中药复方“鼻渊通”治疗嗜酸性粒细胞型慢性鼻窦炎伴鼻息肉术后疗效分析  

Curative Effect Analysis of Chinese Herbal Compound “Biyuantong” on the Postoperative Treatment of Eosinophilic Chronic Rhinosinusitis with Nasal Polyps (ECRSwNP)

作　　者：吴晖[1,2] 黄思蓉 任妍沁 彭坤 吴国清[1,2] 叶玉莹 Wu Hui;Huang Sirong;Ren Yanqing;Peng Kun;Wu Guoqing;Ye Yuying(Department of Otorhinolaryngology,Fujian Provincial People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Fuzhou 350004,China;Fujian University of Traditional Chinese Medicine,Fuzhou 350004,China)

机构地区：[1]福建中医药大学附属人民医院耳鼻喉科,福建福州350004 [2]福建中医药大学,福建福州350004

出　　处：《亚太传统医药》2023年第3期82-87,共6页Asia-Pacific Traditional Medicine

基　　金：福建省自然科学基金面上项目:中药复方“鼻渊通”用于术后预防慢性鼻-鼻窦炎伴鼻息肉(CRSwNP)复发的疗效评价及其作用机制研究(2019J01494);基于NF-κB信号通路探讨中药复方“鼻渊通”在慢性鼻窦炎术后治疗中的作用及其分子机制(2022J01850)。

摘　　要：目的:探讨分析中药复方“鼻渊通”口服联合鼻腔冲洗治疗嗜酸性粒细胞型慢性鼻窦炎伴鼻息肉(ECRSwNP)术后的疗效。方法:选取行鼻内镜手术治疗的嗜酸粒细胞型鼻息肉患者60例,按照随机数字表法分成对照组和治疗组,每组各30例。对照组患者术后予单纯西药联合生理盐水鼻腔冲洗治疗,治疗组患者在西药治疗基础上予中药复方“鼻渊通”口服联合鼻腔冲洗治疗。通过术腔黏膜形态Lund-Kennedy评分和症状的视觉模拟量表(VAS)评分对两组患者疗效进行评价。通过流式细胞术和酶联免疫印迹法(ELISA)进一步探讨“鼻渊通”预防复发的作用机制。结果:两组治疗后的VAS和Lund-Kennedy评分均低于治疗前,且同组治疗前后比较差异有显著统计学意义(P<0.001);治疗后治疗组患者的VAS和Lund-Kennedy评分均低于对照组,组间比较差异有显著统计学意义(P<0.001);治疗组的治疗总有效率、复发率均优于对照组,且两组间比较差异均有统计学意义(P<0.05);流式细胞术和ELISA实验表明中药复方“鼻渊通”能够降低外周血中嗜酸性粒细胞的比例以及炎症因子IL-5和IL-13的表达水平,从而抑制ECRSwNP术后复发。结论:采用中药复方“鼻渊通”口服联合鼻腔冲洗对ECRSwNP患者进行术后治疗,能够改善患者临床症状,促进鼻黏膜的恢复,降低嗜酸性粒细胞和炎症因子水平,抑制术后复发,具有较高的临床应用价值。Objective:To investigate the therapeutic effect of Chinese herbal compound “Biyuantong” orally combined with nasal lavage in the postoperative treatment of eosinophilic chronic rhinosinusitis with nasal polyps(ECRSwNP).Methods:60 patients with ECRSwNP were selected and randomly divided into control group and treatment group according to random number table, with 30 patients in each group.After surgery, the control group were treated with western medicine orally combined with normal saline nasal irrigation, and the treatment group were treated with “Biyuantong” orally combined with nasal irrigation on the basis of western medicine orally.The curative effect of the two groups was evaluated by Lund-Kennedy score of the mucosal morphology of the operation cavity and VAS score of symptoms.Flow cytometry and ELISA were used to further explore the mechanism of “Biyuantong” in preventing recurrence.Results:The VAS and Lund-Kennedy scores of the two groups after treatment were lower than those before treatment, and the difference between the two groups before and after treatment was statistically significant(P<0.001).After treatment, the VAS and Lund Kennedy scores of the patients in the treatment group were lower than those in the control group, and the difference between the groups was statistically significant(P<0.001).The total effective rate and recurrence rate of the treatment group were better than those of the control group, and the difference between the two groups was statistically significant(P<0.05).Flow cytometry and ELISA experiments showed that the Chinese herbal compound “Biyuantong” could reduce the proportion of eosinophils in the peripheral blood and the expression level of inflammatory factors IL-5 and IL-13,thereby inhibiting the recurrence of ECRSwNP.Conclusion:Postoperative treatment of patients with ECRSwNP with Chinese herbal compound “Biyuantong” orally combined with nasal irrigation can improve the clinical symptoms of patients, promote the recovery of nasal mucosa, reduce th

关 键 词：鼻渊通 鼻腔冲洗 嗜酸性粒细胞型慢性鼻窦炎伴鼻息肉 炎症因子 流式细胞术 

分 类 号：R276.1[医药卫生—中医五官科学]