中药超声雾化鼻吸入联合鼻腔冲洗治疗鼻咽癌放疗后鼻窦炎临床研究
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摘要
目的探讨中药超声雾化鼻吸入联合鼻腔冲洗治疗鼻咽癌放疗后鼻窦炎肺经风热证临床疗效。方法采用随机数字表法将80例患者分为观察组和对照组各40例。对照组予鼻腔冲洗;观察组在对照组基础上予中药超声雾化鼻吸入,每次30 min,每日1次,交替轮换鼻腔,治疗5 d后间隔2 d。2组均连续治疗4周。观察2组治疗前后症状评分、慢性鼻窦炎鼻息肉患者内镜评分系统(Lund-kennedy)评分、纤毛传输速率及炎症因子水平,比较2组临床疗效。结果与本组治疗前比较,2组治疗后嗅觉减退、鼻塞、鼻腔分泌物评分及Lund-kennedy评分降低,超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)水平降低,纤毛传输速率升高,差异有统计学意义(P<0.05)。2组治疗后比较,观察组嗅觉减退、鼻塞、鼻腔分泌物评分及Lund-kennedy评分低于对照组,hs-CRP、TNF-α水平低于对照组,纤毛传输速率高于对照组,差异有统计学意义(P<0.05)。观察组总有效率为92.50%(37/40),对照组为75.00%(30/40),观察组明显优于对照组(P<0.05)。结论中药超声雾化鼻吸入联合鼻腔冲洗治疗鼻咽癌放疗后鼻窦炎肺经风热证疗效满意,可改善机体炎症反应及鼻窦功能。
Objective To discuss the clinical efficacy of TCM ultrasonic atomizing nasal inhalation combined with nasal irrigation for the treatment of sinusitis(pattern of wind-heat in lung channel) after radiotherapy for nasopharyngeal carcinoma. Methods Totally 80 patients with nasopharyngeal carcinoma were divided into observation group and control group through random number table method, with 40 cases in each group. The control group was treated with nasal irrigation, and observation group was treated with TCM ultrasonic atomizing for nasal inhalation on the basis of control group, 30 min each time, once a day, alternate rotation of the nasal cavity, rest for 2 days after treatment for 5 days. The treatment for both groups lasted for four weeks. The symptom scores, the endoscopic scoring system(Lund-kennedy) score, the cilia transmission rate and the inflammatory factor level s of the two groups before and after treatment were observed. The clini cal efficacy of both groups was compared. Results Compared with before treatment, hyposmia, nasal congestion, nasal secretion symptom score, Lund-kennedy score, levels of high-sensitivity C-reactive protein(hs-CRP) and tumor necrosis factor-α(TNF-α) decreased, and cilia transmission rate increased, with statistical significance(P<0.05). After treatment, hyposmia, nasal congestion, nasal secretion symptom score and Lund-kennedy score were lower in the observation group than that in the control group. The hs-CRP and TNF-α levels were lower than the control group, and the cilia transmission rate was higher than that of the control group, with statistical significance(P<0.05). The total effective rate was 92.50%(37/40) in the observation group and 75.00%(30/40) in the control group. The observation group was significantly better than the control group(P<0.05). Conclusion TCM ultrasonic atomizing nasal inhalation combined with nasal irrigation for the treatment of sinusitis(pattern of wind-heat in lung channel) after radiotherapy for nasopharyngeal carcinoma has satisfied efficacy, which can improve inflammatory response and sinus function.
