济生乌梅片治疗慢性鼻-鼻窦炎伴鼻息肉疗效观察

目的观察济生乌梅片治疗慢性鼻-鼻窦炎伴鼻息肉的临床疗效。方法将2016年10月—2018年10月重庆市中医院诊治的90例慢性鼻-鼻窦炎伴鼻息肉患者按随机双盲法分为对照组45例和治疗组45例,治疗组给予济生乌梅片联合生理盐水喷鼻治疗,对照组给予布地奈德喷鼻剂联合淀粉片治疗,2组均治疗3个月。比较2组患者治疗前、治疗1个月后、治疗3个月后VAS评分、Lund-Kennedy评分及不良反应发生情况,检测治疗前后血清白细胞介素-5(IL-5)水平和组织中嗜酸性粒细胞计数,HE染色观察鼻息肉组织病理表现,统计2组患者治疗3个月后临床疗效。结果2组患者治疗3个月后VAS评分、Lund-Kennedy评分、血清IL-5水平和组织中嗜酸性粒细胞计数均较治疗前降低(P均<0.05),2组间治疗前、治疗3个月后VAS评分、Lund-Kennedy评分比较差异均无统计学意义(P均>0.05);治疗3个月后2组鼻息肉组织中嗜酸性粒细胞浸润及间质水肿较治疗前明显减少,对照组间质水肿减少更明显;治疗3个月后治疗组完全控制率为19.1%(8/42),低于对照组的23.3%(10/43),但差异无统计学意义(P>0.05);治疗组不良反应发生率为11.9%(5/42),明显低于对照组的67.4%(29/43),差异有统计学意义(P<0.05)。结论济生乌梅片治疗慢性鼻-鼻窦炎伴鼻息肉疗效显著,与使用鼻用激素效果接近,但不良反应少。

Observation on therapeutic effect of Jisheng Wumei tablets on chronic rhinosinusitis with nasal polyps

Objective It is to observe the clinical efficacy of Jisheng Wumei tablets in the treatment of chronic rhinosinusitis with nasal polyps.Methods Ninety patients with chronic rhinosinusitis with nasal polyps diagnosed and treated in Chongqing Hospital of Traditional Chinese Medicine were randomly divided into a control group of 45 cases and a treatment group of 45 cases.The treatment group was given Jisheng Wumei tablets by oral administration combined with saline nasal spray,the control group was treated with budesonide nasal spray combined with starch tablets,and both groups were treated for 3 months.The VAS score,Lund-Kennedy score and the occurrence of adverse reactions were compared between the two groups before treatment,1 month after treatment,and 3 months after treatment.The levels of serum interleukin-5(IL-5)and acidic tropism granulocyte count in tissue were detected before and after treatment.HE staining was used to observe the pathological manifestations of the nasal polyp tissue.The clinical efficacy of the two groups after 3 months of treatment was evaluated.Results The VAS score,Lund-Kennedy score,serum IL-5 level,and eosinophil count in the tissues after 3 months of treatment were all lower than those before treatment in the two groups(P<0.05).There was no significant difference in VAS score and Lund-Kennedy score before treatment and after 3 months of treatment between the two groups(P>0.05);after 3 months of treatment,the eosinophil infiltration and interstitial edema in the nasal polyp tissues of the two groups were significantly reduced compared with before treatment,the reduction of interstitial edema in the control group was more obvious;after 3 months of treatment,the complete control rate of the treatment group was 19.1%(8/42),which was lower than 23.3%(10/43)in the control group,but the difference was not statistically significant(P>0.05);the incidence of adverse reactions in the treatment group was 11.9%(5/42),which was significantly lower than 67.4%(29/43)in the control group,and the difference was statistically significant(P<0.05).Conclusion Jisheng Wumei tablet has a significant curative effect in the treatment of chronic rhinosinusitis with nasal polyps,which is similar to the effect of nasal hormones,but has fewer adverse reactions.