蜂蜜麻油混悬液在鼻窦内窥镜术后的应用研究
摘要
目的：通过蜂蜜加麻油在鼻窦内窥镜术后局部留置及点鼻的治疗，加速筛窦腔创面的上皮化。
方法：对40例慢性鼻窦炎鼻息肉病人术后4天用浸泡蜂蜜及麻油混悬液的明胶海绵填塞筛窦腔，以后每天用该混悬液点鼻，一天三次，每次、每侧鼻腔2滴；另选40例慢性鼻窦炎鼻息肉病人术后不用蜂蜜及麻油，其余治疗方法相同。
结果：
实验组(40例)
Ⅰ型Ⅱ期：10例，平均上皮化时间40.6天。
Ⅰ型Ⅲ期：10例，平均上皮化时间58.8天。
Ⅱ型Ⅱ期：10例中有一例(10％)，在术后7周(49天)观察有较多的囊泡和新生息肉，再次手术处理后，在术后11周(77天)基本上皮化，也计为临床痊愈。平均上皮化时间67.2天。
Ⅱ型Ⅲ期：10例中有两例(20％)在术后九周(63天)观察有密集小囊泡及新生息肉，经Hummer清理后，在术后14周(98天)基本上皮化，平均上皮化时间84天。
对照组(40例)
Ⅰ型Ⅱ期：10例平均上皮化时间62天。
Ⅰ型Ⅱ期：10例中有4例(40％)术腔在术后8周(56天)再次手术处理后，术腔在13周(91天)基本上皮化，平均上皮化时间是84天。
Ⅱ型Ⅱ期(10例)Ⅱ型Ⅲ期(10例)：均有三例(30％)术后7到10周术腔反复出现囊泡、小息肉，在再次手术处理后才上皮化，平均上皮化时间分别为93.8
安徽医科大学硕士学位论文
天与137.9天。
结论:对慢性鼻窦炎、鼻息肉病人用浸泡蜂蜜及麻油的明胶海绵填塞术腔及
术后点鼻，通过两中药的作用，可以使筛窦腔粘膜早期上皮化，减少痴块，预防
感染，减少复发，且病变越轻，范围越小，上皮化越快，效果越好。本研究拓宽
了中药蜂蜜与麻油的应用范围，丰富了祖国医学。
Objective: To accelerate the process of complete epithelization of the ethmoidal sinus
cavity wound through dripping and local application of honey and sesame oil after
Endoscopic Sinus Surgery .
Methods: Group I: 40 chronic nasosinusitis and nasal polyps patients' ethmoidal sinus
cavities were packed with gelatin sponge soaked with honey and sesame oil four days
after surgery. The same mixed suspending liquid was used in dripping the nose two
drops each time for three times a day. Group II: 40 chronic nasosinusitis nasal polyps
patients were not given the honey and sesame oil treatment with other treatments kept
the same.
Results: Group I: II period of type I: the average epithelization time is 40.6 days of
10 cases; III period of type I: the average epithelization time is 58.8 days of 10 cases;
11 period of type II: in 10 cases, after 7 weeks (49 days) of the operation, many vesicles and newly grown polyps was found in 1 case (10%), after another operation, after another 11 weeks (77 days), the basic epithelization can be seen. This is also concluded in the clinical heal. The average epithelization period is 67.2 days.III period of type II: in 10 cases, after 9 weeks (63 days) of the operation, glomerate little vesicles and newly grown polyps were found in 2 cases (20%), after clearing with Hummer, complete epithelization resulted in average period of 14 weeks (98 days). The average epithelization period is 84 days. Group II: II period of type I: the average epithelization time is 62 days of 10 cases; III period of type I: in 10 cases, 4 cases (40%)
another operation was carried out after 8 weeks (56 days) of the operation, basic epithelization resulted resulted after another 13 weeks (91 days). The average epithelization period is 84 days. II period of type II (10 cases) and III period of type II (10 cases): both periods had 3 cases, in which vesicles and little polyps repeatedly appear. After operation, epithelization resulted. The average epithelization period is respectively 93.8 days and 154 days.
Conclusions: To chronic nasosinusitis and nasal polyps patients, with gelatin sponge soaked with honey and sesame oil and nasal dripping, through the function of the two Chinese medicine, it is found that earlier epithelizafion of ethmoidal sinus cavities resulted and infection rate lowers and less recrudesce and scab resulted. And the less symptom and scope of pathological changes, the better effects. This research broadens the application scope of honey and sesame oil and enriches the traditional medicine of China.
