摘要
目的 观察神经生长因子(NGF)局部注射辅助根管治疗术在牙髓炎患儿中的应用效果。方法 选取2020年4月至2022年4月间在咸阳市第一人民医院口腔科接受治疗的90例(110颗患牙)牙髓炎患儿为研究对象,根据随机数表法分为辅助组和对照组各45例(55颗患牙)。对照组采用根管治疗术,辅助组在其基础上给予神经因子20μg/次、1次/d局部注射治疗。治疗10 d后,比较两组患儿的临床效果,以及治疗前后的牙周症状评分、牙周指标[牙龈指数(GI),牙周袋深度(PD)及牙龈沟出血指数(SBI)]、龈沟液炎症因子[肿瘤坏死因子-α (TNF-α)、龈沟液白细胞介素(IL-6)、反应蛋白(CRP)]水平,并比较两组患儿的不良反应发生情况及细菌感染转阴率。结果 治疗后,辅助组患儿的治疗总有效率为94.55%,明显高于对照组的76.36%,差异有统计学意义(P<0.05);治疗后,辅助组患儿的牙周组织肿胀、牙齿松动、牙周疼痛评分分别为(0.70±0.21)分、(0.50±0.17)分、(0.44±0.14)分,明显低于对照组的(1.14±0.35)分、(0.92±0.30)分、(0.91±0.26)分,差异均有统计学意义(P<0.05);治疗后,辅助组患儿的GI、PD、SBI指数分别为(0.87±0.21)分、(1.82±0.27) mm、(0.82±0.16)分,明显低于对照组的(1.23±0.23)分、(3.10±0.30) mm、(1.34±0.19)分,差异均具有统计学意义(P<0.05);治疗后,辅助组患儿的TNF-α、IL-6、CRP分别为(1.21±0.40)μg/L、(243.30±25.63) pg/mL、(3.38±1.68) mg/mL,明显低于对照组的(2.03±0.62)μg/L、(282.30±27.49) pg/mL、(5.81±1.75) mg/mL,差异均有统计学意义(P<0.05);治疗后,辅助组患儿的不良反应发生率为20.00%,略高于对照组的8.89%,差异无统计学意义(P>0.05),但辅助组患儿的细菌转阴率为93.33%,明显高于对照组的77.78%,差异有统计学意义(P<0.05)。结论 NGF局部注射辅助根管治疗术治疗可有效减轻牙髓炎患儿的局部炎症反应,消除细菌感染,并改善牙周状况,临床应用效果良好,且药物安全性较高。
Objective To observe the application effects of local injection of nerve growth factor(NGF)supplemented with root canal therapy on children with pulpitis.Methods Ninety children with pulpitis(110 affected teeth)who were treated in Department of Stomatology,the First People's Hospital of Xianyang between April 2020 and April 2022 were selected as the research subjects.According to the random number table method,the patients were divided into the supplementary group and the control group,with 45 cases(55 affected teeth)in each group.Root canal therapy was performed in the control group,and local injection of 20μg of NGF once a day on this basis was carried out in the supplementary group.The clinical effects after 10 days of treatment,as well as periodontal symptoms scores,periodontal indicators[gingival index(GI),periodontal pocket depth(PD),sulcus bleeding index(SBI)]and inflammatory factors in gingival crevicular fluid[tumor necrosis factor-α(TNF-α),interleukin(IL-6),C-reactive protein(CRP)]before and after treatment were compared between the two groups.The occurrence of adverse reactions and negative conversion rate of bacterial infection were compared between the two groups of children.Results After treatment,the total effective rate of treatment in the supplementary group was 94.55%,which was significantly higher than 76.36%in the control group(P<0.05).The scores of periodontal tissue swelling,tooth loosening,and periodontal pain were(0.70±0.21)points,(0.50±0.17)points,and(0.44±0.14)points in the supplementary group after treatment,significantly lower than(1.14±0.35)points,(0.92±0.30)points,and(0.91±0.26)points in the control group(P<0.05).The GI,PD,and SBI were(0.87±0.21)points,(1.82±0.27)mm,and(0.82±0.16)points in the supplementary group,significantly lower than(1.23±0.23)points,(3.10±0.30)mm,and(1.34±0.19)points in the control group(P<0.05).After treatment,the levels of TNF-α,IL-6,and CRP in the supplementary group were(1.21±0.40)μg/L,(243.30±25.63)pg/mL,and(3.38±1.68)mg/mL,which were significantly lower than(2.03±0.62)μg/L,(282.30±27.49)pg/mL,and(5.81±1.75)mg/mL in the control group(P<0.05).After treatment,the incidence rate of adverse reactions was 20.00%in the supplementary group,slightly higher than 8.89%in the control group(P>0.05),but the bacterial negative conversion rate was 93.33%,significantly higher than 77.78%in the control group(P<0.05).Conclusion Local injection of NGF supplemented with root canal therapy can effectively reduce local inflammatory response,eliminate bacterial infection,and improve periodontal status in children with pulpitis.Moreover,the treatment regimen has good clinical application effects and high drug safety.
作者
包丽娜
付敬敏
颜渊
BAO Li-na;FU Jing-min;YAN Yuan(Department of Stomatology,the First People's Hospital of Xianyang,Xianyang 712000,Shaanxi,CHINA;Department of Stomatology,Ninth Hospital of Xi'an,Xi'an 710054,Shaanxi,CHINA)
出处
《海南医学》
CAS
2023年第8期1122-1126,共5页
Hainan Medical Journal
基金
陕西省咸阳市重点研发计划项目(编号:2019K02-115)。
关键词
儿童
牙髓炎
神经因子
根管治疗
龈沟液炎症因子
细菌感染
Children
Pulpitis
Nerve growth factor
Root canal therapy
Inflammatory factors in gingival crevicular fluid
Bacterial infection
