布洛芬、对乙酰氨基酚和双氯芬酸钾在拔牙后镇痛中的应用比较

Comparison of Application of Ibuprofen,Paracetamol and Diclofenac Potassium in Analgesia After Tooth Extraction

目的:比较布洛芬、对乙酰氨基酚和双氯芬酸钾在成人拔牙后缓解疼痛的功效。方法:选取2018年6月~2019年12月在本院牙槽外科进行第三磨牙拔除手术治疗的120例患者作为研究对象。采用双盲对照研究,将患者随机分为对乙酰氨基酚组(n=40)、布洛芬组(n=40)、双氯芬酸钾组(n=40);分别利用标准100 mm视觉模拟量表(VAS)、Wong-Baker面部表情量表评价患者的疼痛或痛苦表现,并比较3组患者的药物作用快效率。结果:术后2、4、6 h,对乙酰氨基酚组与布洛芬组、对乙酰氨基酚组与双氯芬酸钾组、布洛芬组与双氯芬酸钾组患者VAS疼痛评分有统计学差异(P <0.05)。3组患者术后痛苦程度均得到缓解,与术前相比有统计学差异(P <0.05);组间比较无统计学差异(P> 0.05)。双氯芬酸钾组快效率较高(可达55%),且组间比较有统计学差异(P <0.05)。结论:双氯芬酸钾比对乙酰氨基酚或布洛芬在减轻拔牙术后疼痛方面更有效,可以使用先发性镇痛药减轻患者的痛苦。

Objective:To compare the efficacy of ibuprofen,paracetamol and diclofenac potassium in pain relief after tooth extraction in adults.Methods:A total of 120 patients treated with the third molar extraction surgery in our hospital from Jun 2018 to December 2019 were selected for study.According to a double-blind controlled study,patients were randomly divided into paracetamol group(n=40),ibuprofen group(n=40)and diclofenac potassium group(n=40).The standard 100 mm visual analogue scale(VAS)and the Wong-baker facial expression scale were used to evaluate the pain.The quick start efficiency in three groups were studied and compared.Results:At 2,4,and 6 hours after operation,there was statistically significant difference in VAS pain score while comparing either two groups among paracetamol group,ibuprofen group and diclofenac potassium group(P<0.05).The postoperative pain in the three groups of patients was alleviated,with statistical difference while compared with the pre-surgery(P<0.05).But there was no statistical difference between the groups(P>0.05).The diclofenac potassium group shown better result in quick start efficiency(up to 55%),and there were statistical differences between the groups(P<0.05).Conclusion:Diclofenac potassium is more effective than paracetamol or ibuprofen in reducing pain after tooth extraction,which can be used first-in-class analgesics to relieve pain in patients.