自拟牙痛定疼汤治疗牙髓炎牙痛临床疗效及对复发的影响

Clinical Curative Effect of Self-made Yatong Dingteng Decoction(牙痛定疼汤)on Toothache and Its Influences on Recurrence of Pulpitis

目的探讨自拟牙痛定疼汤治疗牙髓炎牙痛临床疗效及对复发的影响。方法择取杭州市萧山区中医院2018年5月—2021年6月期间收治的160例牙髓炎患者为研究对象,将其按照随机数遍法分为对照组(78例)和观察组(82例),对照组给予常规治疗,观察组在上述基础实施拟牙痛定疼汤治疗,连续治疗2周,比较两组患者临床疗效,以及治疗前后疼痛程度、龈沟液细胞因子[白细胞介素-1β(IL-1β)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、肝细胞生长因子(HGF)],统计复发情况。结果观察组临床有效率(91.46%,75/82)较对照组(74.36%,58/78)显著升高,且差异有统计学意义(P<0.05);治疗前,两组患者疼痛视觉模拟评分量表(VAS)评分、龈沟液细胞因子(IL-1β、IL-8、TNF-α、HGF)水平比较无统计学意义(P>0.05),治疗后,两组患者上述指标均下降,且观察组较对照组更低(P<0.05);观察组复发率(8.54%,7/82)较对照组(25.64%,20/78)明显低(P<0.05);观察组不良反应发生率(6.10%,5/82)略高于对照组(3.84%,3/78),差异无统计学意义(P>0.05)。结论自拟牙痛定疼汤治疗牙髓炎牙痛临床疗效佳,可有效缓解疼痛,下调龈沟液炎症因子表达及HGF浓度,复发率低,且安全性良好。

Objective To explore the clinical curative effect of Self-made Yatong Dingteng Decoction(牙痛定疼汤)on toothache and its influences on recurrence of pulpitis.Methods A total of 160 patients with pulpitis admitted to Xiaoshan Hospital of Traditional Chinese Medicine were enrolled as the research objects between May 2018 and June 2021.According to random number table method,they were divided into control group(78 cases)and observation group(82 cases).The control group was given routine treatment,while the observation group was additionally given Self-made Yatong Dingteng Decoction.All were continuously treated for 2 weeks.The clinical curative effect,pain degree and levels of cytokines[interleukin-1β(IL-1β),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α),hepatocyte growth factor(HGF)]in gingival crevicular fluid before and after treatment were compared between the two groups.The recurrence was statistically analyzed.Results The clinical response rate of the observation group was significantly higher than that of the control group[91.46%(75/82)vs 74.36%(58/78)](P<0.05).Before treatment,there was no significant difference in the scores of visual analogue scale(VAS),levels of cytokines(IL-1β,IL-8,TNF-α,HGF)in gingival crevicular fluid between the two groups(P>0.05).After treatment,the above indexes in both groups were decreased,and those were lower in the observation group than those in the control group(P<0.05).The recurrence rate in the observation group was significantly lower than that in the control group[8.54%(7/82)vs 25.64%(20/78)](P<0.05),and the incidence of adverse reactions was slightly higher than that in the control group[6.10%(5/82)vs 3.84%(3/78)](P>0.05).Conclusion Self-made Yatong Dingteng Decoction has good effect on toothache in pulpitis,and can effectively relieve the pain and down-regulate the expressions of inflammatory factors in gingival crevicular fluid,with low recurrence rate and good safety.