麻芷参苓白术散对鼻窦炎术后鼻黏膜愈合及纤毛清除功能的影响  

Effect of Mazhi Shenling Baizhu Powder on Nasal Mucosal Healing and Ciliary Clearance Function after Sinusitis Operation

作　　者：尉瑞[1] 李静波[1] 袁艳红[1] 陈璐璐[1] 王慧敏 WEI Rui;LI Jingbo;YUAN Yanhong;CHEN Lulu;WANG Huimin(The Second Affiliated Hospital to Henan University of Chinese Medicine/TCM Hospital of Henan Province,Zhengzhou Henan China 450002)

机构地区：[1]河南中医药大学第二附属医院/河南省中医院,河南郑州450002

出　　处：《中医学报》2018年第12期2432-2435,共4页Acta Chinese Medicine

基　　金：河南省高等学校重点科研项目(15A360005)

摘　　要：目的:探讨麻芷参苓白术散对鼻窦炎术后鼻黏膜愈合及纤毛清除功能的影响。方法:将经手术治疗的70例慢性鼻窦炎患者作为研究对象,按随机数字表法分为观察组和对照组,每组各35例,其中对照组采用常规的围手术期治疗;观察组则在对照组的基础上口服麻芷参苓白术散。观察并比较两组术后3个月鼻纤毛传输速率(mucociliary transport rate,MTR),鼻黏膜上皮损伤情况以及临床疗效。结果:术后3个月观察组有效率为88. 57%,明显高于对照组的68. 57%,差异具有统计学意义(χ~2=4. 158,P <0. 05);同时,观察组患者的临床疗效整体上优于对照组患者(Z=-2. 766,P <0. 05)。术后3个月观察组和对照组MTR均低于术前(t=9. 527、3. 953,P <0. 001),观察组术后3个月的MTR明显优于对照组,两组比较,差异具有统计学意义(t=6. 727,P <0. 001)。术后3个月,观察组患者黏膜上皮损伤程度较对照组轻,两组比较,差异有统计学意义(Z=-2. 446,P <0. 05)。术后3个月,观察组患者组织转化生长因子-β(transforming growth factor-β,TGF-β)阳性细胞数和胶原Ⅲ阳性基底膜厚度超过20μm的患者明显少于对照组,差异有统计学意义(t=-4. 747、χ~2=8. 235,P均<0. 001)。结论:针对鼻窦炎术后患者给予麻芷参苓白术散治疗能够提高临床疗效,有助于术后鼻黏膜的愈合和纤毛清除功能的恢复。Objective: To investigate the effects of Mazhi Shenling Baizhu Powder on nasal mucosa healing and the ciliary clearance function after sinusitis operation. Methods: Seventy patients with chronic sinusitis who underwent surgery were enrolled in the study. They were divided into observation group and control group according to the random number table method,with 35 cases in each group. The control group was treated with routine perioperative period,while the observation group was treated with oral administration of Mazhi Shenlingi Baizhu Powder in addition to that of the observation group. The nasal mucociliary transport rate( MTR),nasal mucosal epithelial damage and clinical efficacy of the two groups were observed and compared. Results: The effective rate of the observation group was 88. 57% at 3 months after operation,which was significantly higher than that( 68. 57%) of the control group( χ~2= 4. 158,P < 0. 05). At the same time,the overall clinical efficacy of the observation group was significantly better than that of the control group( Z =-2. 766,P < 0. 05). The MTR of the observation group and the control group were lower than those before operation( t = 9. 527,3. 953,P < 0. 001). The MTR of the observation group was significantly better than that of the control group at 3 months after operation( t = 6. 727,P < 0. 001). At 3 months after operation,the degree of mucosal epithelial damage in the observation group was significantly less severe than that in the control group( Z =-2. 446,P < 0. 05). At 3 months after operation,the number of tissue transforming growth factor-β( TGF-β) positive cells and collagen Ⅲ positive basement membrane thickness exceeding 20 μm in the observation group were significantly less than those in the control group( t =-4. 747,χ~2=8. 235,P < 0. 001). Conclusion: The treatment of patients with sinusitis after operation with Mazhi Shenling Baizhu Powder can improve the clinical efficacy and help the healing of nasal mucosa and the recovery of cilia clearance.

关 键 词：慢性鼻窦炎 麻芷参苓白术散 鼻黏膜愈合 纤毛清除功能 

分 类 号：R259.654.1[医药卫生—中西医结合]