通鼻消涕颗粒对慢性鼻窦炎患者局部免疫功能及炎症细胞的影响  

Effect of Tongbixiaoti granule on local immune function and inflammatory cells in patients with chronic sinusitis

作　　者：吴敏曼 张翰文 王旋 马越 郭兆刚 黄春江 张玲 邱博文 杜晓璇 WU Minman;ZHANG hanwen;WANG xuan;MA Yue;GUO Zhaogang;HUANG Chunjiang;ZHANG Lin;QIU Bowen;DU Xiaoxuan(Department of Otorhinolaryngology,First Affiliated Hospital of Yunnan University of Traditional Chinese Medicine,Kunming,Yunnan,650021,China)

机构地区：[1]云南中医药大学第一附属医院,云南昆明650021

出　　处：《中国中西医结合耳鼻咽喉科杂志》2024年第2期136-139,130,共5页Chinese Journal of Otorhinolaryngology in Integrative Medicine

基　　金：国家自然科学基金(编号:81960890);云南省科技厅中医联合专项课题基金资助(编号:2018FF001-034)。

摘　　要：目的 本课题通过临床实验研究为通鼻消涕颗粒治疗慢性鼻窦炎提供客观实验数据支持。方法 72例慢性鼻窦炎患者(随机分为试验组36例和对照组36例)口服通鼻消涕颗粒或克拉霉素片1个月前后进行鼻黏膜刮片HE染色检测以嗜酸性粒细胞或中性粒细胞为主的炎症情况。以及收集鼻分泌物进行ELISA实验检测鼻分泌物中SIg A和鼻黏膜保护性蛋白PLUNC、Cu/ZnSOD、PACAP、DJ-1蛋白、谷胱苷肽S转移酶-pi和NKEF-B。采用t检验进行统计分析,对比服药前、服药后各个阶段的免疫指标含量变化有无显著差异。结果 本项研究发现慢性鼻窦炎患者口服通鼻消涕颗粒或克拉霉素片1个月后,通过观察治疗前后鼻分泌物涂片HE染色发现治疗后炎症细胞减少,EOS减少,通鼻消涕颗粒组减少更明显。口服通鼻消涕颗粒组与口服克拉霉素片组在治疗2周后鼻分泌物中SIg A、PLUNC、Cu/ZnSOD等含量相比无明显差异(P<0.05);在治疗1个月后有明显增多,通鼻消涕颗粒组增多更明显(P<0.05)。结论 本研究发现通鼻消涕颗粒可通过提高鼻黏膜局部特异性免疫功能指标SIg A和天然免疫功能指标(PLUNC、Cu/ZnSOD、PACAP、DJ-1蛋白、谷胱苷肽S转移酶-pi和NKEF-B),并减少鼻窦黏膜中以嗜酸性粒细胞或中性粒细胞为主的炎性细胞浸润程度而达到“扶正驱邪”的治疗效果。Objective To provide objective experimental data support for the treatment of chronic sinusitis with Tongbixiaoti granule through clinical experimental research.Methods Seventy-two patients with chronic sinusitis were treated with Tongbixiaoti granules or clarithromycin tablets for 1 month,which were randomly divided into experimental group(n = 36) and control group(n =36).HE staining of nasal mucosa scrapings was performed before and after treatment to detect the inflammation dominated by eosinophils or neutrophils.Nasal secretions were also collected for ELISA test to detect SIg A、PLUNC、Cu/ZnSOD、PACAP、DJ-1、Glutathione transferase-pi and NKEF-B.T-test was used for statistical analysis to compare the score changes of each stage before and after medication.Results One month after oral administration of Tongbixiaoti granules or clarithromycin tablets in patients with chronic sinusitis,HE staining of nasal secretion smears before and after treatment showed that inflammatory cells and EOS decreased after treatment,and the reduction in Tongbixiaoti granules group was more significant.There was no significant difference in the contents of SIg A、PLUNC、Cu/ZnSOD、PACAP、DJ-1、Glutathione transferase-pi and NKEF-B in nasal secretions between oral tongbixiaoyi granule group and oral clarithromycin tablet group after 2 weeks of treatment(P<0.05)..After one month of treatment,there was a significant increase,especially in Tongbixiaoti granule group(P<0.05).Conclusion This study found that Tongbixiaoti granule can achieve the therapeutic effect of“strengthening the right and expelling evil”by improving the local specific immune function indexes SIg A and natural immune function indexes of nasal mucosa(PLUNC、Cu/ZnSOD、PACAP、DJ-1、Glutathione transferase-pi and NKEF-B),and reducing the infiltration of inflammatory cells dominated by eosinophils or neutrophils in nasal sinus mucosa.

关 键 词：慢性鼻窦炎 通鼻消涕颗粒 克拉霉素片 局部免疫功能 炎症细胞 

分 类 号：R276.1[医药卫生—中医五官科学]