目的 探討西吡氯銨含漱液聯(lián)合丁硼乳膏治療智齒冠周炎的臨床療效及對(duì)炎癥介質(zhì)的影響。方法 回顧性分析2020年2月-2021年2月在延安市人民醫(yī)院治療的216例智齒冠周炎患者的臨床資料，根據(jù)用藥的差別分為對(duì)照組和治療組，每組各108例。對(duì)照組給予丁硼乳膏，取1 g藥物涂抹于患處，滯留3~5 min后用清水漱口洗去，3次/d。治療組在對(duì)照組的基礎(chǔ)上含漱西吡氯銨含漱液，15 mL/次，強(qiáng)力漱口1 min，3次/d。兩組均經(jīng)14 d治療。觀察兩組患者臨床療效，比較治療前后兩組患者VAS、MDAS、癥狀評(píng)分，牙周袋探診深度、菌斑指數(shù)、牙周附著水平、齦溝出血指數(shù)及齦溝液C反應(yīng)蛋白（CRP）、前列腺素E₂（PGE₂）、白細(xì)胞介素-6（IL-6）和基質(zhì)金屬蛋白抑制酶1（TIMP-1）水平。結(jié)果 治療后，對(duì)照組總有效率明顯低于治療組（85.19%vs 99.07%，P<0.05）。經(jīng)治療，兩組VAS評(píng)分、MDAS評(píng)分、癥狀評(píng)分均明顯下降，且治療組下降更顯著（P<0.05）。經(jīng)治療，兩組牙周袋探診深度、菌斑指數(shù)、牙周附著水平、齦溝出血指數(shù)水平均明顯降低（P<0.05），且治療組患者明顯低于對(duì)照組（P<0.05）。經(jīng)治療，兩組齦溝液CRP、PGE₂、IL-6、TIMP-1水平均顯著下降（P<0.05），并以治療組降低最顯著（P<0.05）。結(jié)論 西吡氯銨含漱液聯(lián)合丁硼乳膏治療智齒冠周炎可有效改善患者癥狀，降低機(jī)體炎癥反應(yīng)，改善牙周狀況，具有一定臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effect of cetylpyridinium chloride gargle combined with butylborone cream in treatment of pericoronitis of wisdom teeth and its effect on inflammatory mediators. Methods The clinical data of 216 patients with pericoronitis of wisdom teeth in Yan'an People's Hospital from February 2020 to February 2021were analyzed retrospectively and divided into control and treatment groups based on different treatments, and each group had 108 cases. Patients in the control group were administered with Dingpeng Emulsion, applied 1 g medicine to the affected area, rinsed with clean water after staying for 3-5 min, three times daily. Patients in the treatment group were gargled with Cetylpyridinium Chloride Gargle, 15 mL/time, gargled forcefully for 1 min, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, the VAS, MDAS, symptom scores, periodontal pocket probing depth, plaque index, periodontal attachment level, gingival sulcus bleeding index, and the levels of CRP, PGE₂, IL-6 and TIMP-1 in gingival crevicular fluid in two groups before and after treatment were compared. Results After treatment, the clinical effective rate in the control group was significantly lower than that in the treatment group (85.19% vs 99.07%, P<0.05). After treatment, the VAS score, MDAS score and symptom score in two groups were significantly decreased (P<0.05), and the treatment group decreased more significantly (P<0.05). After treatment, the probing depth of periodontal pocket, plaque index, periodontal attachment and gingival sulcus bleeding index were significantly decreased in two groups (P<0.05), and these indexes in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the levels of CRP, PGE₂, IL-6, and TIMP-1 in gingival crevicular in two groups fluid decreased significantly (P<0.05), especially in the treatment group (P<0.05). Conclusion Cetylpyridinium Chloride Gargle combined with Dingpeng Emulsion in treatment of pericoronitis of wisdom teeth can effectively improve the symptoms of the patients, reduce the inflammatory reaction and improve the periodontal condition, which has a certain clinical application value.

R988.2

陜西省重點(diǎn)研發(fā)計(jì)劃項(xiàng)目（S2018-YF-YBSF-04560）