云南白药胶囊对正颌外科术后肿胀反应影响的评价

目的 研究和评价正颌外科围手术期口服云南白药胶囊对术后面部肿胀和炎症反应的影响.方法 87例行正颌外科手术的患者根据随机数字表分为实验组和对照组,术前3 d和术后5 d分别口服云南白药胶囊和安慰剂胶囊.检测术后1、2、3、5 d血清C-反应蛋白(CRP)和IL-6,IL-1水平,并评定术后3、5、7 d面部肿胀程度,比较分析云南白药对面部肿胀程度和炎症反应强度的影响.结果 两组术后第1天血清CRP、IL-6和IL-1水平均达最高峰值,2 d开始降低.实验组术后2、3、5 d血清CRP水平低于对照组,两组CRP值比较,差异具有统计学意义.术后2 d实验组IL-6水平也低于对照组,两组差异具有统计学意义.实验组术后第3、5、7天面部肿胀程度均低于对照组.结论 围手术期口服云南白药胶囊可抑制正颌外科术后细胞因子的水平和C-反应蛋白的合成,减轻了炎症反应强度和面部组织肿胀程度.云南白药胶囊具有一定的抗炎作用.

Evaluation of Yunnan Baiyao capsules for reducing postoperative swelling after orthognathic surgery

Objective To evaluate the effects of Yunnan Baiyao capsules on facial swelling and anti-inflammatory response after orthognathic surgery. Methods 87 patients scheduled for Le Fort I osteotomy and bilateral sagittal split ramus osteotomy (BSSRO) and genioplasty were randomly divided into 2 groups: experiment roup (n =43) given with Yunnan Baiyao capsules orally 4 days before operation once daily and then via nasal feeding tube after operation once a day for 5 days, and placebo group given with placebo capsules. Antibiotic was routinely given to both groups. Serum levels of C-reactive protein (CRP), interleukin 6 ( IL-6), and IL-1 were quantified on postoperative days 1,2,3, and 5. Degrees of facial swelling were evaluated on postoperative days 3,5, and 7. Results Peak CRP and cytokines levels were reached on the first postoperative day in both groups, and the the variables decreased. The serum concentrations of CRP and IL-6 in the Yunan Baiyao group were lower than those in the control group. The CRP kevels on the postoperative day 2, 3 and 5 of the experiment group were all significantly lower than those of the placebo group, and the IL-6 level on the second postoperative day of the experiment group was significantly lower than that of the placebo group. Conclusion Perioperative administration of Yunnan Baiyao capsules can reduce the magnitude of inflammatory response and facial swelling after orthognathie surgery. Yunnan Baiyao capsule has efficacy of anti-inflammatory response.