制霉素片联合康复新液预防阻生智齿拔除术后口腔感染的临床效果及对Th17/Treg细胞免疫的影响

Cliniacl effect of nystatin tablets combined with Kangfuxin solution on prevention of postoperative oral infection in patients undergoing impacted wisdom tooth extraction and impact on immunity of Th17/Treg cells

目的探讨制霉素片联合康复新液预防阻生智齿拔除术后口腔感染的临床效果及对辅助性T细胞17/调节性T细胞(Th17/Treg)细胞免疫的影响。方法去选取2022年8月-2023年8月衡水市人民医院收治的200例阻生智齿患者为研究对象,根据随机数表法分为研究组100例和对照组100例。比较两组基本资料、口腔感染发生率、口腔菌群变化、Th17/Treg及叉头翼状螺旋转录因子(Foxp3)、维甲酸相关孤核受体yt(RORyt)、白细胞介素-17(IL-17)、转化生长因子β(TGF-β)水平。结果研究组感染发生率为1.63%,低于对照组的9.09%(P<0.05);术前两组革兰阴性菌、革兰阳性菌、螺旋体细菌数量比较,无统计学差异,术后7d研究组革兰阴性菌、螺旋体数量低于对照组,革兰阳性菌数量高于对照组(P<0.05);术前两组Th17、Treg、Th17/Treg、Foxp3、RORt、IL-17、TGF-β水平比较,无统计学差异,术后7d研究组Th17、Th17/Treg、RORt、IL-17、TGF-β水平低于对照组,Treg、Foxp3水平高于对照组(P<0.05)。结论制霉素片联合康复新液可以减少阻生智齿拔除术后患者口腔感染发生率,维持口腔菌群稳态,调节Th17/Treg细胞免疫平衡,提高患者抗菌抗感染能力。

OBJECTIVE To explore the cliniacl effect of nystatin tablets combined with Kangfuxin solution on pre-vention of postoperative oral infection in the patients undergoing impacted wisdom tooth extraction and observe the impact on immunity of helper T cell 17/regulatory T cell(Th17/Treg).METHODS A total of 200 patients with impacted wisdom teeth who were treated in Hengshui People's Hospital from Aug 2022 to Aug 2023 were recrui-ted as the research subjects and were randomly divided into the study group with 1oo cases and the control group with 100 cases.The baseline data,incidence of oral infection,oral microflora,Th17/Treg and the levels of fork-head/winged helix transcription factor p3(Foxp3),retinoic acid-related or-phan nuclear receptor-t(RORt),interleukin-17(IL-17)and transforming growth factor-β(TGF-β)were observed and compared between the two groups.RESULTS The incidence of infection of the study group was 1.63%,lower than 9.09%of the control group(P<0.05).There were no significant differences in the colony counts of gram-negative bacteria,gram-bac-teria and spirochaete between the two groups before the surgery.The colony counts of gram-negative bacteria and spirochaete of the study group were less than those of the control group after the surgery for 7 days,while the colony counts of gram-positive bacteria of the study group were more than those of the control group(P<o.05).There were no significant differences in the levels of Th17,Treg,Th17/Treg,Foxp3,RORt,IL-17 and TGF-βbetween the two groups before the surgery;the levels of Th17,Th17/Treg,RORyt,IL-17 and TGF-βof the study group were lower than those of the control group after the surgery for 7 days;the levels of Treg and Foxp3 of the study group were higher than those of the control group(P<O.05).CONCLUSION Nystatin tablets combined with Kangfuxin solution can reduce the incidence of postoperative oral infection in the patients undergoing impacted wisdom teeth extraction,maintain homeostasis of oral flora,regulate the immune balance of Th17/Treg cells and boost the patients'capability against bacteria and infection.