中医鼻病序贯疗法治疗急性鼻窦炎主客观疗效评估及相关性研究  

Objective evaluation and correlation study on the treatment of acute rhinosinusitis by Sun's sequential therapy of nasal diseases

作　　者：刘娇媚[1] 孙书臣[1] 孙瑶[1] 李美静[1] 赵莹莹[1] 汪玉娇[1] LIU Jiaomei;SUN Shuchen;SUN Yao;LI Meijing;ZHAO Yingying;WANG Yujiao(Guang’anmen Hospital China Academy of Chinese Medical Sciences,Beijing 102618,China)

机构地区：[1]中国中医科学院广安门医院(南区)耳鼻咽喉科,北京102618

出　　处：《中国中西医结合耳鼻咽喉科杂志》2019年第1期35-40,共6页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的采用中医鼻病序贯疗法对急性鼻窦炎进行治疗后主客观疗效评价。方法 66例急性鼻窦炎风热蕴肺证患者采用随机数字表法分为2组,各33例.序贯组运用煎煮中药蒸汽熏鼻并口服中药治疗14天;中药组:采用与序贯疗法组相同的汤药煎药口服治疗14天。两组患者在给予药物治疗前需记录鼻塞流涕严重程度、鼻粘膜充血情况、头痛程度、嗅觉、局部有无压痛,并完成病情视觉模拟量表(VAS)、鼻腔鼻窦结局测试22条(SNOT-22)评分以及鼻内窥镜检查,内窥镜检查所得图像采用MLK(Modofied Lund-Kennedy)内镜评分系统进行评估。待治疗结束后两组患者需重新进行上述检查,完善评估以便于对比治疗效果。结果本研究中两组病例病情vas评分、snot-22评分、MLK评分、症状评分都有随时间变化的趋势,两组病例病情vas评分、snot-22评分、MLK评分、症状评分都有随时间下降的趋势,其中序贯组下降速度高于中药组,差异具有显著性。病情vas评分与症状评分、症状评分与Snot-22评分、MLK内镜评分与Snot-22评分在治疗前后均显示相关性显著。结论序贯组、中药组对于急性鼻窦炎的均有很好治疗效果。中医鼻病序贯疗法在改善急性鼻窦炎患者的临床症状及健康生存质量,降低MLK内镜评分方面优于口服汤药疗法。患者对自身病情的严重程度认识与局部症状的感受存在一致性,患者局部症状的改善与患者整体健康生存质量密切相关,鼻内镜图像的改变可以客观的评价疗法对急性鼻窦炎的疗效。Objective To assess subjective and objective outcomes of acute rhinosinusitis after treatment with Sun’s sequential therapy. Methods sSixty-six patients with acute rhinosinusitis characterized by lung by wind heat were divided into two different groups randomly and there were 33 patients in each group. One group was called the sequential therapy group, and the other was called the traditional Chinese medicine group. The former one used the steam produced by decocting traditional Chinese medicine to fumigate patient’s nose and at the same time, oral treatments were also required, which lasted for 14 days. Patients in the latter one were required to drink the same herbal medicine for two weeks. Before and after the treatment, the data of two groups of patients with runny nose, nasal obstruction, headache, the degree of congestion and swelling of nasal mucosa, local tenderness points, olfactory dysfunction, disease visual analogue scale and the test result of sino-nasal outcome test-22 and nasal endoscopic examination were recorded separately. All the pictures were scored based on the principle using MLK endoscopic score. Result In this study, the vas score, snot-22 score, MLK endoscopic score, symptom score of the two groups showed the trend of change over time. The vas score, snot-22 score, MLK endoscopic score and symptom score had the falling trend over time. The descending rate of the sequential group was faster than the traditional Chinese medicine group, with significant difference. The disease vas score and symptom score, symptoms score and snot-22 score, MLK endoscopic score and snot-22 score showed significant correlation before and after treatment. Conclusion Both the two groups gained good treatment effect. The Sun’s sequential therapy is better than oral medicine therapy in improving the clinical symptoms and healthy living quality of patients with acute rhinosinusitis and reducing the MLK endoscopic score. The patient’s understanding of the severity of his condition is consistent with the feeli

关 键 词：急性鼻窦炎 中医鼻病序贯疗法 苍耳子散 

分 类 号：R276.1[医药卫生—中医五官科学]