Objective To discuss the clinical efficacy of TCM ultrasonic atomizing nasal inhalation combined with nasal irrigation for the treatment of sinusitis(pattern of wind-heat in lung channel) after radiotherapy for nasopharyngeal carcinoma. Methods Totally 80 patients with nasopharyngeal carcinoma were divided into observation group and control group through random number table method, with 40 cases in each group. The control group was treated with nasal irrigation, and observation group was treated with TCM ultrasonic atomizing for nasal inhalation on the basis of control group, 30 min each time, once a day, alternate rotation of the nasal cavity, rest for 2 days after treatment for 5 days. The treatment for both groups lasted for four weeks. The symptom scores, the endoscopic scoring system(Lund-kennedy) score, the cilia transmission rate and the inflammatory factor level s of the two groups before and after treatment were observed. The clini cal efficacy of both groups was compared. Results Compared with before treatment, hyposmia, nasal congestion, nasal secretion symptom score, Lund-kennedy score, levels of high-sensitivity C-reactive protein(hs-CRP) and tumor necrosis factor-α(TNF-α) decreased, and cilia transmission rate increased, with statistical significance(P<0.05). After treatment, hyposmia, nasal congestion, nasal secretion symptom score and Lund-kennedy score were lower in the observation group than that in the control group. The hs-CRP and TNF-α levels were lower than the control group, and the cilia transmission rate was higher than that of the control group, with statistical significance(P<0.05). The total effective rate was 92.50%(37/40) in the observation group and 75.00%(30/40) in the control group. The observation group was significantly better than the control group(P<0.05). Conclusion TCM ultrasonic atomizing nasal inhalation combined with nasal irrigation for the treatment of sinusitis(pattern of wind-heat in lung channel) after radiotherapy for nasopharyngeal carcinoma has satisfied efficacy, which can improve inflammatory response and sinus function.
引文
[1]梁锌,杨剑,高婷,等.中国鼻咽癌流行概况[J].中国肿瘤,2016,25(11):835-840.
[2]邱元正,刘超,李果.鼻咽癌放射治疗的现状与对策[J].中国耳鼻咽喉颅底外科杂志,2015,21(6):435-438.
[3]李艳,周丽芹.鼻内镜术后用高渗盐水与等渗盐水行鼻腔冲洗的对比观察及护理[J].护士进修杂志,2007,22(15):1437.
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[6]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[J].中华耳鼻咽喉头颈外科杂志,2013,48(2):3.
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[8]张罗,韩德民,王琪.鼻腔黏液纤毛传输系统功能的评估[J].中国耳鼻咽喉头颈外科,2006,13(7):507-510.
[9]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:86.
[10]刘娜,闫娟,刘涛.慢性鼻-鼻窦炎的免疫机制研究进展[J].山东大学耳鼻喉眼学报,2014,28(3):86-88.
[11]牟俊波,吕忠兰,杨凤娇,等.诱导化疗加同步放化疗治疗局部晚期鼻咽癌的临床研究[J].中国肿瘤临床与康复,2016,23(3):264-267.
[12]郭蓓,袁琨,崔前波,等.鼻咽癌放疗后慢性鼻-鼻窦炎的3种治疗方法的疗效分析[J].临床耳鼻咽喉头颈外科杂志,2016,30(7):563-565.
[13]沈纲.两种鼻咽冲洗方式对减轻鼻咽癌放疗并发症的疗效观察[J].中国现代医药杂志,2012,14(1):88-89.
[14]NIKAHLAGH S,GHAFOURIAN-BOUROUJERDNIA M,SAKI N,et al.Immunologic factors in patients with chronic polypoid sinusitis[J].APA Research Office Technical Reports,2013,18(4):380-383.
[15]张学辉,黄健男,傅向军,等.鼻咽癌放射治疗后鼻窦炎相关因素分析[J].中华耳鼻咽喉科杂志,2004,39(12):29-31.
[16]戴润芝,马飞.鼻渊舒口服液联合克拉霉素对慢性鼻窦炎患者症状及Lund-kennedy评分的影响[J].湖北中医药大学学报,2015,17(3):24-26.
[17]苏群,高力英,李益民,等.鼻咽癌放疗后放射性鼻窦炎的影响因素及治疗效果探讨[J].实用肿瘤杂志,2014,29(3):219-222.
