慢性鼻—鼻窦炎患者鼻内镜手术后生活质量和中医体质的关系研究

发布时间：2018-01-11 18:18

本文关键词：慢性鼻—鼻窦炎患者鼻内镜手术后生活质量和中医体质的关系研究　出处：《福建中医药大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：调查不同中医体质的慢性鼻-鼻窦炎患者手术前后生活质量,探讨慢性鼻-鼻窦炎患者鼻内镜手术后生活质量与中医体质的相关性。从而评价鼻内镜手术治疗效果。方法：收集湿热质、气虚质、痰湿质的慢性鼻-鼻窦炎患者各30例,采用医学结果简化量表-36(SF-36)及鼻腔鼻窦结局测试-20(SNOT-20)分别于术前、术后六个月对各体质慢性鼻-鼻窦炎患者进行问卷调查,比较同种体质慢性鼻-鼻窦炎患者术前和术后的生活质量及不同间体质慢性鼻-鼻窦炎患者的术前术后生活质量。结果：各体质组患者在病程、年龄、性别等方面无明显差异,湿热质、气虚质及痰湿质三种中医体质组慢性鼻-鼻窦炎患者术前SF-36总分无显著性差异(P0.05)。SNOT-20评分中有显著性差异(P0.05),其中SNOT-20,总分湿热质气虚质,痰湿质气虚质,湿热质与痰湿质术前SNOT-20,总分比较无明显差异(P0.05)。说明在鼻腔鼻窦结局测试中湿热质及痰湿质患者所受影响程度小于气虚质患者。鼻内镜手术术后6个月与术前相比,三种中医体质慢性鼻-鼻窦炎患者SF-36与SNOT-20评分均具有高度显著差异(P0.01)。说明湿热质、气虚质、痰湿质患者鼻内镜手术后6个月后总体生活质量明显改善。术后6个月慢性鼻-鼻窦炎患者的SNOT-20总分在各体质组间无显著性差异(P0.05),说明各体质组鼻腔鼻窦局部病变恢复到一致水平。不同体质的慢性鼻-鼻窦炎患者在SF-36总分具有显著性差异(P0.05),其中SF-36总分湿热质气虚质,具有显著性差异(P0.05),湿热质痰湿质,具有显著性差异(P0.05),气虚质与痰湿质术后SF-36总分比较无明显差异(P0.05)。说明在鼻内镜手术对湿热质患者总体健康改善情况要好于气虚质及痰湿质患者。结论：1、慢性鼻-鼻窦炎对湿热质、气虚质、痰湿质三种体质患者在生活质量上均有影响,其中在鼻腔鼻窦局部病变中湿热质及痰湿质患者所受影响程度小于气虚质患者。2、鼻内镜手术可以明显的改善不同中医体质患者的生活质量,其中对湿热质患者改善情况要优于气虚质及痰湿质患者。3、鼻内镜手术后生活质量改善情况与中医体质存在相关性。4、通过中医体质可以预测性的评价鼻内镜手术治疗效果。
[Abstract]:Objective: to investigate the quality of life of patients with chronic rhinosinusitis with different TCM constitution before and after operation. To investigate the relationship between the quality of life and TCM constitution in patients with chronic rhinosinusitis. Methods: 30 cases of chronic rhinosinusitis with dampness heat, qi deficiency and phlegm dampness were collected. The simplified medical results scale (-36 SF-36) and the nasal cavity and paranasal sinus outcome test (-20 SNOT-20) were used before operation. Six months after operation, the patients with chronic rhinosinusitis were investigated by questionnaire. The quality of life before and after operation in patients with chronic rhinosinusitis of the same constitution and the quality of life in patients with chronic rhinosinusitis with different constitution were compared. Results: the course and age of patients with chronic rhinosinusitis were compared. There is no significant difference in sex and other aspects, moisture and heat quality. Qi-deficiency and phlegm-dampness in the three groups of chronic rhinosinusitis patients with no significant difference in preoperative SF-36 total score P0.05 SNOT-20 score was significant difference (P0.05). SNOT-20, the total score of damp-heat qi deficiency, phlegm-dampness Qi deficiency, damp-heat and phlegm-wet SNOT-20. There was no significant difference in total score between the two groups (P 0.05), which indicated that the degree of influence in the patients with dampness, heat and phlegm in the nasal cavity and nasal sinus outcome test was less than that in the patients with deficiency of qi. The scores of SF-36 and SNOT-20 in patients with chronic rhinosinusitis of three kinds of TCM constitution were significantly different (P 0.01). The total quality of life of the patients with phlegm dampness improved significantly 6 months after endoscopic surgery, and the total score of SNOT-20 in patients with chronic rhinosinusitis was not significantly different among the physical groups (P0.05). The results showed that the local pathological changes of nasal cavity and paranasal sinus recovered to the same level in all physique groups. There was significant difference in the total score of SF-36 in patients with chronic rhinosinusitis with different constitution (P 0.05). The total score of SF-36 was damp-heat qi deficiency, with significant difference (P0.05A, P 0.05), and damp-heat phlegm-dampness (P0.05). There was no significant difference in the total score of SF-36 between qi deficiency and phlegm wet after operation (P 0.05), which indicated that the general health improvement of patients with dampness and heat was better than that of qi deficiency and phlegm wet. Conclusion 1, chronic rhinosinusitis has an effect on the quality of life of the patients with dampness and heat, deficiency of qi and phlegm and dampness. In the local lesions of nasal cavity and paranasal sinuses, the influence of dampness and heat and phlegm dampness is less than that of Qi-deficiency patients. Nasal endoscopic surgery can obviously improve the quality of life of patients with different physique of traditional Chinese medicine. Among them, the improvement of dampness and heat is better than that of qi deficiency and phlegm dampness. The improvement of quality of life after nasal endoscopic surgery has a correlation with TCM constitution. The effect of endoscopic sinus surgery can be evaluated by predicting the physique of traditional Chinese medicine.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R765.9

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