通窍鼻炎颗粒对慢性鼻窦炎伴鼻息肉远期复发的影响及其机制研究
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摘要
目的观察通窍鼻炎颗粒对慢性鼻窦炎伴鼻息肉复发的预防作用,并初步探讨其机制。方法将2014年1月～2016年12月就治的慢性鼻窦炎伴鼻息肉患者128例按随机数字表法分为两组,每组64例,两组均实施鼻内镜手术治疗,术后对照组进行常规治疗,观察组加予通窍鼻炎颗粒治疗,2g/次,3次/d,持续治疗2个月,观察两组治疗效果,统计远期复发情况,并检测治疗前、后外周血细胞因子水平变化。结果治疗后,观察组鼻塞、头闷痛评分均低于对照组,Lund-Kennedy内镜黏膜形态评分系统中息肉、水肿、鼻漏、瘢痕、结痂等评分均低于对照组,差异有统计学意义(P<0.05);治疗后,观察组TNF-α、IL-4、IL-9、IL-10、IFN-γ等细胞因子水平低于对照组,差异有统计学意义(P<0.05);治疗12个月后,观察组复发率低于对照组,差异有统计学意义(P<0.05)。结论通窍鼻炎颗粒可缓解慢性鼻窦炎伴鼻息肉患者临床症状,促进鼻腔黏膜修复,可有效预防疾病的远期复发,这可能与通窍鼻炎颗粒对炎症的抑制有关。
Objective To observe the preventive effect of Tongqiao Biyan granule on the recurrence of chronic sinusitis with nasal polyps and to explore its mechanism. Methods One hundred and twenty eight patients with chronic sinusitis with nasal polyps were divided into two groups according to the random number table method from January 2014 to October 2016. Each group was treated with nasal endoscopic surgery. Patients in the observation group were treated with Tongqiao Biyan granule, 2 g/t, 3 t/d, continue treated for 2 months. The treatment effect and the long-term recurrence was observed,and detected blood cytokine levels. Results After treatment, the scores of nasal congestion, headache were lower than those of the control group. The scores of polyp, edema, rhinorrhea,scar and scab were lower in Lund-Kennedy endoscopic mucosal scoring system(P<0.05). After treatment, the levels of TNF-α, IL-4,IL-9, IL-10 and IFN-γ in the observation group were lower than those in the control group, the difference was statistically significant(P<0.05). After 12 months of treatment, the recurrence rate of the observation group was lower than that of the control group, the difference was statistically significant(P<0.05). Conclusion Tongqiao rhinitis granules can relieve the clinical symptoms of chronic sinusitis with nasal polyps and promote nasal mucosal repair, which can effectively prevent the recurrence. This may be related to the inhibition of inflammation by Tongqiao rhinitis granules.
Objective To observe the preventive effect of Tongqiao Biyan granule on the recurrence of chronic sinusitis with nasal polyps and to explore its mechanism. Methods One hundred and twenty eight patients with chronic sinusitis with nasal polyps were divided into two groups according to the random number table method from January 2014 to October 2016. Each group was treated with nasal endoscopic surgery. Patients in the observation group were treated with Tongqiao Biyan granule, 2 g/t, 3 t/d, continue treated for 2 months. The treatment effect and the long-term recurrence was observed,and detected blood cytokine levels. Results After treatment, the scores of nasal congestion, headache were lower than those of the control group. The scores of polyp, edema, rhinorrhea,scar and scab were lower in Lund-Kennedy endoscopic mucosal scoring system(P<0.05). After treatment, the levels of TNF-α, IL-4,IL-9, IL-10 and IFN-γ in the observation group were lower than those in the control group, the difference was statistically significant(P<0.05). After 12 months of treatment, the recurrence rate of the observation group was lower than that of the control group, the difference was statistically significant(P<0.05). Conclusion Tongqiao rhinitis granules can relieve the clinical symptoms of chronic sinusitis with nasal polyps and promote nasal mucosal repair, which can effectively prevent the recurrence. This may be related to the inhibition of inflammation by Tongqiao rhinitis granules.
