败丹黄液鼻腔灌洗对慢性鼻窦炎术后鼻黏膜功能及形态恢复的影响  

Effect of Baidanhuang Nasal Irrigation Solution on Recovery of Nasal Mucosal Function and Morphology in Chronic Rhinosinusitis Patients After Surgery

作　　者：张春林[1,2] 林小燕[3] 陈新野[2] 谢民强[1] 

机构地区：[1]南方医科大学珠江医院耳鼻咽喉科,广东广州510282 [2]中山大学附属第五医院耳鼻咽喉科,广东珠海519000 [3]广东省妇幼保健院耳鼻咽喉科,广东广州510010

出　　处：《广州中医药大学学报》2013年第4期468-473,607,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家"十一.五"科技支撑计划项目(编号:2007BAI20B036);广东省中医药局科研项目(编号:2008039)

摘　　要：【目的】多时间点动态观察败丹黄液鼻腔灌洗治疗对慢性鼻窦炎术后鼻黏膜功能及形态恢复的影响。【方法】收集92例慢性鼻窦炎患者,随机分成3组,A组32例,B组31例,C组29例。A组患者术后用败丹黄液行鼻腔灌洗;B组用地塞米松、庆大霉素盐水灌洗液行鼻腔灌洗;C组为对照组,不进行鼻腔灌洗。分别于术前和术后6周、3个月、6个月、1年进行鼻黏膜纤毛传输速率(mucociliary transport rate,MTR)测定及鼻内镜体征评分,进行上述指标及临床疗效比较。【结果】3组患者治愈率、有效率比较差异无统计学意义(均P>0.05);术腔清洁时间A组、B组较C组短(P<0.05或P<0.01),A组优于B组(P<0.01);3组上皮化时间无统计学差异(P>0.05)。术后6周,3组鼻内镜评分总分有统计学差异(P<0.05),黏膜水肿单项评分,A组优于B组及C组(P<0.01),MTR比较,A组、B组均优于C组(P<0.01),A组优于B组(P<0.01)。术后3个月,3组鼻内镜评分总分无统计学差异(P>0.05),黏膜水肿单项评分,A组优于B组及C组(P<0.01),MTR比较,A组、B组均优于C组(P<0.01),A组优于B组(P<0.01)。术后6个月、1年,3组MTR比较差异无统计学意义(P>0.05),鼻内镜评分总分及各单项评分均无统计学差异(P>0.05)。【结论】鼻内镜术后鼻黏膜功能、形态的恢复过程二者相辅相成,进程并不完全一致;败丹黄液鼻腔灌洗可以加快鼻黏膜功能及形态的恢复,该作用在术后早期明显,值得在临床推广应用。Objective To observe the therapeutic effect of Baidanhuang nasal irrigation solution（BNIS）on the recovery of nasal mucosal function and morphology in chronic rhinosinusitis patients after surgery at different time points.Methods A total of 92 chronic rhinosinusitis patients were enrolled and were randomly divided into groups A,B and C.Group A（N=32） was given nasal irrigation of BNIS,group B（N=31）was given nasal irrigation of Dexamethasone and Gentamicin solution,and group C（N=29）had no nasal irrigation.At five time points of before surgery,and 6 weeks,3 months,6 months and one year after surgery,nasal endoscopic sign was scored and mucociliary transport rate（MTR） was measured,and their therapeutic effect was also evaluated Results The total effective rate and cure rate had no significant difference（P〈0.05） among the three groups.The nasal cleaning time for group A and group B was shorter than that for group C（P〈0.05 or P〈0.01）,and the time for group A was the shortest（P〈0.01）.The difference of epithelization time was insignificant among the three groups（P〈0.05）.Six weeks after surgery,the total nasal endoscopic scores had significant difference among the three groups（P〈0.05）,the scores of mucosal edema in group A were superior to those in group B and group C（P〈0.01）,and MTR in group A and group B was higher than that in group C（P〈0.01）,MTR in group A being the highest（P〈0.01）.Three months after surgery,the differencesof total nasal endoscopic scores were insignificant among the three groups（P〈0.05）,the scores of mucosal edema in group A were superior to those in group B and group C（P〈0.01）,and MTR in groups A and B was higher than that in group C（P〈0.01）,MTR in group A being the highest（P〈0.01）.Six months and one year after surgery,three groups showed no significant differences of nasal endoscopic sign and MTR（P〈0.05）.Conclusion After surgery,the recovery of nasal mucosal function and morphology is not at the same

关 键 词：慢性鼻窦炎 中西医结合疗法 败丹黄液 治疗应用 鼻腔灌洗 黏液纤毛传输系统 

分 类 号：R765.41[医药卫生—耳鼻咽喉科]