[18]卿丽华,朱力.中药超声雾化鼻吸入治疗萎缩性鼻炎的临床观察:附125例病例报告[J].成都中医药大学学报,2005,28(4):18-19.
[19]张美丽,倪培华,蔡昌枰,等.IL-6基因多态性与慢性鼻-鼻窦炎易感性的相关性研究[J].临床耳鼻咽喉头颈外科杂志,2012,26(5):197-200,204.
[20]李泳文.苍耳子散加味方联合鼻腔冲洗对鼻咽癌放疗患者放射性鼻窦炎发生的影响[J].中医杂志,2015,56(15):1314-1317.
[2]邱元正,刘超,李果.鼻咽癌放射治疗的现状与对策[J].中国耳鼻咽喉颅底外科杂志,2015,21(6):435-438.
[3]李艳,周丽芹.鼻内镜术后用高渗盐水与等渗盐水行鼻腔冲洗的对比观察及护理[J].护士进修杂志,2007,22(15):1437.
[4]何小进.探讨鼻咽癌患者常规放疗后鼻窦炎的发生情况及影响因素[J].中国医学工程,2013,21(11):39-40.
[5]孙燕,石远凯.临床肿瘤内科手册[M].5版.北京:人民卫生出版社,2007:476-491.
[6]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[J].中华耳鼻咽喉头颈外科杂志,2013,48(2):3.
[7]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:39.
[8]张罗,韩德民,王琪.鼻腔黏液纤毛传输系统功能的评估[J].中国耳鼻咽喉头颈外科,2006,13(7):507-510.
[9]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:86.
[10]刘娜,闫娟,刘涛.慢性鼻-鼻窦炎的免疫机制研究进展[J].山东大学耳鼻喉眼学报,2014,28(3):86-88.
[11]牟俊波,吕忠兰,杨凤娇,等.诱导化疗加同步放化疗治疗局部晚期鼻咽癌的临床研究[J].中国肿瘤临床与康复,2016,23(3):264-267.
[12]郭蓓,袁琨,崔前波,等.鼻咽癌放疗后慢性鼻-鼻窦炎的3种治疗方法的疗效分析[J].临床耳鼻咽喉头颈外科杂志,2016,30(7):563-565.
[13]沈纲.两种鼻咽冲洗方式对减轻鼻咽癌放疗并发症的疗效观察[J].中国现代医药杂志,2012,14(1):88-89.
[14]NIKAHLAGH S,GHAFOURIAN-BOUROUJERDNIA M,SAKI N,et al.Immunologic factors in patients with chronic polypoid sinusitis[J].APA Research Office Technical Reports,2013,18(4):380-383.
[15]张学辉,黄健男,傅向军,等.鼻咽癌放射治疗后鼻窦炎相关因素分析[J].中华耳鼻咽喉科杂志,2004,39(12):29-31.
[16]戴润芝,马飞.鼻渊舒口服液联合克拉霉素对慢性鼻窦炎患者症状及Lund-kennedy评分的影响[J].湖北中医药大学学报,2015,17(3):24-26.
[17]苏群,高力英,李益民,等.鼻咽癌放疗后放射性鼻窦炎的影响因素及治疗效果探讨[J].实用肿瘤杂志,2014,29(3):219-222.
[18]卿丽华,朱力.中药超声雾化鼻吸入治疗萎缩性鼻炎的临床观察:附125例病例报告[J].成都中医药大学学报,2005,28(4):18-19.
[19]张美丽,倪培华,蔡昌枰,等.IL-6基因多态性与慢性鼻-鼻窦炎易感性的相关性研究[J].临床耳鼻咽喉头颈外科杂志,2012,26(5):197-200,204.
[20]李泳文.苍耳子散加味方联合鼻腔冲洗对鼻咽癌放疗患者放射性鼻窦炎发生的影响[J].中医杂志,2015,56(15):1314-1317.