一氧化二氮吸入对药物性牙龈增生合并高血压患者牙周基础治疗影响的临床研究

目的:比较高血压患者一氧化二氮吸入和传统牙周基础治疗时的疼痛评分及血压状况差异。方法:本研究为随机对照临床试验。纳入药物性牙龈增生患者40例,其中36例完成了临床检查和治疗。36名患者在牙周探诊时分为2组(n=18),A组在一氧化二氮吸入下进行,B组在无麻醉下进行;4周后2组交换麻醉方式,比较2组临床指标、VAS评分、血压差异。龈下刮治根面平整阶段将患者分为2组(n=18),第一次治疗C组在一氧化二氮吸入下进行,D组在局部浸润下进行;第二次治疗阶段2组交换麻醉方式,比较2组临床指标、VAS评分、血压差异。结果:一氧化二氮吸入牙周探诊VAS疼痛评分均显著低于常规探诊组(P<0.05);A、B组内一氧化二氮吸入牙周探诊检查中的血压低于治疗前(P<0.05)。C、D两组组内一氧化二氮吸入组VAS疼痛评分显著低于局麻组(P<0.05)。结论:与传统的牙周基础治疗比较,高血压患者在一氧化二氮吸入条件下牙周治疗疼痛较轻,血压更稳定。

Clinical effects of nitrous oxide inhalation on the periodontal initial therapy for the patients with drug-induced gingival overgrowth and hypertension

Objective:To compare the difference of pain(VAS)and blood pressure between nitrous oxide inhalation periodontal therapy and traditional periodontal therapy in patients with drug-induced gingiva overgrowth and hypertension(DIGOH).Methods:40 patients with DGOH were enrolled in a randomized controlled clinical study,36 of them completed the clinical examination and were randomly assigned into group A and group B(n=18).At baseline,the subjects in group A were given nitrous oxide inhalation and those in group B were without anesthesia for periodontal probe test.After 4 weeks,the anesthesia methods were exchanged between the 2 groups,the differences in periodontal clinical indexes,VAS and blood pressure were compared between the 2 groups and within each group.A split-mouth periodontal treatment was designed in initial therapy,and patients were randomly divided into group C and D(n=18).In group C,the right side of SRP was performed after local infiltration anesthesiain,the left side of SRP was performed after local anesthesia.In group D,the treatment methods were exchanged between 2 sides as discribed in group C.The differences in periodontal clinical indexes,VAS and blood pressure were compared between the 2 groups and within each group.Results:The VAS in the nitrous oxide inhalation group was lower than that of the conventional periodontal examination group(P<0.05);the systolic and diastolic blood pressure during the examination were lower than before(P<0.05).Ingroup C and D,the VAS of SRP with nitrous oxide inhalation was significantly lower than that with aesthesia(P<0.05).Conclusion:Periodontal therapy for hypertensive patients with nitrous oxide inhalation is more effective than traditional periodontal initialtherapy in the control of pain and blood pressure.