沙参麦冬汤对放射性鼻窦炎黏膜形态和功能转归的影响

目的:探讨应用加减沙参麦冬汤对放射性鼻窦炎黏膜形态和功能恢复的影响。方法:对51例鼻咽癌放疗后鼻窦炎患者随机分为治疗组26例和对照组25例,治疗组每次服用加减沙参麦冬汤,对照组用罗红霉素治疗,其他措施2组相同并做对比观察。随访3个月于治疗前、治疗1个月、治疗3个月进行糖精试验,每组4例患者分别于治疗前、治疗1个月、治疗3个月取窦口鼻道复合体黏膜进行电镜观察。结果:治疗组鼻腔黏膜形态和功能恢复时间均较对照组显著提前(P<0.05)。2组患者治疗前的SIgA无显著性差异(P>0.05),治疗1个月治疗组患者SIgA与对照组比较显著升高(P<0.05)。治疗前治疗组纤毛传输速率为3.14±1.05mm/min,2组比较差异无显著性(P>0.05);治疗3个月治疗组纤毛传输速率为6.09±2.63mm/min,与治疗前比较差异有显著性(P<0.01),对照组为5.04±1.22mm/min,2组之间比较有显著性差异(P<0.05)。电镜观察:治疗前黏膜上皮纤毛脱落,治疗后纤毛排列较整齐,粗细较均匀,呈"9+2"微管结构。结论:应用加减沙参麦冬汤能加快鼻腔黏膜形态和功能的恢复。

Influence on radioactive sinusitis morphology and function of nasal mucosa by the Shashen Maidong Decoction

Objective:To investigate the effect of Modified Shashen Maidong Decoction given for the patients with Radiation nasosinusitis.Methods:Modified Shashen Maidong Decoction(MSMD)was used orraly for 26 patients with radiation nasosinusitis,and roxithromycin was given in the same manner in another group(Control group)with 25 patients who suffered radiation nasosinusitis,the effects were compared.Saccharin test was given for all patients before the treatment,1 months and 3 months after the treatment,respectively.Results:The morphological and functional recovery of nasal mucaso occurred ealier in MDSD than in the control group(P<0.05),the level of SIgA was similar between the two groups before treatment(P>0.05),whereas after MSMD treatment,the level of SIgA was significantly elevated in the treated group.Mucociliary transport rate was similar betweet the two group before the treatment(3.14±1.0 mm/min 5vs 3.31±1.09mm/min,P>0.05),but 3 months after the treatment,the mucociliary transport rate increased to 6.09±2.63 mm/min in MDSD group and 5.04±1.22 mm/min in control group,showing significant difference between them.Under electron microscope,the cilia of epithelial cells were found exfoliated preoperatively but arranged after the treatment,presenting the "9+2" architecture of microtubule.Conclusion:MDSD used for radiation nasosinusitis can improve morphological and functional recovery of nasal mucaso.