方法：对40例慢性鼻窦炎鼻息肉病人术后4天用浸泡蜂蜜及麻油混悬液的明胶海绵填塞筛窦腔，以后每天用该混悬液点鼻，一天三次，每次、每侧鼻腔2滴；另选40例慢性鼻窦炎鼻息肉病人术后不用蜂蜜及麻油，其余治疗方法相同。
结果：
实验组(40例)
Ⅰ型Ⅱ期：10例，平均上皮化时间40.6天。
Ⅰ型Ⅲ期：10例，平均上皮化时间58.8天。
Ⅱ型Ⅱ期：10例中有一例(10％)，在术后7周(49天)观察有较多的囊泡和新生息肉，再次手术处理后，在术后11周(77天)基本上皮化，也计为临床痊愈。平均上皮化时间67.2天。
Ⅱ型Ⅲ期：10例中有两例(20％)在术后九周(63天)观察有密集小囊泡及新生息肉，经Hummer清理后，在术后14周(98天)基本上皮化，平均上皮化时间84天。
对照组(40例)
Ⅰ型Ⅱ期：10例平均上皮化时间62天。
Ⅰ型Ⅱ期：10例中有4例(40％)术腔在术后8周(56天)再次手术处理后，术腔在13周(91天)基本上皮化，平均上皮化时间是84天。
Ⅱ型Ⅱ期(10例)Ⅱ型Ⅲ期(10例)：均有三例(30％)术后7到10周术腔反复出现囊泡、小息肉，在再次手术处理后才上皮化，平均上皮化时间分别为93.8
安徽医科大学硕士学位论文
天与137.9天。
结论:对慢性鼻窦炎、鼻息肉病人用浸泡蜂蜜及麻油的明胶海绵填塞术腔及
术后点鼻，通过两中药的作用，可以使筛窦腔粘膜早期上皮化，减少痴块，预防
感染，减少复发，且病变越轻，范围越小，上皮化越快，效果越好。本研究拓宽
了中药蜂蜜与麻油的应用范围，丰富了祖国医学。
Objective: To accelerate the process of complete epithelization of the ethmoidal sinus
cavity wound through dripping and local application of honey and sesame oil after
Endoscopic Sinus Surgery .
Methods: Group I: 40 chronic nasosinusitis and nasal polyps patients' ethmoidal sinus
cavities were packed with gelatin sponge soaked with honey and sesame oil four days
after surgery. The same mixed suspending liquid was used in dripping the nose two
drops each time for three times a day. Group II: 40 chronic nasosinusitis nasal polyps
patients were not given the honey and sesame oil treatment with other treatments kept
the same.
Results: Group I: II period of type I: the average epithelization time is 40.6 days of
10 cases; III period of type I: the average epithelization time is 58.8 days of 10 cases;
11 period of type II: in 10 cases, after 7 weeks (49 days) of the operation, many vesicles and newly grown polyps was found in 1 case (10%), after another operation, after another 11 weeks (77 days), the basic epithelization can be seen. This is also concluded in the clinical heal. The average epithelization period is 67.2 days.III period of type II: in 10 cases, after 9 weeks (63 days) of the operation, glomerate little vesicles and newly grown polyps were found in 2 cases (20%), after clearing with Hummer, complete epithelization resulted in average period of 14 weeks (98 days). The average epithelization period is 84 days. Group II: II period of type I: the average epithelization time is 62 days of 10 cases; III period of type I: in 10 cases, 4 cases (40%)
another operation was carried out after 8 weeks (56 days) of the operation, basic epithelization resulted resulted after another 13 weeks (91 days). The average epithelization period is 84 days. II period of type II (10 cases) and III period of type II (10 cases): both periods had 3 cases, in which vesicles and little polyps repeatedly appear. After operation, epithelization resulted. The average epithelization period is respectively 93.8 days and 154 days.
Conclusions: To chronic nasosinusitis and nasal polyps patients, with gelatin sponge soaked with honey and sesame oil and nasal dripping, through the function of the two Chinese medicine, it is found that earlier epithelizafion of ethmoidal sinus cavities resulted and infection rate lowers and less recrudesce and scab resulted. And the less symptom and scope of pathological changes, the better effects. This research broadens the application scope of honey and sesame oil and enriches the traditional medicine of China.
