老年人工股骨头置换术后隐性失血是影响手术的重要因素之一,手术后机体生理、病理的变化是一个较为复杂的过程。目前中医对其病因病机尚无系统研究。临床中常存在辨证思维局限,难以客观、全面揭示该病病因病机的特点,进而导致遣方用药难以把握。该文旨在对老年人工股骨头置换术后隐性失血的病因病机进行探讨,认为该病的证候特点为气血亏虚兼瘀,病性为本虚标实,病位肝脾肾,其中气血亏虚贯穿疾病始终,而气为关键。

Hidden blood loss after artificial femoral head replacement in the elderly is one of the important factors affecting the operation,and the change of physiology and pathology after operation is a complicated process．At present,there is no systematic study on its etiology and pathogenesis in traditional Chinese medicine．In clinical practice,there are limitations of dialectical thinking,which make it difficult to Objective ly and comprehensively reveal the characteristics of the etiology and pathogenesis of the disease,and difficult to prescribe．The purpose of this paper is to explore the etiology and pathogenesis of hidden blood loss after artificial femoral head replacement in the elderly．It is considered that the syndrome of the disease is characterized by deficiency of qi and blood and blood stasis,and the disease is based on deficiency of liver,spleen and kidney,in which deficiency of qi and blood runs through the disease all the time,and qi is the key．

目的 探索以解语丹联合靳三针为基础的不同治疗方案对卒中后失语症（PSA）的治疗效果。方法 收集广州市第一人民医院神经内科、中医科PSA患者120例,随机分为解语丹组、靳三针组、联合组和对照组,每组各30例。试验组除给予常规卒中治疗外,分别给予解语丹、靳三针及解语丹联合靳三针治疗,对照组仅给予常规卒中治疗,治疗周期共12周。分别利用西方失语成套测验（WAB）、汉语失语检查量表（ABC）、副反应量表（TESS）于试验前、试验2周及12周时对患者进行评估,并进行药物安全性评价,观察解语丹联合靳三针治疗卒中后失语症的临床治疗效果。结果 经2周治疗后,试验组各组WAB中的失语指数（AQ）、操作指数（PQ）、大脑皮质指数（CQ）评分分别为68.14±7.23;67.26±7.23;69.73±6.97、15.47±3.91;15.92±6.35;18.06±7.83、66.84±7.85;65.78±6.75;70.35±6.73,均较治疗前及对照组有明显改善,比较差异有统计学意义（P<0.05）;试验组各组比较,联合组各项评分优于解语丹组和靳三针组,比较差异有统计学意义（P<0.05）;治疗12周后,试验组WAB的AQ、PQ、CQ评分分别为91.87±7.81;85.75±6.87;94.58±7.83、31.57±7.38;25.67±6.28;35.72±8.31、89.74±6.98;84.16±6.79;93.56±7.88,与治疗2周后比较,差异有统计学意义（P<0.05）。言语功能各亚项评分显示,联合组在口语表达、听理解、复述、命名等方面优于其他各组,两两比较差异有统计学（P<0.05）。试验各组在2周及12周时,TESS评分比较差异无统计学意义（P<0.05）。统计分析表明,解语丹联合靳三针治疗卒中后失语症,2周后起效12周后效果更为明显。结论 解语丹联合靳三针早期治疗PSA患者能有效提升认知功能,改善患者的言语功能,提高患者的人际交往和生活自理能力,且具有较好的安全性,无严重不良反应,可为临床治疗PSA提供一种新的方法。

