placebo-controlled trial, 90 patients who underwent extraction of impacted mandibular third molar, were divided into 3 groups based on the use of ccelecoxib, ibuprofen and placebo. Each group had 30 patients. After 4 hours of extraction, patients were given 400 mg celecoxib in the celecoxib group, 400 mg ibuprofen in the ibuprofen group. While in the placebo group, 100 mg vitamin C was administrated. Pain and adverse events were recorded after extraction and application of 3 drugs. Chi-square test and analysis of variance were carried out for comparison between the three groups using SPSS 13.0 software package. RESULTS： There were significant differences in analgesic onset time, PID, PAR, SPID, TOPPAR and overall assessment between celecoxib group, ibuprofen and placebo group （P〈0.05）. Compared with celecoxib group and ibuprofen group, the analgesic effect was quite the same. 12 h after administration, only the PID of the two groups had significant difference （P〈0.05）. Within 24 h, there was no significant difference in time to onset of analgesia, PAR, SPID, TOPPAR, and overall assessment （P〉0.05）. CONCLUSIONS： Celecoxib has distinct analgesic effect in extraction of impacted teeth with acute severe pain.