鼻炎康汤治疗胆腑郁热证慢性鼻-鼻窦炎60例临床分析

目的:观察鼻炎康汤治疗慢性鼻-鼻窦炎(CRS)胆腑郁热证的临床疗效及对患者生活质量的改善作用。方法:将120例符合胆腑郁热证CRS患者,采用随机按数字表法分为对照组和观察组各60例。对照组服用克拉霉素颗粒,250 mg/次,2次/d;儿童则按体重15 mg·kg-1·d-1,分2次口服;并采用0.9%生理盐水+庆大霉素+地塞米松液鼻腔冲洗,每侧鼻腔冲洗100 m L,2次/d。观察组在口服克拉霉素的同时采用鼻炎康汤内服和鼻腔冲洗。两组均进行4周的治疗,4周后再服用半量克拉霉素口服8周。采用视觉模拟量表(VAS)评价主观病情,采用Lund-Kennedy评分法评价客观病情,采用糖精试验测量鼻黏膜纤毛传输速率(MTR),采用鼻腔鼻窦结局测试-20(SNOT-20)调查问卷评价生活质量,治疗前后各评价1次。结果:经Ridit分析,治疗后观察组临床疗效优于对照组(P0.05);治疗后观察组VAS,Lund-Kennedy和症状积分均低于对照组(P0.01);治疗后观察鼻黏膜纤毛传输速率(MTR)高于对照组(P0.01);治疗后观察组鼻部症状、相关症状、睡眠障碍和情感结局及SNOT-20总分低于对照组(P0.01)。结论:鼻炎康汤内服和鼻腔冲洗能改善CRS胆腑郁热证患者主、客症状,增加MTR,提高生活质量,其疗效优于单纯西药治疗。

Clinical Curative Effect Analysis of Biyankang Decoction in Treating 60 Patients with Chronic Rhinosinusitis of Stagnated Heat of Gallbladder Symptom

Objective: To observe the clinical effect of Biyankang decoction in treating chronic rhinosinusitis (CRS) of stagnated heat of gallbladder symptom, and to investigate its influence on improving patients' quality of life. Method: One hundred and twenty patients with CRS were randomly divided into the control group (60 cases) and the observation group (60 cases). Patients in the control group received 250 mg clarithromycin granules twice daily and 15 mg·kg^-1 for the children according to their weight. On the basis of nasal washing therapy in the control group, patients in the observation group added Biyankang decoction orally. All patients in two groups received 4 weeks of treatment. Then patients in two groups received half does of clarithromycin granules orally for another 8 weeks. The subjective condition was evaluated by using a visual analog scale (VAS) and the objective condition was evaluated by using the Lund-Kennedy scoring method. Nasal mucociliary transport rate (MTR) was detected by using saccharin test. The quality of life was evaluated by using sinuses nasal outcome test-20 (SNOT-20) questionnaire before and after the therapy. Result: The curative effect in the observation group was superior to that in the control group (P <0.05). The VAS, Lund-Kennedy and sign scores in the observation group were less than those in the control group (P <0.01). After treatment, nasal MTR in the observation group was higher than the control group (P <0.01). The symptoms including nasal symptoms, associated symptoms, sleep disorders and emotional end, SNOT-20 total scores in the observation group were inferior to those in the control group (P <0.01). Conclusion: Biyankang decoction could improve the subjective, objective symptoms, enhance MTR and improve the quality of life in patients with CRS of stagnated heat of gallbladder symptom. Its curative effect is superior to using western medicine treatment alone.