摘要
目的:观察开结化痰汤加减治疗慢性鼻-鼻窦炎伴鼻息肉气滞痰阻证患者术后的近期疗效。方法:90例患者随机分为对照组和观察组,各45例。所有患者均给予鼻内窥镜术,对照组术后给予糠酸莫米松,观察组术后给予开结化痰汤内服加局部冲洗,疗程均为4周。治疗前后及随访1年分别观察两组鼻腔鼻窦结局测试-20(SNOT-20),鼻内窥镜检查评分量表(Lund-Kennedy),中医证状。治疗前后分别检测两组血清及鼻分泌液中肿瘤坏死因子α(TNF-α),白细胞介素(IL)-1β,IL-8,IL-17,嗜酸性粒细胞阳离子蛋白(ECP),免疫球蛋白E(IgE)含量。比较两组安全性,治疗后及随访1年的临床疗效。结果:治疗后及随访1年,观察组总控制率分别为97.7%,93.0%,高于对照组的87.8%,75.6%(P<0.05);与对照组治疗后及随访1年比较,观察组同期SNOT-20,Lund-Kennedy,中医证状积分降低(P<0.05);与对照组治疗后比较,观察组血清和鼻分泌液中TNF-α,IL-1β,IL-8,IL-17,ECP,IgE明显降低(P<0.05);观察组术后并发症发生率2.3%,低于对照组的17.1%(P<0.05);观察组不良反应发生率4.7%,低于对照组的41.5%(P<0.05)。结论:开结化痰汤加减可明显提高慢性鼻-鼻窦炎伴鼻息肉气滞痰阻证患者术后近期临床疗效,不良反应发生率低。
Objective: To observe the short-term effect of modified Kaijie Huatantang on chronic rhinosinusitis with nasal polyp due to qi stagnation phlegm syndrome. Method:A total of 90 cases were divided into control group and observation group,with 45 cases in each group. The control group was given mometasone furoate,and the observation group was given modified Kaijie Huatantang after nasal endoscopy surgery for 4 weeks. After treatment and follow-up for 1 years,the sino-nasal outcome test-20(SNOT-20),Lund-Kennedy and traditional Chinese medicine(TCM)syndrome were observed. The serum and nasal secretions tumor necrosis factor-alpha(TNF-α),interleukin(IL)-1β,IL-8,IL-17,eosinophilic cationic protein(ECP)and immunoglobulin E(IgE)were detected before and after treatment. The safety,clinical efficacy after treatment and follow-up for 1 years were compared between two groups. Result: After treatment and follow-up for 1 years,the total control rates were 97.7%,93.0% in observation group,which were higher than 87.8%,75.6% in control group(P<0.05).Compared with the control group after treatment and follow-up for 1 years,SNOT-20,Lund-Kennedy and TCM syndrome scores in the observation group decreased in the same period(P<0.05). Compared with the control group after treatment,the serum and nasal secretions TNF-α,IL-1β,IL-8,IL-17,ECP and IgE in the observation group were significantly decreased(P<0.05). The incidence of postoperative complications was 2.3% in the observation group,which was lower than 17.1% in the control group(P<0.05). The incidence of adverse reactions was 4.7% in the observation group,which was lower than 41.5% in the control group(P<0.05).Conclusion: Modified Kaijie Huatantang can significantly improve the short-term clinical efficacy of patients with chronic rhinosinusitis and nasal polyp due to Qi stagnation phlegm obstruction,with a low incidence of adverse reactions.
作者
张灵敏
李静波
蔡纪堂
陈文明
ZHANG Ling-min;LI Jing-bo;CAI Ji-tang;CHEN Wen-ming(Henan Province Hospital of Traditional Chinese Medicine,Zhengzhou 450002,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2021年第3期123-128,共6页
Chinese Journal of Experimental Traditional Medical Formulae
基金
河南省中医药科学研究专项(2018ZY1010)。
关键词
开结化痰汤加减
鼻内窥镜手术
慢性鼻-鼻窦炎
鼻息肉
气滞痰阻证
modified Kaijie Huatantang
nasal endoscopy
chronic rhinosinusitis
nasal polyps
Qi stagnation phlegm obstruction syndrome