Objective To compare the therapeutic effects of different treatment plans based on Jieyu Dan combined with Jin's Three Needle on aphasia patients after stroke．Methods A total of 120 patients with aphasia after stroke in the neurology and traditional Chinese medicine departments of Guangzhou First People's Hospital were collected and randomly divided into Jieyu Dan group,Jin's Three Needle group,combined group and control group,with 30 cases in each group．The treatment groups were treated with Jieyu Dan,Jin's Three Needle and Jieyu Dan combined with Jin's Three Needle respectively,in addition to conventional stroke treatment．The control group was only treated with conventional stroke treatment,with a total treatment period of 12 weeks．The Western Aphasia Battery（WAB）,Aphasia Battery of Chinese（ABC）and Treatment Emergent Symptom Scale（TESS）were used to evaluate patients before,at 2 weeks and 12 weeks of the trial,and drug safety was evaluated to observe the clinical therapeutic effect of Jieyu Dan combined with Jin's Three Needle in treating post stroke aphasia．Results After 2 weeks of treatment,the aphasia quotient（AQ）,performance quotient（PQ）,cortical quotient（CQ）scores of WAB in each group of the experimental group were 68.14±7.23,67.26±7.23,69.73±6.97;15.47±3.91,15.92±6.35,18.06±7.83;66.84±7.85,65.78±6.75,70.35±6.73,respectively,and all significantly improved compared to before treatment and the control group,with significant differences（P<0.05）．Compared with the experimental group,the combined group had better scores than the Jieyu Dan group and Jin's Three Needle group,with a statistically significant difference（P<0.05）．After 12 weeks of treatment,the AQ,PQ,and CQ scores of the experimental group's WAB were 91.87±7.81,85.75±6.87,94.58±7.83;31.57±7.38,25.67±6.28,35.72±8.31;89.74±6.98,84.16±6.79,93.56±7.88,respectively．Compared with 2 weeks of treatment,the difference was statistically significant（P<0.05）．The scores of each sub item of speech function showed that the combined group was significantly better than the other groups in terms of oral expression,listening comprehension,retelling,naming,etc．,with statistical significance（P<0.05）．At 2 and 12 weeks,there were no significant statistical differences in TESS scores among the experimental groups（P<0.05）．Statistical analysis showed that the combination of Jieyu Dan and Jin's Three Needle in the treatment of post-stroke aphasia had a more significant effect after 2 weeks and 12 weeks．Conclusions The combination of Jieyu Dan and Jin's Three Needle can effectively improve cognitive function and enhance patients' self-care ability in the early treatment of aphasia after stroke．The clinical efficacy is significant and has good safety,making it an effective treatment plan for aphasia after stroke．

目的 分析老年患者腰-硬联合麻醉术中给予不同剂量瑞马唑仑的有效性及安全性。方法 纳入2020年5月—2023年4月在武穴市第一人民医院手术需进行腰-硬联合麻醉的老年患者126例,随机分为低剂量组[42例,术中持续泵注2 μg/（kg·min）瑞马唑仑]、中剂量组[42例,术中持续泵注3 μg/（kg·min）瑞马唑仑]、高剂量组[42例,术中持续泵注4 μg/（kg·min）瑞马唑仑],评估患者麻醉前（T0）、麻醉给药5 min（T1）、15 min（T2）、30 min（T3）时镇静程度并记录生命体征指标,记录患者麻醉起效时间、阻滞完善时间,统计麻醉给药后恶心呕吐、低血压等不良反应发生情况。结果 三组患者T1、T2、T3时Ramsay评分较T0时均升高（P<0.05）,中剂量组、高剂量组T2、T3时Ramsay评分高于低剂量组（P<0.05）,高剂量组T2、T3时Ramsay评分高于中剂量组（P<0.05）,低剂量、中剂量组T2、T3时平均动脉压、心率高于高剂量组（P<0.05）;高剂量组、中剂量组麻醉起效时间、阻滞完善时间均短于低剂量组（P<0.05）;低剂量组、中剂量组低氧血症、低血压等不良反应总发生率低于高剂量组（P<α,α=0.017）。结论 老年患者腰-硬联合麻醉术中给予3 μg/（kg·min）的瑞马唑仑效果较为理想,其镇痛作用优于2 μg/（kg·min）,对生命体征的影响低于4 μg/（kg·min）,不良反应较少,兼顾镇静作用与麻醉安全性。