引文
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9张清,赵瑞,张珉.复发性鼻窦炎、鼻息肉的再手术治疗体会[J].医学理论与实践,2016,29(3):356-357.
10郑妮亚,唐月英,曾屹生,等.加味苍耳子散在鼻内镜术后黏膜炎症恢复中的疗效观察[J].天津中医药大学学报,2012,31(3):144-146.
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12 De Moor C,Reardon G,McLaughlin J,et al.Aretrospective comparison of acute rhinosinusitis outcomes in patients prescribed antibiotics,mometasone furoate nasal spray,or both[J].Am J Rhinol Allergy,2012,26(4):308-314.
13胡则勒,柳辉高,吴定芬.外用鼻窦灌注液冲洗治疗鼻内镜术后鼻源性慢性咽炎[J].中国实验方剂学杂志,2014,20(13):232-234.
14奚玲,马志跃.慢性鼻-鼻窦炎患者筛窦黏膜的细菌学特征研究[J].中华实验和临床感染病杂志(电子版),2013,7(4):14-16.
15肖二彬.IL-9在慢性鼻-鼻窦炎合并鼻息肉患者中的检测及意义[J].中国中西医结合耳鼻咽喉科杂志,2015,23(2):128-129.
2丁琼.头孢丙烯联合通窍鼻炎颗粒治疗急性鼻炎临床效果分析[J].北方药学,2015,12(9):150-151.
3徐艳,马梅,张宗强.通窍鼻炎颗粒联合针刺治疗过敏性鼻炎及对患者血清IL-4,IL-6及IL-10的影响[J].中国实验方剂学杂志,2015,21(14):169-172.
4张立刚.通窍鼻炎颗粒联合布地奈德治疗鼻窦炎97例[J].河南中医,2015,35(9):2288-2290.
5中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组,中华医学会耳鼻咽喉头颈外科学分会鼻科学组.慢性鼻-鼻窦炎诊断和治疗指南(2012年,昆明)[J].中华耳鼻咽喉头颈外科杂志,2013,48(2):92-94.
6中华中医药学会.中医内科常见病诊疗指南·中医病证部分[M].北京:中国中医药出版社,2008:8-13.
7郑筱萸.中药新药临床研究指导原则[M].2版.北京:中国医药科技出版社,2002:172-173.
8赵春雷,杨维.鼻内镜下中鼻甲不同术式对慢性鼻-鼻窦炎合并鼻息肉患者的影响分析.中国耳鼻喉颅底外科杂志,2015,21(1):46-49.
9张清,赵瑞,张珉.复发性鼻窦炎、鼻息肉的再手术治疗体会[J].医学理论与实践,2016,29(3):356-357.
10郑妮亚,唐月英,曾屹生,等.加味苍耳子散在鼻内镜术后黏膜炎症恢复中的疗效观察[J].天津中医药大学学报,2012,31(3):144-146.
11沈映君,陈长勋.中药药理学[M].上海:上海科学技术出版社,2012:104-176.
12 De Moor C,Reardon G,McLaughlin J,et al.Aretrospective comparison of acute rhinosinusitis outcomes in patients prescribed antibiotics,mometasone furoate nasal spray,or both[J].Am J Rhinol Allergy,2012,26(4):308-314.
13胡则勒,柳辉高,吴定芬.外用鼻窦灌注液冲洗治疗鼻内镜术后鼻源性慢性咽炎[J].中国实验方剂学杂志,2014,20(13):232-234.
14奚玲,马志跃.慢性鼻-鼻窦炎患者筛窦黏膜的细菌学特征研究[J].中华实验和临床感染病杂志(电子版),2013,7(4):14-16.
15肖二彬.IL-9在慢性鼻-鼻窦炎合并鼻息肉患者中的检测及意义[J].中国中西医结合耳鼻咽喉科杂志,2015,23(2):128-129.