自拟中药汤剂含漱联合芩连芷柏汤口服治疗妊娠期智齿冠周炎疗效及安全性分析

Effect and Safety of Gargling with Self-made TCM Decoction Combined with Qinlian Zhibai Decoction for Oral Administration in the Treatment of Gestational Opsigenes Pericoronitis

目的探讨自拟中药汤剂含漱联合芩连芷柏汤口服治疗妊娠期智齿冠周炎患者的疗效及在减轻患者炎性反应、改善临床症状、减轻疼痛程度方面的作用,并观察联合用药的安全性,旨在为妊娠期冠周炎孕妇的合理治疗方案提供参考。方法选取2013年2月—2016年4月在山东省青岛市第八人民医院进行治疗的妊娠期智齿冠周炎孕妇108例为研究对象,采用随机数字表法分为观察组和对照组各54例,对照组给予自拟中药汤剂含漱治疗,观察组在此基础上联合芩连芷柏汤口服治疗,两组均持续治疗3个疗程,比较两组疗效、治疗前后炎性指标[血清白介素-6(Interleukin-6,IL-6)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、C反应蛋白(C-reactive protein,CRP)],分析对患者临床症状的影响,同时观察药物的安全性。结果治疗后观察组治疗有效率(96.30%)显著高于对照组(81.48%)(P<0.05);治疗后两组张口受限、牙痛、面部肿胀、牙龈红肿症状积分均显著降低,且观察组治疗后以上积分均明显低于对照组,差异有统计学意义(P<0.05);治疗后3、5 d两组视觉模拟疼痛(VAS)评分均显著降低,且观察组明显低于对照组,差异有统计学意义(P<0.05);治疗后两组CRP、TNF-α、IL-6水平均显著降低,且观察组明显低于对照组,差异有统计学意义(P<0.05);两组治疗后均未出现任何不良反应,且孕期各项检查正常,未对胎儿造成影响。结论自拟中药汤剂含漱联合芩连芷柏汤口服治疗妊娠期智齿冠周炎的疗效确切,可显著改善患者临床症状,降低机体炎症反应及牙齿疼痛程度,安全有效,值得在临床上推广应用。

Objective To explore the effect and safety of gargling with self-made traditional Chinese medicine decoction combined with Qinlian Zhibai Decoction for oral administration in the treatment of gestational opsigenes pericoronitis and the role of the combined treatment in reducing inflammatory response,improving clinical symptoms and reducing the pain degree,so as to provide references for a reasonable treatment plan for pregnant women with gestational opsigenes pericoronitis. Methods 108 pregnant women with gestational opsigenes pericoronitis who were treated in the hospital from February 2013 to April 2016 were enrolled. They were divided into observation group and control group by random number table method,54 cases in each group. The control was treated with self-made TCM Decoction gargle. On this basis,observation group was additionally treated with Qinlian Zhibai Decoction for oral administration. Both groups were given three courses of treatment. The curative effect and inflammatory index [serum interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)] before and after treatment were compared between the two groups. The influence on clinical symptoms was analyzed,and the safety of medication was observed. Results After treatment,the response rate of observation group was significantly higher than that of control group(96.30% vs 81.48%)(P<0.05). After treatment,scores of symptoms such as mouth opening limitation,toothache,facial swelling and gingival swelling in both groups were significantly decreased. And the above scores in observation group were significantly lower than those in control group(P<0.05). At 3 d and 5 d after treatment,VAS scores were significantly decreased. And VAS scores in observation group were significantly lower than those in control group(P<0.05). After treatment,levels of CRP,TNF-α and IL-6 in the two groups were significantly decreased. And levels of CRP,TNF-α and IL-6 in observation group were significantly lower than those in control group(P<0.05). After treatment,there was no adverse reactions in either group. All tests during pregnancy were normal,without influence on the fetus. Conclusion The curative effect of self-made TCM decoction gargle combined with Qinlian Zhibai Decoction for oral administration is significant on gestational opsigenes pericoronitis,which can significantly improve clinical symptoms,reduce body inflammatory reaction and tooth pain degree. It is safe and effective.