引文
1．王荣光．临床鼻科学．河北：河北科学技术出版社．1995：160
2. Ray NF, Baraniuk JN, Thamer M, et al. Healthcare expenditures for sinusitis in: 1996 contributions of asthma, rhinitis, and other airway disorders. J Allergy Clin ImmunoL, 1999; 103:408-14
3．王荣光，许庚，郭宝煌．鼻内窥镜手术图解．北京：解放军出版社，1998：4
4．韩德民，周兵．鼻内窥镜外科学．北京：人民卫生出版社，2001：213
5．张志钢，李添应．鼻内手术后的鼻腔填塞．中国医学文摘—耳鼻咽喉科学，2004；19(1)：11
6．许庚，陈合新，文卫平，等．内窥镜鼻窦手术后局部应用 Merogel的临床效果观察．中华耳鼻咽喉科杂志，2003；38(2)：95-97
7. Laurent UBG, Reed RK. Turmover of Hyahuronan in the tissue. Adv drug deliv Rev, 1991; 7:237-256
8．褚汉启，刘争，郭红，等．可吸收性填塞材料在功能性鼻内窥镜手术中的应用．山东大学基础学院学报，2003；17(1)：32-33
9．卜国铉．鼻科学．上海：上海科学技术出版社，2000：95
10．卜国铉，鼻科学．上海：上海科学技术出版社，2000：163
11．贾红生，吴晓霞．蜂蜜外用对伤口愈合的促进作用初探．陕西中医学院学报，1998；21：34
12．兰福森．蜂蜜外治效方选．中国养蜂，2002；503：26
13．黄泰康，丁志遵，赵宝训，等．现代本草纲目．北京：中国医药科技出版社，2000：2633
14．中华医学会耳鼻咽喉科学会，中华耳鼻咽喉科杂志编辑委员会．慢性鼻窦炎，鼻息肉临床分型分期及内窥镜鼻窦手术疗效评定标准 (1997年，海口)．中
华耳鼻咽喉科杂志，1998；33：134
15．王荣光，许庚，郭宝煌．鼻内窥镜手术图解．北京：解放军出版社，1998：37-38
16．庞宗领，王式杰．耳鼻咽喉科围手术期治疗学．北京：人民卫生出版社，1999：216-217
17. Schaefer SD, Manning S, Close LG. Endoscpic paranasal sinus surgery: indications and considerations. Laryngoscope, 1989; 99(1): 1-5
18. CervinA. The Anti-inflammatory Effect of Erythromycin and its Derivatives,with Special Reference to Nasal Polyposis and Chronic Sinusistis. Acta Otolaryngol,2001; 121:83-92
19．张连山．耳鼻咽喉科学．北京：中国协和医科大学出版社，2001：411
20. Kennedy DW, Zinreich SJ. Functional endoscopic surgery in M -years EN, Bluestone CD, Brackmann DE, eds. Advances Otolaryngology head and neck surgery. Chicago: Year Book Medical Publishers, 1989; 1-26
21. Benninger Ms, Seleck BA ,Levine H. Mucosal regeneration of maxillary sinus after surgery.Otolary Head Neck Suryg 1989;101:33.
22. Joki S, Toskala E, Sanno V, et al. Correlation between ciliary beat frequency and the structure of ciliated epithelia in pathologic human nasal mucosa, laryngoscope.中华耳鼻咽喉科杂志, 1998;33:130
23. Fang SY. Transformation of mucosal secretory elements in chronic maxillary sinusitis after endoscopies sinus surgery.Acta Otol Rhinol Laryngol, 1994; 103: 439-443
24．何春燕，刘红刚，王先忠，等．慢性鼻窦炎鼻息肉筛窦粘腊病理形态学研究．中华耳鼻咽喉杂志，2003；38(2)：91
25. Stammberger H. Endoscopic endonasal surgery-concepts in treatment of recurring rhinosinusitis. Part 1. Anatomic and parthophysiology considerations.
