龙血竭粉外用联合三联液鼻腔冲洗对慢性鼻-鼻窦炎术后鼻黏膜功能及形态恢复的影响  

Effect of external application of Longxuejie Powder combined with triple liquid for nasal irrigation on the recovery of nasal mucosa function and morphology after endoscopic sinus surgery for chronic rhinosinusitis

作　　者：刘莉萍 李菁 徐俊艳 LIU Li-ping;LI Jing;XU Jun-yan(Department of Otorhinolaryngology,the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine,Xianyang 712000,Shaanxi,CHINA)

机构地区：[1]陕西中医药大学附属医院耳鼻喉科,陕西咸阳712000

出　　处：《海南医学》2023年第7期978-982,共5页Hainan Medical Journal

基　　金：陕西省科技厅课题(编号:2020SF-348)。

摘　　要：目的探讨龙血竭粉外用联合三联液鼻腔冲洗对慢性鼻-鼻窦炎(CRS)术后鼻黏膜功能及形态恢复的影响。方法选取2020年6月至2021年6月在陕西中医药大学附属医院接受治疗的298例CRS患者作为研究对象,按随机数表法分为对照组和观察组各149例。对照组患者鼻内镜手术(ESS)后使用三联液对鼻腔冲洗,观察组患者在对照组治疗的基础上联合龙血竭粉外用,两组均接受治疗8周。比较两组患者治疗前后的临床症状、鼻黏膜功能、鼻黏膜形态、血清学指标,以及采用鼻腔鼻窦结局测试20(SNOT-20)量表中文版评价两组患者的生活质量。结果治疗后,两组患者的鼻塞、流脓涕、头痛、嗅觉障碍等主要临床症状及总体感觉评分较治疗均显著下降,且观察组明显低于对照组,差异均有统计学意义(P<0.05);治疗后,两组患者的鼻腔黏液纤毛传输时间(MTT)较治疗前显著缩短,鼻纤毛传输速率(MTR)较治疗前显著上升,且观察组患者的MTT为(506.12±92.33)s,明显短于对照组的(594.45±96.12)s,观察组MTR为(8.24±0.54)mm/min,明显高于对照组的(6.47±0.49)mm/min,差异均有统计学意义(P<0.05);两组患者治疗后4周、8周时的内镜Lund-Kennedy评分较治疗前显著下降,且观察组患者的内镜Lund-Kennedy评分明显低于对照组,差异均有统计学意义(P<0.05);治疗后,两组患者的血清白介素-5(IL-5)、肿瘤坏死因子-α(TNF-α)水平较治疗前显著下降,且观察组患者的IL-5、TNF-α水平明显低于对照组,差异均有统计学意义(P<0.05);治疗后,两组患者SNOT-20量表中文版相关症状、鼻部相关症状、睡眠障碍、情感结局评分较治疗前显著下降,且观察组患者的上述各项评分明显低于对照组,差异均有统计学意义(P<0.05)。结论龙血竭粉外用联合三联液鼻腔冲洗治疗能促进慢性鼻-鼻窦炎术后患者鼻黏膜功能及形态的恢复,降低炎症反应,提高患者生活质量。Objective To investigate the effect of external application of Longxuejie Powder combined with triple liquid for nasal irrigation on the recovery of nasal mucosa function and morphology after surgery for chronic rhinosinusitis(CRS).Methods A total of 298 patients with CRS who were treated in the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from June 2020 to June 2021 were selected as the research subjects.According to random number table method,the patients were divided into a control group and an observation group,with 149 patients in each group.The patients in the control group were treated with nasal irrigation using triple liquid after endoscopic sinus surgery(ESS),and patients in the observation group were additionally treated with external application of Longxuejie Powder.Both groups received treatment for 8 weeks.Clinical symptoms,nasal mucosa function and morphology and serological indicators were compared between the two groups before and after treatment.The Sino-Nasal Outcome Test-20(SNOT-20)was used to evaluate quality of life between the two groups.Results After treatment,the main clinical symptoms such as nasal congestion,purulent discharge,headache,and olfactory disorder and overall sensory scores decreased significantly compared with those before treatment,and the scores in observation group were significantly lower than those in the control group,with statistically significant difference(P<0.05).After treatment,the nasal mucociliary transmission time(MTT)was significantly shorter than that before treatment,and the nasal cilia transmission rate(MTR)increased significantly compared with that before treatment;the MTT in the observation group was(506.12±92.33)s,which was significantly shorter than(594.45±96.12)s in the control group,while the MTR was(8.24±0.54)mm/min,significantly higher than(6.47±0.49)mm/min in the control group(P<0.05).The endoscopic Lund-Kennedy score at 4 weeks and 8 weeks after treatment decreased significantly compared with those before treatment

关 键 词：龙血竭粉 三联液 鼻腔冲洗 慢性鼻-鼻窦炎 鼻黏膜功能 鼻黏膜形态 

分 类 号：R765.4[医药卫生—耳鼻咽喉科]