目的 探讨齿痛消炎灵颗粒联合米诺环素软膏治疗慢性根尖周炎的临床疗效。方法 选取2020年6月—2022年11月唐山市人民医院收治的82例慢性根尖周炎患者，共90颗患牙，根据随机数字表法将所有患者分为对照组（41例，46颗患牙）和治疗组（41例，44颗患牙）。对照组使用米诺环素软膏进行封闭治疗，米诺环素软膏注入注射针后，将针尖接近根尖孔，将药物注满根管内，待注满溢出后使用氧化锌丁香油黏固粉封闭，每周1次。治疗组患者在对照组基础上口服齿痛消炎灵颗粒，10 g/次，3次/d。两组患者连续4周。观察两组的临床疗效，比较患牙的牙龈指数、菌斑指数，对比两组患者生活质量的变化，以及渗出液中炎症因子白细胞介素-10（IL-10）、白细胞介素-1β（IL-1β）、白细胞介素-34（IL-34）水平。结果 治疗后，治疗组总有效率为93.18%，明显高于对照组总有效率76.09%，组间比较差异有统计学意义（P＜0.05）。治疗后，两组的牙龈指数、菌斑指数明显降低（P＜0.05），且治疗组的牙龈指数、菌斑指数明显低于对照组（P＜0.05）。治疗后，两组的口腔健康影响程度（OHIP-14）评分明显降低（P＜0.05），且治疗组的OHIP-14评分明显低于对照组（P＜0.05）。治疗后，两组的渗出液IL-10、IL-1β、IL-34水平低于治疗前（P＜0.05），治疗组的渗出液IL-10、IL-1β、IL-34水平明显低于对照组（P＜0.05）。结论 齿痛消炎灵颗粒联合米诺环素软膏能提高慢性根尖周炎的疗效，减轻患者的牙周症状，提高患者生活质量，减轻炎症反应，并且安全性良好。

Objective To investigate the clinical effect of Chitong Xiaoyanling Granules combined with Minocycline Hydrochloride Ointment in treatment of chronic periapical inflammation. Methods Patients (82 cases, 90 affected teeth) with chronic periapical inflammation in Tangshan People's Hospital from June 2020 to November 2022 were divided into the control group (41 cases, 46 affected teeth) and the treatment group (41 cases, 44 affected teeth) according to the random number table method. Patients in the control group were treated with Minocycline Hydrochloride Ointment for sealing treatment. After injecting Minocycline Hydrochloride Ointment into the injection needle, the needle tip was placed close to the apical hole, and the drug was filled into the root canal. After filling up and overflowing, zinc oxide clove oil cement powder was used to seal, once weekly. Patients in the treatment group were po administered with Chitong Xiaoyanling Granules on the basis of the control group, 10 g/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacies were evaluated, and the gingival index and plaque index, the changes in quality of life, the levels of IL-10, IL-1β, and IL-34 in the exudate in two groups were compared. Results After treatment, the total effective rate in the treatment group was 93.18%, significantly higher than the total effective rate in the control group of 76.09%, and the difference between two groups was statistically significant (P < 0.05). After treatment, the gingival index and plaque index of two groups were significantly decreased (P < 0.05), and the gingival index and plaque index of the treatment group were significantly lower than those of the control group (P < 0.05). After treatment, the OHIP-14 scores in two groups were significantly lower (P < 0.05), and the OHIP-14 scores in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the levels of IL-10, IL-1β, and IL-34 in the exudates of the two groups were lower than those before treatment (P < 0.05), and the levels of IL-10, IL-1β, and IL-34 in the exudates of the treatment group were significantly lower than those of the control group (P < 0.05). Conclusion Chitong Xiaoyanling Granules combined with Minocycline Hydrochloride Ointment can improve the efficacy of chronic periapical inflammation, reduce periodontal symptoms, reduce inflammatory response, improve the quality of life of patients, and the drug safety is reasonable.

R988.2

河北省卫生健康委医学科学研究课题计划（20181210）