Objective To analyze the effectiveness and safety of different doses of remimazolam in elderly patients with combined spinal-epidural anesthesia．Methods From May 2020 to April 2023,126 elderly patients who needed combined spinal-epidural anesthesia in Wuxue First People's Hospital were included and randomly divided into low-dose group[42 cases,continuous infusion of 2 μg/（kg·min）reimazolam during operation],medium-dose group[42 cases,continuous infusion of 3 μg/（kg·min）reimazolam during operation],and high-dose group[42 cases,continuous infusion of 4 μg/（kg·min）reimazolam during operation]．The degree of sedation and vital signs were recorded at 5 minutes（T1）,15 minutes（T2）,and 30 minutes（T3）of administration,and the anesthesia effective time and block completion time were recorded,and the incidence of adverse reactions such as nausea,vomiting,and hypotension after anesthesia administration were recorded．Results The Ramsay scores at T1,T2 and T3 of the three groups were significantly higher than those at T0（P<0.05）．The Ramsay scores of the middle-dose group and high-dose group were significantly higher than those of the low-dose group at T2 and T3（P<0.05）．The Ramsay scores of the high-dose group were significantly higher than those of the middle-dose group at T2 and T3（P<0.05）．The mean arterial pressure and heart rate of the low-dose group and the middle-dose group at T2 and T3 were higher than those of the high-dose group（P<0.05）．The effective time of anesthesia and block completion time in the high-dose group and the middle-dose group were significantly shorter than those in the low-dose group（P<0.05）．The total incidences of adverse reactions such as hypoxemia and hypotension in the low-dose group and the middle-dose group were significantly lower than those in the high-dose group（P<α,α=0.017）．Conclusions The effect of 3 μg/（kg·min）remimazolam in elderly patients with spinal-epidural combined anesthesia is ideal,its analgesic effect is better than 2 μg/（kg·min）,the impact on vital signs is less than 4 μg/（kg·min）,with fewer adverse reactions,which is a balance between the sedative effect and the safety of anesthesia．

目的 观察环泊酚在老年患者无痛胃肠镜检查中的麻醉效果和不良反应。方法 选择80例65岁以上行无痛胃肠镜检查的老年患者,将患者随机分为环泊酚组（C组）40例和丙泊酚组（P组）40例。每例患者均静脉注射舒芬太尼0.08 μg/kg,30 s后C组给予环泊酚0.3 mg/kg、P组给予丙泊酚1.5 mg/kg。记录2组患者麻醉前（T₀）、睫毛反射消失时（T₁）、置入胃镜后即刻（T₂）和操作结束时（T₃）的心率（HR）和平均动脉压（MAP）;记录2组患者检查操作时间、清醒时间、追加药物次数及静脉注射痛、呼吸抑制、呛咳、体动等不良反应发生情况。结果 2组患者行胃肠镜检查操作时间、麻醉清醒时间和追加药物次数比较差异无统计学意义（P>0.05）。与T₀时间点（102.6±14.1 mmHg）比较,P组患者的MAP在T₁（86.0±12.5 mmHg）、T₂（86.1±13.2 mmHg）、T₃（92.8±12.6 mmHg）时间点明显下降,差异有统计学意义（P<0.05）;与C组T₁（95.9±10.8 mmHg）、T₂（96.3±9.6 mmHg）时间点比较,P组的MAP在T₁（86.0±12.5 mmHg）、T₂（86.1±13.2 mmHg）时均明显降低（P<0.05）。C组患者静脉注射痛、呼吸抑制的发生率明显低于P组（P<0.05）;2组体动和呛咳的发生率比较差异无统计学意义（P>0.05）。结论 环泊酚0.3 mg/kg在老年患者胃肠镜检查中能提供和丙泊酚1.5 mg/kg相似的麻醉效果,环泊酚组的老年患者发生注射痛、血压下降、呼吸抑制的比例更低。

Objective To observe the effect of ciprofol and propofol in painless gastroenteroscopy in elderly patients．Methods A total of 80 elderly patients aged 65 or above who underwent painless gastroenteroscopy were randomly divided into a group of 40 patients receiving ciprofol（Group C）and a group of 40 patients receiving propofol（Group P）．All patients were given sufentanil 0.08 μg/kg,and group C was given ciprofol 0.3 mg/kg,group P was given propofol 1.5 mg/kg after 30 seconds．The heart rate（HR）and mean arterial pressure（MAP）of two groups of patients before anesthesia（T₀）,at the disappearance of eyelash reflex（T₁）,after gastroscopy insertion（T₂）,and at the end of the procedure（T₃）were recorded．The operating time,anesthesia awakening time,number of additional medications and the adverse reactions such as injection pain,respiratory depression,cough,body movements were also recorded．Results There were no significant differences（P>0.05）in the gastroenteroscopy operating time,recovery time and number of additional medications between the two groups．Compared with T₀ time point（102.6±14.1 mmHg）,the MAP of group P patients significantly decreased at T₁（86.0±12.5 mmHg）,T₂（86.1±13.2 mmHg）and T₃（92.8±12.6 mmHg）time points（P<0.05）．Compared with Group C at T₁（95.9±10.8 mmHg）,T₂（96.3±9.6 mmHg）time points,the MAP of Group P decreased significantly at T₁（86.0±12.5 mmHg）and T₂（86.1±13.2 mmHg）time points（P<0.05）．The incidences of injection pain and respiratory depression in group C were significantly lower than those in group P（P<0.05）．There was no statistically significant difference in the incidences of body movements and cough between the two groups（P>0.05）．Conclusions Ciprofol 0.3 mg/kg combined with sufentanil can provide anesthesia effect similar to that of propofol 1.5 mg/kg combined with sufentanil in gastroenteroscopy of elderly patients．The proportions of injection pain,blood pressure decreasing and respiratory depression in elderly patients in the ciprofol group were lower．

