中药冲洗提高鼻内镜手术后疗效的观察

目的 观察中药冲洗对鼻内镜手术后疗效的影响,并初步探讨其作用机制.方法 鼻内镜手术患者100例,随机分为两组,于术后第2天取出鼻腔油纱条开始鼻腔冲洗,对照组50例用生理盐水100 mL,前2个月2次/d,第3个月1次/d;试验组50例给予自制中药洗液100 mL冲洗,方法相同.分别观察治疗效果.术中及术后3个月鼻内镜下分别取患者鼻息肉组织和鼻道窦口周围黏膜,采用免疫组织化学技术,对照观察黏膜诱导型一氧化氮合酶(inducible nitric oxide synthase,iNOS)的表达情况.结果 试验组疗效明显优于对照组,术中试验组及对照组iNOS差异无统计学意义;术后3个月试验组阴性率明显高于对照组(P<0.05).结论 鼻内镜术后用中药液冲洗鼻腔可提高鼻内镜手术的疗效,这可能是通过调节鼻腔黏膜的iNOS,促进术后鼻黏膜修复而实现的.

Effect of traditional Chinese medicine irrigation on functional endoscopic sinus surgery

Objective To observe the curative effect of traditional Chinese medicine irrigation on functional endo- scopic sinus surgery（ FESS）, and to investigate its mechanism. Methods One hundred patients with nasosinusitis and rhinopolyps who had received FESS were randomly divided into two groups. Nasal washing was performed after pulling out the gauze 2 days after the surgery. Sodium Chloride（ 100 mL） in control group（ n = 50） and self-made traditional Chinese medicine solution （ 100 mL） in experiment group （n = 50） was used to wash the nasal cavity twice per day in the former 2 months and once per day in the third month. The expression of inducible nitric oxide synthase （iNOS）in nasal polyps and mucosa around the nasal meatus and apertures was studied by means of immunohistochemistry. Results The curative effect of the experiment group was better than the control group. The expression of iNOS was not significantly different be- tween the two groups during the operation, but at 3 months postoperation （ P 〈 0.05）. Conclusions Washing with self- made traditional Chinese medicine solution could improve the curative effect, which might be done by regulating the in- ducible nitric oxide synthase expression in NP after FESS. （Chin J Ophthalmol and Otorhinolaryngol,2010,10：234-235 ）