中药方剂联合西医治疗牙周-牙髓联合病变的疗效及安全性评价

Efficacy and Safety Evaluation of Traditional Chinese Medicine Prescription Combined with Western Medicine in Treatment of Combined Periodontal-Endodontic Lesions

目的评价中药方剂联合西医治疗牙周-牙髓联合病变的疗效及安全性。方法以2020年6月—2021年4月该院收治的牙周-牙髓联合病变患者80例为研究对象,采用随机数字表法分为对照组(40例)和观察组(40例)。对照组采用Vitapex糊剂根管充填进行治疗,观察组在对照组的基础上采用中药方剂补中益气汤进行治疗,两组均治疗1个月。统计两组治疗1个月后的临床疗效及治疗期间牙齿松动、牙周炎、牙齿叩痛情况、安全性,比较两组治疗前和治疗1个月后血清炎性因子水平、牙周情况。结果治疗1个月后,观察组总有效率为92.50%(37/40),显著高于对照组[75.00%(30/40),P<0.05]。治疗1个月后与治疗前比较,两组血清肿瘤坏死因子-α(TNF-α)、高敏-C反应蛋白(hs-CRP)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)水平及改良龈沟出血指数(mSBI)、改良菌斑指数(mPLI)、探诊深度(PD)和附着丧失(AL)降低,观察组低于对照组(P<0.05)。治疗期间,观察组牙齿叩痛发生率为10.00%(4/40),显著低于对照组[27.50%(6/40),P<0.05],两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论采用中药方剂补中益气汤联合Vitapex糊剂根管充填对牙周、牙髓联合病变患者进行治疗,可有效降低患者机体炎症反应,改善患者牙周情况,同时降低患者牙齿叩痛发生率,安全性良好,具有较好的临床疗效。

Objective To evaluate the efficacy and safety of traditional Chinese medicine prescription combined with western medicine in the treatment of combined periodontal-endodontic lesions.Methods A total of 80 patients with combined periodontal-endodontic lesions who were admitted to the hospital from June 2020 to April 2021 were included in the study.They were divided into a control group(40 cases)and an observation group(40 cases)according to the random number table method.The control group was treated with Vitapex paste for root canal filling,and the observation group was treated with traditional Chinese medicine prescription Buzhong Yiqi Decoction(补中益气汤)on the basis of the control group.All the patients were treated for 1 month.The clinical effects of patients after 1 month of treatment and the conditions,the safety and efficacy of tooth mobility,the periodontitis and knocking pain during the treatment in the two groups were counted,and the levels of serum inflammatory factors and periodontal conditions before treatment and after 1 month of treatment in the two groups were compared.Results After 1 month of treatment,the total effective rate of the observation group was 92.50%(37/40),which was significantly higher than that of the control group[75.00%(30/40),P<0.05].After 1 month of treatment,compared with those before treatment,the levels of serum tumor necrosis factor-α(TNF-α),high-sensitivity C-reactive protein(hs-CRP),interleukin-1β(IL-1β)and interleukin-6(IL-6)as well as the modified gingival crevicular hemorrhage indexes mSBI),modified plaque indexes(mPLI),probing depth(PD)and adhesion loss(AL)in the two groups were decreased,and those in the observation group were lower than those in the control group(P<0.05).During the treatment,the incidence rate of dental knocking pain in the observation group was 10.00%(4/40),which was significantly lower than that in the control group[27.50%(6/40),P<0.05].There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion In the treatment of patients with combined periodontal-endodontic lesions,the traditional Chinese medicine prescription Buzhong Yiqi Decoction combined with Vitapex paste root canal filling could effectively reduce the body inflammatory responses,improve the periodontal conditions and reduce the incidence of dental knocking pain in patients with good safety and clinical efficacy.