目的 观察丁细牙痛胶囊联合替硝唑糊剂治疗急性根尖周炎的临床疗效。方法 选取2021年12月—2022年12月沧州市人民医院收治的急性根尖周炎患者128例，依据随机数字法分为对照组（64例）和治疗组（64例）。对照组患者给予替硝唑糊剂填充，1次/周。在对照组的基础上，治疗组口服丁细牙痛胶囊，4粒/次，3次/d。两组患者用药14 d观察治疗情况。观察两组患者临床疗效，比较治疗前后两组患者症状好转时间，牙齿松动度（TM）评分和视觉模拟疼痛（VAS）评分，炎性因子丙二醛（MDA）、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)和前列腺素E₂(PGE₂)水平。结果 治疗后，治疗组总有效率（98.44%）明显高于对照组（85.94%,P<0.05）。治疗后，治疗组牙根痛、牙龈红肿、叩痛、伸长感好转时间均明显短于对照组（P<0.05）。治疗后，两组患者MD评分和VAS评分比治疗前明显下降（P<0.05），且治疗后治疗组MD评分和VAS评分下降更明显（P<0.05）。治疗后，两组MDA、IL-1β、TNF-α、PGE₂水平明显低于治疗前（P<0.05），且治疗后，与对照组对比，治疗组炎性因子水平下降更显著（P<0.05）。结论 替硝唑糊剂与丁细牙痛胶囊协同治疗，可极大地改善牙根尖周炎症状，促进牙齿疼痛及松动度的好转，使机体促炎性反应因子含量降低，有效改善口腔微环境。

Objective To explore the clinical efficacy of Dingxi Yatong Capsules combined with tinidazole in treatment of acute periapical periodontitis. Methods Patients（128 cases） with acute periapical periodontitis in Cangzhou People’s Hospital from December 2021 to December 2022 were divided into control（64 cases） and treatment（64 cases） group according to random number method. Patients in the control group were administered with Tinidazole Paste, once weekly. Patients in the treatment group were po administered with Dingxi Yatong Capsules, 4 grains/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical evaluations were evaluated, the symptom relief time, MD and VAS scores, the levels of MDA, IL-1β, TNF-α, and PGE₂ in two groups before and after treatment were compared. Results After treatment, the effective rate in the treatment group（98.44%） was significantly higher than that in the control group（85.94%, P＜0.05）. After treatment, the improvement time for symptoms such as root pain, gingival redness, tapping pain, and elongation in the treatment group was significantly earlier than that in the control group（P＜0.05）. After treatment, MD score and VAS score in two groups were significantly decreased compared with before treatment（P＜0.05）, and MD score and VAS score decreased more significantly in the treatment group（P＜0.05）. After treatment, the levels of MDA, IL-1β, TNF-α, and PGE₂ in two groups were significantly lower than those before treatment（P＜0.05）. After treatment, compared with the control group, the levels of inflammatory factors in the treatment group decreased more significantly（P＜0.05）. Conclusion The synergistic treatment of Tinidazole Paste and Dingxi Yatong Capsules can greatly improve the symptoms of periapical periodontitis, promote the improvement of tooth pain and mobility, reduce the content of pro-inflammatory response factors in the body, and effectively improve the oral microenvironment.

R988.2

沧州市重点研发计划指导项目(204106007)