目的 探讨选择输尿管软镜下钬激光碎石术治疗肾结石（直径≤3 cm）的效果。方法 回顾性选择2021年1月—2023年1月广州市增城区新塘医院接收的180例肾结石（直径≤3 cm）患者为研究对象,按照手术方式分为对照组（n=90,给予经皮肾镜碎石术治疗）与观察组（n=90,给予输尿管软镜下钬激光碎石术治疗）,比较两组的结石清除效果、并发症、手术治疗情况、炎症反应、肾功能指标。结果 观察组结石清除89例、清除率98.89%,与对照组85例、清除率94.44%比较差异无统计学意义（χ²=2.758,P=0.096）;观察组发生并发症1例、发生率1.11%,比对照组8例、发生率8.89%更低（χ²=5.731,P=0.016）。与对照组（58.45±10.62）min、（32.26±4.49）mL、（10.42±2.27）g/L、（4.25±0.86）min比较,观察组手术操作时长（70.05±15.24）min更高,术中失血量（10.22±2.28）mL更少、术后血红蛋白（Hb）下降值（3.94±1.05）g/L更低,视觉模拟评分法（VAS）（2.22±0.42）分更低（t分别为5.924、41.521、24.579、20.121,P<0.05）。术后两组白细胞计数（WBC）、C-反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）、降钙素原（PCT）明显升高,而观察组（7.62±1.15）×10⁹/L、（14.25±2.24）mg/L、（1.65±0.34）mg/mL、（17.22±1.45）ng/ml明显低于对照组（8.82±1.41）×10⁹/L、（22.26±3.63）mg/L、（2.56±0.44）mg/mL、（20.64±2.87）ng/mL（t分别为6.256、17.814、15.525,10.090,P<0.05）。术后两组各指标明显升高,血肌酐（Scr）、胱抑素-C（Cys-C）、血尿素氮（BUN）组间比较差异无统计学意义（P>0.05）;而观察组、中性粒细胞明胶酶相关脂质运载蛋白（NGAL）（4.95±0.84）μg/L明显低于对照组（6.45±1.15）μg/L（t=9.992,P<0.05）。结论 输尿管软镜引导下置入钬激光进行碎石可有效治疗直径≤3 cm肾结石,取得与经皮肾镜相当的疗效,可进一步减轻疼痛,减少出血,控制炎症反应,避免肾功能损伤,安全性更高。

目的 探讨妊娠期高血压疾病患者血尿酸、淀粉酶水平的变化的临床意义。方法 选择2020年2月—2023年2月期间焦作市第二人民医院收治的150例合并妊娠期高血压疾病孕妇作为观察组,另选择同期接收的50例正常妊娠孕妇作为对照组,测定两组孕妇孕早期、孕中期、孕晚期的血尿酸、淀粉酶水平,比较两组检测结果,并采取受试者工作特征曲线分析（ROC）血尿酸、淀粉酶水平筛查妊娠期高血压疾病的诊断效能,比较观察组妊娠期高血压、子痫前期、子痫孕妇的检测结果。结果 观察组孕妇在孕早期、孕中期、孕晚期的血尿酸水平高于对照组,淀粉酶水平低于对照组（P<0.05）;孕早期与孕中期的血尿酸、淀粉酶水平比较,两组孕妇比较差异均无统计学意义（P>0.05）;孕晚期两组孕妇的血尿酸水平升高,淀粉酶水平降低,与孕早期、孕中期比较差异有统计学意义（P<0.05）。ROC曲线分析显示,妊娠期高血压疾病的筛查中血尿酸灵敏度为58.15%、特异度为88.72%,淀粉酶灵敏度为56.47%、特异度为92.24%,血尿酸联合淀粉酶灵敏度为82.24%、特异度为98.57%。子痫、重度子痫前期、轻度子痫前期、妊娠期高血压孕妇的血尿酸、淀粉酶水平比较差异均有统计学意义（P<0.05）。结论 与正常妊娠孕妇相比,合并妊娠期高血压疾病孕妇的血尿酸水平升高、淀粉酶水平降低,二者联合可实现对妊娠期高血压疾病的准确筛查,而且可评估病情进展。

