自拟鼻渊方对脾胃湿热型慢性鼻窦炎术后患者康复的疗效观察  

Efficacy observation of postoperative rehabilitation of self-prepared Biyuan decoction on spleen and stomach damp-heat type chronic sinusitis patients

作　　者：沈利民 郁燕敏 邓永君 郭方强 SHEN Limin;YU Yanmin;DENG Yongjun;GUO Fangqiang(Department of Otolaryngology,Guangming Hospital of Traditional Chinese Medicine,Pudong New Area,Shanghai,201399,China)

机构地区：[1]上海浦东新区光明中医医院耳鼻咽喉科,201399 [2]上海浦东新区中医医院耳鼻咽喉科

出　　处：《中国中西医结合耳鼻咽喉科杂志》2025年第1期33-37,共5页Chinese Journal of Otorhinolaryngology in Integrative Medicine

基　　金：上海市浦东新区科技发展基金(PKJ2020-Y79)。

摘　　要：目的 探讨自拟鼻渊方对脾胃湿热型慢性鼻窦炎(CS)术后患者康复的疗效。方法 纳入2021年1月~2023年7月在上海市浦东新区光明中医医院行功能性内窥镜鼻窦手术(FESS)治疗的CS病例102例,依据随机数字法分至治疗组和对照组,均纳入51例。对照组病例术后第2d采取糠酸莫米松鼻喷雾剂治疗。治疗组病例常规用药同对照组,增服自拟鼻渊方。两组病例均予8周观察。比较两组疗效、主观病情视觉模拟量表(VAS)评分、客观病情鼻窦CT评分与鼻内镜检测评分、脾胃湿热证评分以及鼻分泌物中白细胞介素(IL)-5、IL-1β、肿瘤坏死因子(TNF)-α水平,安全性及随访6个月复发率。结果 8周疗程完成后,治疗组病例的总有效率(94.12%)显著高于对照组(76.47%)(P<0.05)。8周疗程完成后,两组病例VAS评分显著减少,且治疗组病例在同时点分别减少更显著(P<0.05)。8周疗程完成后,两组病例Lund-Mackay与Lund-Kennedy评分显著减少,同时治疗组病例减少更显著(P<0.05)。8周疗程完成后,两组病例脾胃湿热证评分显著减少,同时治疗组病例减少更显著(P<0.05)。8周疗程完成后,两组病例鼻分泌物IL-5、IL-1β、TNF-α水平明显减少,同时治疗组病例减少更显著(P<0.05)。治疗组患者不良反应发生率为1.96%,低于对照组为9.80%,但比较未见明显差异(P>0.05)。术后6个月,治疗组的复发率(3.92%)低于对照组为15.69%,但相比未见明显差异(P>0.05)。结论 本组自拟鼻渊方对脾胃湿热型CS术后患者的康复效果显著,有助于主观与客观病情的控制,改善中医证候,以及抑制炎症反应,以及减少不良反应和复发风险。Objective To investigate the efficacy of postoperative rehabilitation of self-prepared Biyuan decoction on spleen and stomach damp-heat type chronic sinusitis(CS)patients.Method A total of 102 CS patients who underwent functional endoscopic sinus surgery(FESS)at Shanghai Pudong New Area Guangming Hospital of Traditional Chinese Medicine from January of 2021 to July of 2023 were enrolled according to the random number method and divided into the treatment group and the control group with 51 cases in each group.The control group was treated with mometasone furoate nasal spray on the second day after operation.The treatment group was treated with the same routine medication as the control group,and the self-prepared Biyuan decoction was added.Both groups were observed for 8 weeks.The curative effect,subjective disease visual analogue scale(VAS)score,objective disease sinus CT score and nasal endoscopic test score,spleen and stomach damp-heat syndrome score,and nasal secretion levels of interleukin(IL)-5,IL-1β,and tumor necrosis factor(TNF)-α,safety,and recurrence rate with 6 months'follow-up were compared between the two groups.Results After 8 weeks of treatment,the total effective rate of treatment group(94.12%)was significantly higher than that of control group(76.47%)(P<0.05).After 8 weeks of treatment,the VAS scores of the two groups decreased significantly,and the treatment group decreased more significantly at the same time point(P<0.05).After 8 weeks of treatment,the Lund-Mackay and Lund-Kennedy scores of the two groups decreased significantly,and the treatment group decreased more significantly(P<0.05).After 8 weeks of treatment,the scores of spleen and stomach damp-heat syndrome in the two groups were significantly reduced,and the reduction in the treatment group was more significant(P<0.05).After 8 weeks of treatment,the levels of IL-5,IL-1βand TNF-αin nasal secretions of the two groups were significantly reduced,and the reduction in the treatment group was more significant(P<0.05).The incidence of adv

关 键 词：鼻渊方 鼻窦炎 脾胃湿热证 白细胞介素-5 白细胞介素-1Β 肿瘤坏死因子-α 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]