鼻康复鼻腔填塞治疗急性鼻窦炎的临床研究  

Clinical Study of Curative Effect of Bikangfu Nasal Tamponade on Acute Rhinosinusitis

作　　者：袁艳红[1] 尉瑞[1] 陈璐璐 王俊杰[1] 蔡纪堂[1] YUAN Yan-hong;WEI Rui;CHEN Lu-lu;WANG Jun-jie;CAI Ji-tang(Department of Otolaryngology,Henan Province Hospital of Traditional Chinese Medicine,Zhengzhou 450002,China)

机构地区：[1]河南省中医院耳鼻喉科,河南郑州450002

出　　处：《南京中医药大学学报》2023年第4期312-318,共7页Journal of Nanjing University of Traditional Chinese Medicine

基　　金：河南省中医药科学研究专项课题(20-21ZY2206,2023ZYZD08);2020年中医药古籍文献和特色技术传承专项(GZY-KJS-2020-085)。

摘　　要：目的观察鼻康复鼻腔填塞治疗急性鼻窦炎的疗效及对血清和鼻分泌液中炎性因子、炎症相关蛋白及神经肽的影响。方法144例患者随机分为对照组和观察组各72例。对照组在常规治疗基础上给予糠酸莫米松鼻喷雾剂喷鼻,观察组在常规治疗基础上给予鼻康复鼻腔填塞。观察治疗前后2组患者中医证候积分及临床疗效、鼻内镜检查量化评估量表(Lund-Kennedy)、鼻腔鼻窦结局测试-20(SNOT-20)评分及鼻气道阻力(NAR)变化;检测患者鼻纤毛清除功能[鼻黏膜纤毛清除率(MCC)、鼻纤毛传输速率(MTR)、糖精颗粒清除时间(SCT)];检测血清及鼻分泌液中炎性因子[白三烯C 4(LTC 4)、白细胞介素17(IL-17)、前列腺素D 2(PGD 2)]、炎症相关蛋白[嗜酸性粒细胞阳离子蛋白(ECP)、水通道蛋白-3(AQP-3)、免疫球蛋白E(IgE)]及神经肽[P物质(SP)、神经激肽A(NKA)、神经肽Y(NPY)]表达水平。结果治疗后,2组患者中医证候积分、Lund-Kennedy评分、SNOT-20评分、NAR、SCT及LTC 4、IL-17、PGD 2、ECP、IgE水平均显著降低(P<0.05,P<0.01),MCC、MTR及AQP-3、SP、NKA、NPY水平明显升高(P<0.05,P<0.01),观察组优于对照组(P<0.05,P<0.01),观察组中医临床疗效总有效率明显高于对照组(P<0.05)。结论鼻康复鼻腔填塞可有效缓解急性鼻窦炎患者的临床症状,其作用机制可能与调节血清和鼻分泌液中炎性因子、炎症相关蛋白及神经肽水平有关。OBJECTIVE To observe the effects of Bikangfu nasal tamponade on acute rhinosinusitis,inflammatory factors,inflammation-related proteins and neuropeptides in serum and nasal secretions.METHODS 144 cases were randomly divided into the control group and observation group(n=72).On the basis of conventional treatment the control group was given mometasone furoate,and the observation group was treated with Bikangfu nasal tamponade.The nasal situation Lund-Kennedy(Lund-Kennedy)and sinus nasal outcome test-20(SNOT-20)were used,and the nasal airway resistance(NAR)and TCM symptoms were observed before and after treatment.The nasal ciliary clearance function,including mucosal ciliary clearance rate(MCC),mucociliary transport rate(MTR),and saccharin clearance time(SCT),was tested.The inflammatory factors leukotriene C 4(LTC 4),interleukin 17(IL-17),prostaglandin D 2(PGD 2),inflammation-related proteins eosinophil cationic protein(ECP),aquaporin-3(AQP-3),immunoglobulin E(IgE),and neuropeptides substance P(SP),neurokinin A(NKA),neuropeptide Y(NPY)in serum and nasal secretions were detected.RESULTS After treatment,the TCM symptoms,Lund-Kennedy score,SNOT-20 score,NAR,SCT,LTC 4,IL-17,PGD 2,ECP and IgE of the two groups were decreased(P<0.05,P<0.01),and MTR,MCC,AQP-3,SP,NKA and NPY of the two groups were increased(P<0.05,P<0.01).Moreover,the observation group displayed better therapeutic effects than the control group(P<0.05,P<0.01).The clinical total effective rate of TCM in the observation group was significantly higher than that in the control group(P<0.05).CONCLUSION Bikangfu nasal tamponade can remit the clinical symptoms of patients with acute rhinosinusitis,and the mechanism of the action may be related to regulating inflammatory factors,inflammation-related proteins and neuropeptides in serum and nasal secretions.

关 键 词：鼻康复 鼻腔填塞 急性鼻窦炎 炎性因子 炎症相关蛋白 神经肽 

分 类 号：R276.1[医药卫生—中医五官科学]