目的 探讨茵栀黄口服液、还原型谷胱甘肽联合光疗对新生儿黄疸的临床疗效。方法 以2020年2月—2023年3月河南省驻马店市中医院收治的100例黄疸患儿为研究对象。按照随机数字表法分为A组和B组,每组各50例。A组和B组患儿均接受蓝光治疗,B组予以还原型谷胱甘肽治疗,A组在B组的基础上联合茵栀黄口服液。观察A组和B组患儿临床疗效、黄疸消退时间、胆红素水平、T淋巴细胞亚群以及不良反应发生情况。结果 A组总有效率高于B组（96.00% vs 82.00%）（P<0.05）;治疗7 d后,A组和B组患儿组总胆红素、间接胆红素、直接胆红素水平均低于治疗前,且A组低于B组（P<0.05）;A组和B组患儿组CD3⁺、CD4⁺、CD4⁺/CD8⁺均高于治疗前且A组高于B组,A组和B组CD8⁺低于治疗前且A组低于B组（P<0.05）;A组皮疹、腹泻等不良反应的总发生率和B组组间对比差异无统计学意义（10.00% vs 6.00%,P>0.05）。结论 茵栀黄口服液联合还原型谷胱甘肽和光疗用于新生儿黄疸的治疗中可加快总胆红素水平的降低,改善T淋巴细胞亚群,进而提高临床疗效且不增加不良反应。

目的 探讨免疫球蛋白（Ig）与超敏C-反应蛋白（hs-CRP）联合在幼儿手足口病病情中的应用价值。方法 选取2021年1月—2023年4月广州市妇女儿童医疗中心接受诊治的160例手足口病患儿作为观察组,依据其病情严重程度将其分为普通型98例、重症型62例;并选取同期健康体检儿童160名作为对照组。于观察组入组时、对照组体检时采集静脉血,对所有受试者进行IgG、IgA、IgM与hs-CRP检测,对比观察组、对照组和轻症型、重症型的指标水平,分析上述指标诊断效能。结果 观察组hs-CRP、IgM高于对照组,IgG、IgA低于对照组（P<0.05）;轻症型hs-CRP、IgM均低于重症型患儿,IgG、IgA均高于重症型患儿（P<0.05）;ROC曲线分析,hs-CRP、IgG、IgA、IgM联合对幼儿手足口病的诊断敏感性最高,为87.50%,AUC=0.952（0.922~0.973）,约登指数为0.769。结论 免疫球蛋白联合hs-CRP能够明显提高幼儿手足口病的诊断敏感性,可作为评价患儿病情严重程度的参考指标检测。

目的 探讨重复经颅磁刺激应用于帕金森病失眠患者中的效果及对睡眠质量的影响。方法 选取2021年1月—2022年3月南阳南石医院神经内科收治的帕金森病失眠患者100例,按照随机数字表法均分为参照组（n=50）和研究组（n=50）,参照组采用常规西药治疗,研究组在参照组基础上采用重复经颅磁刺激治疗,对比两组治疗效果、神经递质指标水平、帕金森症状表现及睡眠质量评分的差异。结果 研究组治疗总有效率98.00%（49/50）高于参照组82.00%（41/50）,对比差异有统计学意义（P<0.05）。治疗后,研究组神经递质多巴胺及5-羟色胺水平分别为（6.84±0.62）、（22.75±0.59）,均高于参照组,对比差异均有统计学意义（P<0.05）。治疗后,研究组帕金森病症状表现及睡眠质量总评分均低于参照组,对比差异均有统计学意义（P<0.05）。结论 重复经颅磁刺激应用到帕金森病失眠患者的治疗中,能提升疗效,明显改善患者睡眠质量和帕金森病症状。

