疏风通窍汤联合甲泼尼龙片用于慢性鼻窦炎伴鼻息肉患者术后疗效观察  

Analysis of the effect of Shufeng Tongqiao decoction combined with methylprednisolone tablets in patients with chronic sinusitis and nasal polyp after operation

作　　者：董文荣[1] 冯全跃 秦隆朝 田立俊 李倩倩 DONG Wenrong;FENG Quanyue;QIN Longchao;TIAN Lijun;LI Qianqian(Department of Otolaryngology,Shijiazhuang Third Hospital,Shijiazhuang 050011,China;Department of Laboratory,Hengshui Traditional Chinese Medicine Hospital;Department of Otolaryngology Head and Neck Surgery(WardⅡ),Handan Central Hospital;Department of Traditional Chinese Medicine,Shijiazhuang Third Hospital)

机构地区：[1]石家庄市第三医院耳鼻咽喉科,050011 [2]衡水市中医医院检验科 [3]邯郸市中心医院耳鼻咽喉头颈外二科 [4]石家庄市第三医院中医科

出　　处：《天津医药》2025年第3期312-316,共5页Tianjin Medical Journal

基　　金：河北省中医药管理局科研计划项目(2024392)。

摘　　要：目的分析疏风通窍汤联合甲泼尼龙片用于慢性鼻窦炎伴鼻息肉(CRSwNP)患者术后的效果。方法前瞻性选取行鼻内镜手术的104例CRSwNP患者,将其随机分为激素组(术后应用甲泼尼龙片)和研究组(术后在激素组基础上联合疏风通窍汤治疗)。经剔除及脱落后激素组纳入50例,研究组纳入49例。比较2组疗效、肺经风热证积分、鼻黏膜恢复情况(采用Lund-Kennedy评分系统评定)、鼻黏膜重塑情况;采用酶联免疫吸附试验检测血清人β防御素(hBD)-2、高迁移率族蛋白B1(HMGB1)水平。结果研究组疾病总控制率高于激素组(95.92%vs.80.00%,P<0.05)。术后12周,2组肺经风热证积分、Lund-Kennedy评分及血清HMGB1水平均低于术前,且研究组均低于激素组;研究组血清hBD-2水平均高于术前,且研究组高于激素组(P<0.05)。术后12周,研究组上皮损伤改善情况优于激素组,基底膜厚度薄于激素组(P<0.05)。结论CRSwNP患者术后应用疏风通窍汤联合甲泼尼龙片治疗效果较佳,可明显改善血清hBD-2、HMGB1水平,有效抑制鼻黏膜重塑,显著提高鼻黏膜恢复效果。Objective To analyze the effect of Shufeng Tongqiao decoction combined with methylprednisolone tablets in patients with chronic sinusitis and nasal polyp(CRSwNP)after operation.Methods A total of 104 patients with CRSwNP underwent endoscopic nasal surgery were prospectively selected,and patients were randomly divided into the hormone group(n=52,postoperative methylprednone tablets)and the study group(n=52,postoperative combined treatment with Shufeng Tongqin Decoction).After removal and shedding,50 cases were included in the hormone group,and 49 cases were included in the study group.The curative effect,lung wind-heat syndrome score,nasal mucosa recovery(assessed by Lund-Kennedy score system)and nasal mucosa remodeling were compared between the two groups.Serum levels of humanβ-defensin(HBD)-2 and high mobility group protein B1(HMGB1)were detected by enzyme-linked immunosorbent assay.Results The total control rate was higher in the study group than that of the hormone group(95.92%vs.80.00%,P<0.05).At 12 weeks after surgery,the lung meridian wind heat syndrome scores,Lund-Kennedy scores and serum HMGB1 level were lower than before surgery in both groups(P<0.05),and the study group was lower than the hormone group(P<0.05).At 12 weeks after surgery,the epithelial injury grading was better in the study group than that in the hormone group(P<0.05),and the basement membrane thickness was thinner than that in the hormone group(P<0.05).Conclusion The joint of Shufeng Tongqiao decoction and methylprednisolone tablets has a better effect on postoperative CRSwNP patients,and it can greatly improve the levels of serum hBD-2 and HMGB1,effectively inhibit nasal mucosal remodeling,and greatly improve the recovery of nasal mucosa.

关 键 词：鼻窦炎 鼻息肉 鼻黏膜 甲泼尼龙 Β防御素 HMGB1蛋白质 疏风通窍汤 

分 类 号：R765.41[医药卫生—耳鼻咽喉科]