清鼻汤辅助治疗慢性鼻窦炎内窥镜术后96例

目的:观察清鼻汤对慢性鼻窦炎(CRS)功能性内窥镜鼻窦手术(FESS)后患者疾病愈合的影响。方法:将194例CRS患者随机按数字法分为对照组98例和观察组96例。两组FESS术后采用常规西药抗生素治疗和鼻腔冲洗。观察组在常规治疗的基础上加服清鼻汤,1剂/d。两组疗程均为8周,并进行1个月的随访。记录术腔黏膜水肿、窦腔分泌物、囊泡及水肿样肉芽增生和黏膜上皮化的改善情况及时间;记录术前,术后1,2,8及12周鼻塞、鼻分泌物、头痛、失嗅主要症状积分;进行鼻内镜检查,采用Lund-Kennedy评分法评价结果;采用糖精试验测量术前及术后12周鼻黏膜纤毛传输速率(MTR)。结果:观察组疾病疗效总有效率为95.7%,优于对照组的87.5%(P<0.05);观察组鼻塞/流涕减轻、嗅觉恢复、黏膜水肿减轻、术腔清洁、囊泡消失、黏膜上皮化所需时间均低于对照组(P<0.01);术后2,8及12周观察组鼻塞等主要症状积分低于对照组(P<0.01);术后8,12周观察组Lund-Kennedy评分低于对照组(P<0.01);术后12周两组MTR较术前增快,观察组MTR高于对照组(P<0.01)。结论:清鼻汤改善了慢性鼻窦炎FESS术后患者的症状和体征、缩短了愈合时间,促进了疾病愈合,值得临床使用。

Qingbi Decoction Adjuvant Treatment Chronic Sinusitis after Endoscopic Surgery with 96 Cases

Objective:Observe the influence of Qingbi decoction treat patients' chronic sinusitis(CRS) healing after functional endoscopic sinus surgery(FESS). Method:One hundred and ninety four cases with CRS randomly divided into control group (98 cases) and observation group (96 cases).Both groups' patients received conventional western medicine antibiotic treatment and nasal irrigation after FESS surgery.Patients in observation group took Qingbi decoction on the basis of conventional treatment,1 does/day.Treatment courses for both groups continued eight weeks and followed up for one month.Record improvement cavity mucosal edema, sinus tract secretions,vesicles and edema granulation hyperplasia and mucosal epithelial change situation. Record the main symptom integral of rhinobyon,nasal discharge, headache, loss of smell in preoperative time and the first week, second week,eighth week and twelve week after surgery. Examinate nasal endoscopic adopting the Lund-Kennedy grading to evaluate results. Using saccharin test the nasal mucosa cilia transmission rate (MTR) before treatment and during twelve weeks after treatmen. Result:The total effective rate of disease curative effect in the observation group was 95.7% superior to 87.5% in the control group(P<0.05),the observation group,the time of abatement of nasal obstruction/nasal discharge,recovery of sense of smell,abatement of mucosal edema,cavity irrigation,obliteration of vesicle and mucosal epithelium were all less than those in the control group(P<0.01),in the second week,eighth week and twelfth week after surgery,the main symptom integral such as nasal obstruction in the observation group were lower than the control group(P<0.01),in eighth week and twelfth week after surgery,Lund-Kennedy score in the observation group was lower than that in the control group(P<0.01),in twelfth week after surgery,compared with preoperative time,MTR in the two groups increased quickly,and MTR in the observation group was higher than that in the control group(P<0.01). Conclusion:After FESS surgery, it ameliorated patients' symptoms and sign,reduced time of agglutination,and promoted healing diseases when Qingbi decoction was used to patients of chronic sinusitis,it's worthy to be used in clinic.