Otolaryngol Head Neck Sury, 1986; 94:143-147
26．李云川，李玉春，李怀胜．鼻内窥镜外科临床与进展．哈尔滨：黑龙江科学技术出版社，1999：16-17
27．黄文诚．蜂蜜医疗作用的科学解释．中国养蜂，2003；54(3)：46-47
28．张志钢，李添应等．鼻内手术后的鼻腔填塞．中国医学文摘耳鼻咽喉科学，2004；19：10
29．王荣光，许庚．鼻内窥镜手术图解．解放军出版社，1996：45
30．许庚，李源，谢民强．功能性内窥镜鼻窦手术术腔粘膜转轨阶段划分及处理原则．中华耳鼻咽喉科杂志，1999；34：304-305
2. Ray NF, Baraniuk JN, Thamer M, et al. Healthcare expenditures for sinusitis in: 1996 contributions of asthma, rhinitis, and other airway disorders. J Allergy Clin ImmunoL, 1999; 103:408-14
3．王荣光，许庚，郭宝煌．鼻内窥镜手术图解．北京：解放军出版社，1998：4
4．韩德民，周兵．鼻内窥镜外科学．北京：人民卫生出版社，2001：213
5．张志钢，李添应．鼻内手术后的鼻腔填塞．中国医学文摘—耳鼻咽喉科学，2004；19(1)：11
6．许庚，陈合新，文卫平，等．内窥镜鼻窦手术后局部应用 Merogel的临床效果观察．中华耳鼻咽喉科杂志，2003；38(2)：95-97
7. Laurent UBG, Reed RK. Turmover of Hyahuronan in the tissue. Adv drug deliv Rev, 1991; 7:237-256
8．褚汉启，刘争，郭红，等．可吸收性填塞材料在功能性鼻内窥镜手术中的应用．山东大学基础学院学报，2003；17(1)：32-33
9．卜国铉．鼻科学．上海：上海科学技术出版社，2000：95
10．卜国铉，鼻科学．上海：上海科学技术出版社，2000：163
11．贾红生，吴晓霞．蜂蜜外用对伤口愈合的促进作用初探．陕西中医学院学报，1998；21：34
12．兰福森．蜂蜜外治效方选．中国养蜂，2002；503：26
13．黄泰康，丁志遵，赵宝训，等．现代本草纲目．北京：中国医药科技出版社，2000：2633
14．中华医学会耳鼻咽喉科学会，中华耳鼻咽喉科杂志编辑委员会．慢性鼻窦炎，鼻息肉临床分型分期及内窥镜鼻窦手术疗效评定标准 (1997年，海口)．中
华耳鼻咽喉科杂志，1998；33：134
15．王荣光，许庚，郭宝煌．鼻内窥镜手术图解．北京：解放军出版社，1998：37-38
16．庞宗领，王式杰．耳鼻咽喉科围手术期治疗学．北京：人民卫生出版社，1999：216-217
17. Schaefer SD, Manning S, Close LG. Endoscpic paranasal sinus surgery: indications and considerations. Laryngoscope, 1989; 99(1): 1-5
18. CervinA. The Anti-inflammatory Effect of Erythromycin and its Derivatives,with Special Reference to Nasal Polyposis and Chronic Sinusistis. Acta Otolaryngol,2001; 121:83-92
19．张连山．耳鼻咽喉科学．北京：中国协和医科大学出版社，2001：411
20. Kennedy DW, Zinreich SJ. Functional endoscopic surgery in M -years EN, Bluestone CD, Brackmann DE, eds. Advances Otolaryngology head and neck surgery. Chicago: Year Book Medical Publishers, 1989; 1-26
21. Benninger Ms, Seleck BA ,Levine H. Mucosal regeneration of maxillary sinus after surgery.Otolary Head Neck Suryg 1989;101:33.
22. Joki S, Toskala E, Sanno V, et al. Correlation between ciliary beat frequency and the structure of ciliated epithelia in pathologic human nasal mucosa, laryngoscope.中华耳鼻咽喉科杂志, 1998;33:130
23. Fang SY. Transformation of mucosal secretory elements in chronic maxillary sinusitis after endoscopies sinus surgery.Acta Otol Rhinol Laryngol, 1994; 103: 439-443
24．何春燕，刘红刚，王先忠，等．慢性鼻窦炎鼻息肉筛窦粘腊病理形态学研究．中华耳鼻咽喉杂志，2003；38(2)：91
25. Stammberger H. Endoscopic endonasal surgery-concepts in treatment of recurring rhinosinusitis. Part 1. Anatomic and parthophysiology considerations.
Otolaryngol Head Neck Sury, 1986; 94:143-147
26．李云川，李玉春，李怀胜．鼻内窥镜外科临床与进展．哈尔滨：黑龙江科学技术出版社，1999：16-17
27．黄文诚．蜂蜜医疗作用的科学解释．中国养蜂，2003；54(3)：46-47
28．张志钢，李添应等．鼻内手术后的鼻腔填塞．中国医学文摘耳鼻咽喉科学，2004；19：10
29．王荣光，许庚．鼻内窥镜手术图解．解放军出版社，1996：45
30．许庚，李源，谢民强．功能性内窥镜鼻窦手术术腔粘膜转轨阶段划分及处理原则．中华耳鼻咽喉科杂志，1999；34：304-305