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菠萝蛋白酶-对乙酰氨基酚组合对根管治疗术后疼痛强度的影响:一项随机临床试验。

The effect of bromelain-acetaminophen combination on the intensity of endodontic postoperative pain: A randomized clinical trial.

作者信息

Abbasi Fatemeh, Abbasi Bahar, Rezazadeh Mahboubeh, Ghazalgoo Ali

机构信息

Department of Oral and Maxillofacial Medicine, Dental Research Center, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

Dental Students Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Dent Res J (Isfahan). 2025 Aug 25;22:34. doi: 10.4103/drj.drj_234_23. eCollection 2025.

Abstract

BACKGROUND

Despite significant advances in dentistry, postendodontic pain is one of the problems that patients still suffer from. This study aimed to evaluate the effect of bromelain-acetaminophen combination on the reduction of postendodontic pain in teeth with symptomatic irreversible pulpitis.

MATERIALS AND METHODS

In this randomized double-blind clinical trial, 60 patients with mandibular first molars with irreversible pulpitis were evaluated. To homogenize the samples, patients who needed endodontic treatment of mandibular first molars with moderate severity were selected according to the American Association of Endodontists case difficulty assessment form. After endodontic treatment, half of the patients were given a placebo and 500 mg acetaminophen every 6 h, and the other half were given 500 mg Anahil capsule and 500 mg acetaminophen every 6 h until the patients' pain was ameliorated. If the patient did not feel pain, they didn't take medication, also we excluded the patients who felt pain for more than 2 days. The Visual Analog Scale (VAS) was used to measure pain before and 6, 12, 24, and 48 h after endodontic treatment. Data were analyzed by SPSS (version 22) software using -test, Mann-Whitney, and Kaplan-Meyer tests at a 5% error level.

RESULTS

The amount of pain decreased more in the experimental group than in the placebo group 6 and 12 h after endodontic treatment, but by controlling the effect of initial pain ( = 0.627), no significant difference was observed between the two groups in the amount of pain ( = 0.875).

CONCLUSION

The bromelain-acetaminophen combination did not have an added value when it comes to controlling postendodontic pain.

摘要

背景

尽管牙科领域取得了重大进展,但根管治疗后疼痛仍是患者仍面临的问题之一。本研究旨在评估菠萝蛋白酶 - 对乙酰氨基酚组合对减轻有症状的不可逆性牙髓炎牙齿根管治疗后疼痛的效果。

材料与方法

在这项随机双盲临床试验中,对60例下颌第一磨牙患有不可逆性牙髓炎的患者进行了评估。为使样本同质化,根据美国牙髓病学家协会病例难度评估表,选择需要对中度严重的下颌第一磨牙进行根管治疗的患者。根管治疗后,一半患者每6小时服用一次安慰剂和500毫克对乙酰氨基酚,另一半患者每6小时服用500毫克阿纳希尔胶囊和500毫克对乙酰氨基酚,直至患者疼痛缓解。如果患者没有感到疼痛,他们就不再服药,同时我们也排除了疼痛超过2天的患者。使用视觉模拟量表(VAS)测量根管治疗前以及治疗后6、12、24和48小时的疼痛程度。数据使用SPSS(版本22)软件进行分析,采用t检验、曼 - 惠特尼检验和卡普兰 - 迈耶检验,误差水平为5%。

结果

根管治疗后6小时和12小时,实验组的疼痛减轻程度比安慰剂组更大,但在控制初始疼痛的影响后(P = 0.627),两组在疼痛程度上未观察到显著差异(P = 0.875)。

结论

在控制根管治疗后疼痛方面,菠萝蛋白酶 - 对乙酰氨基酚组合没有附加价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c0a/12404429/0826ce8637cd/DRJ-22-34-g003.jpg

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