Objective To investigate the effect of repetitive transcranial magnetic stimulation（rTMS）on Parkinson's insomnia and its influence on sleep quality．Methods A total of 100 Parkinson's patients with insomnia admitted to the Department of Neurology,Nanyang Nanshi Hospital from January 2021 to March 2022 were selected and divided into the reference group（n=50）and the study group（n=50）according to random number table method．The reference group was treated with conventional western medicine,and the study group was treated with rTMS on the basis of the reference group．The levels of neurotransmitters,symptoms of Parkinson's disease and sleep quality were compared．Results The effective rate of the study group was 98.00%（49/50）,which was higher than 82.00%（41/50）of the reference group,with statistical significance（P<0.05）．After treatment,the levels of dopamine and 5-hydroxytryptamine in the study group,（6.84±0.62）and（22.75±0.59）,were higher than those in the reference group,and the comparison was statistically significant（P<0.05）．After treatment,the total score of Parkinson's symptom and sleep quality in the study group were lower than those in the reference group,with statistical significance（P<0.05）．Conclusions The application of rTMS in the treatment of Parkinson's patients with insomnia can improve the curative effect,significantly improve the sleep quality and symptoms of Parkinson's disease,and is worthy of further application and promotion．

目的 探究纤维桩联合复合树脂及氧化锆烤瓷冠修复治疗根管治疗（RCT）后后牙楔状缺损（WSD）的效果。方法 选取2019年8月—2022年8月在新乡市口腔医院治疗的300例（300牙）RCT后后牙WSD患者,按随机数字表法分成A组（n=150）、B组（n=150）。A组接受纤维桩联合复合树脂及氧化锆烤瓷冠修复治疗,B组接受金属烤瓷冠（PFM）联合金属桩核（MPC）修复治疗。对比2组修复成功率、修复效果、修复前后牙周健康指标[牙龈指数（GI）、菌斑指数（PLI）、牙周探诊深度（PD）]、龈沟液炎性因子[白细胞介素-6（IL-6）、白细胞介素-10（IL-10）、肿瘤坏死因子-α（TNF-α）]水平。结果 A组修复成功率为97.33%（146/150）,高于B组的87.33%（131/150）（P<0.05）;A组边缘密合性、表面质地、颜色匹配均优于B组（P<0.05）;修复6个月后A组GI、PLI、PD较B组低（P<0.05）;修复1个月后A组龈沟液TNF-α、IL-6水平较B组低,IL-10水平较B组高（P<0.05）。结论 与PFM联合MPC修复治疗RCT后后牙WSD患者相比,应用纤维桩联合复合树脂及氧化锆烤瓷冠修复治疗更有助于提升修复成功率及修复效果,改善牙周健康,且对组织产生创伤更小。

Objective To investigate the restorations outcome of fibre post + composite resin + zirconia porcelain crown for patients with wedge-shaped defects（WSD）in posterior teeth after root canal therapy（RCT）．Methods A total of 300 patients（300 teeth）with posterior WSD after RCT in our hospital（from August 2019 to August 2022）were selected and divided into group A（n=150）and group B（n=150）according to random number table method．Group A received composite resin + zirconia porcelain crown + fiber post repair treatment,while group B received porcelain fused to metal（PFM）+ metal post core（MPC）repair treatment．The success rate of repair,the effect of repair,the periodontal health indicators before and after repair[gingival index（GI）,plaque index（PLI）,periodontal probing depth（PD）],and the levels of gingival creval fluid inflammatory factors[interleukin-6（IL-6）,IL-10,tumor necrosis factor-α（TNF-α）] were compared between the two groups．Results The success rate of repair in group A was 97.33%（146/150）,higher than 87.33%（131/150）of group B（P<0.05）．The edge tightness,surface texture and color matching of group A were better than those of group B（P<0.05）．After 6 months of repair,GI,PLI and PD in group A were lower than those in group B（P<0.05）．After one month of repair,the contents of TNF-α and IL-6 in gingival crevicular fluid of group A were lower than those of group B,and the contents of IL-10 were higher than those of group B（P<0.05）．Conclusions Compared with PFM+MPC in the treatment of posterior WSD patients after RCT,the application of composite resin + zirconia porcelain crown + fiber post repair is more helpful to improve the success rate and effect of repair,improve periodontal health,and cause less tissue trauma．