目的 探讨西吡氯铵含漱液联合丁硼乳膏治疗智齿冠周炎的临床疗效及对炎症介质的影响。方法 回顾性分析2020年2月-2021年2月在延安市人民医院治疗的216例智齿冠周炎患者的临床资料，根据用药的差别分为对照组和治疗组，每组各108例。对照组给予丁硼乳膏，取1 g药物涂抹于患处，滞留3~5 min后用清水漱口洗去，3次/d。治疗组在对照组的基础上含漱西吡氯铵含漱液，15 mL/次，强力漱口1 min，3次/d。两组均经14 d治疗。观察两组患者临床疗效，比较治疗前后两组患者VAS、MDAS、症状评分，牙周袋探诊深度、菌斑指数、牙周附着水平、龈沟出血指数及龈沟液C反应蛋白（CRP）、前列腺素E₂（PGE₂）、白细胞介素-6（IL-6）和基质金属蛋白抑制酶1（TIMP-1）水平。结果 治疗后，对照组总有效率明显低于治疗组（85.19%vs 99.07%，P<0.05）。经治疗，两组VAS评分、MDAS评分、症状评分均明显下降，且治疗组下降更显著（P<0.05）。经治疗，两组牙周袋探诊深度、菌斑指数、牙周附着水平、龈沟出血指数水平均明显降低（P<0.05），且治疗组患者明显低于对照组（P<0.05）。经治疗，两组龈沟液CRP、PGE₂、IL-6、TIMP-1水平均显著下降（P<0.05），并以治疗组降低最显著（P<0.05）。结论 西吡氯铵含漱液联合丁硼乳膏治疗智齿冠周炎可有效改善患者症状，降低机体炎症反应，改善牙周状况，具有一定临床推广应用价值。

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

陕西省重点研发计划项目（S2018-YF-YBSF-04560）