皂角刺颗粒溶液经鼻窦负压置换法治疗鼻咽癌放疗后放射性鼻窦炎的效果观察

目的探讨皂角刺颗粒溶液经鼻窦负压置换法治疗鼻咽癌放疗后放射性鼻窦炎的效果。方法将30例鼻咽癌放疗后放射性鼻窦炎患者随机分为皂角刺组和生理盐水组各15例,皂角刺组接受皂角刺颗粒溶液20 mL行鼻窦负压置换法治疗,每周5次;生理盐水组接受生理盐水20 mL行鼻窦负压置换法治疗,每周5次;疗程均为3周。治疗前后评价两组鼻塞、鼻分泌物鼻后滴漏、前鼻孔分泌物、头/面痛、嗅觉损失5个鼻部症状的视觉模拟评分(VAS)和内镜Kennedy评分。比较两组疗效及不良反应发生情况。结果两组患者治疗前VAS评分、内镜Kennedy评分比较,差异均无统计学意义(P分别为0.500 6、0.725 7);治疗后皂角刺组患者鼻分泌物鼻后滴漏、鼻塞症状及嗅觉损失的VAS评分改善幅度和鼻咽后鼻孔分泌物潴留、中鼻道分泌物、黏膜水肿的鼻内镜评分改善幅度均高于生理盐水组,差异均有统计学意义(P分别为0.003 3、0.046 4、0.018 8、<0.000 1、<0.000 1、<0.000 1)。皂角刺组、生理盐水组治疗总有效率分别为100%、26.67%,两组比较差异有统计学意义(χ~2=22,P<0.000 1)。皂角刺组与生理盐水组均仅有1例出现鼻出血,两组不良反应发生率比较差异无统计学意义(χ~2=0.000 0,P=1.000)。结论皂角刺颗粒溶液经鼻窦负压置换法治疗鼻咽癌放疗后放射性鼻窦炎疗效显著,能明显改善患者临床症状,且较为安全。

Therapeutic effect of Zao-Jiao-Ci(the spine of Gleditsia sinensis Lam.)granule solution on radiation sinusitis after radiotherapy for nasopharyngeal carcinoma by sinus negative pressure replacement

Objective To investigate the effect of saponin granule solution in the treatment of nasopharyngeal carcinoma after radiotherapy with radioactive sinusitis. Method Thirty patients with radioactive sinusitis after radiotherapy for nasopharyngeal carcinoma were randomly divided into the saponin group and the saline group. The saponin group received 20 mL of saponin granule solution for sinus negative pressure replacement treatment, 5 times a week; the saline group received 20 mL of normal saline for sinus negative pressure replacement, 5 times a week; the course of treatment was 3 week. Visual analogue scores(VAS)of nasal symptoms(including nasal obstruction, nasal secretion, anterior nasal secretion, headache/facial pain, loss of smell)and endoscopic scores(Kennedy scores)were performed of both groups before and after treatment. The efficacy and adverse reactions of the two groups were compared. Result There were no significant differences in the pre-treatment VAS and Kennedy scores between the two groups(P is 0.500 6, 0.725 7 respectively). However, after 3 weeks of treatment, the improvement of VAS of nasal secretion, nasal obstruction and loss of smellin the Zao-Jiao-Ci group, and the improvement of nasal endoscopic scores of nasopharyngeal secretion, middle nasal secretions and mucosal edema were significantly higher than those in the saline group, the differences were statistically significant(P is 0.003 3, 0.046 4, 0.018 8, <0.000 1, <0.000 1, <0.000 1). The total effective rate of the saponin group and the saline group were 100% and 26.67%, respectively. The difference between the two groups was statistically significant(χ2=22, P<0.000 1). There was no significant difference in the incidence of adverse reactions between the two groups(χ2=0.000 0, P=1.000). Conclusion The Zao-Jiao-Ci granule solution is effective in the treatment of nasopharyngeal carcinoma after radiotherapy with radiation sinusitis by sinus negative pressure replacement, which can significantly improve the clinical symptoms of patients and is safer.