清鼻汤辅助治疗慢性鼻窦炎内窥镜术后96例

发布时间：2018-11-27 15:37

【摘要】：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%(P0.05);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(P0.01);术后2,8及12周观察组鼻塞等主要症状积分低于对照组(P0.01);术后8,12周观察组Lund-Kennedy评分低于对照组(P0.01);术后12周两组MTR较术前增快,观察组MTR高于对照组(P0.01)。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。
[Abstract]:Objective: to observe the effect of Qingbi decoction on the healing of chronic sinusitis after (FESS) with (CRS) functional endoscope. Methods: 194 patients with CRS were randomly divided into control group (n = 98) and observation group (n = 96). The two groups were treated with routine western medicine antibiotics and nasal irrigation after FESS. Observation group on the basis of routine treatment plus Qingbi decoction, 1 dose per day. The two groups were treated for 8 weeks and followed up for 1 month. The improvement and time of mucosal edema, sinus secretion, vesicle and edematous granulation proliferation and mucosal epithelization were recorded, and the scores of nasal obstruction, nasal discharge, headache, loss of olfactory were recorded before and after operation. Nasal endoscopy was performed and Lund-Kennedy score was used to evaluate the results. The nasal mucosal ciliary transmission rate (MTR).) was measured by saccharin test before and 12 weeks after operation. Results: the total effective rate of disease in the observation group was 95.7%, which was better than that in the control group (87.5%) (P0.05). In the observation group, nasal congestion / runny reduced, olfactory recovery, mucosal edema relieved, operation cavity clean, vesicle disappeared, and the time required for mucosal epithelization was lower than that in the control group (P0.01). The scores of nasal obstruction and other major symptoms in the observation group were lower than those in the control group at 8 and 12 weeks after operation (P0.01), and the Lund-Kennedy score in the observation group was lower than that in the control group at 8 and 12 weeks after operation (P0.01). At 12 weeks after operation, MTR in the two groups increased faster than that before operation, and MTR in the observation group was higher than that in the control group (P0.01). Conclusion: Qingbi decoction can improve the symptoms and signs of patients with chronic sinusitis after FESS, shorten the healing time and promote the healing of the disease.
【作者单位】：郑州大学第一附属医院;
【基金】：河南省卫生厅医学科技攻关计划项目(201003026)
【分类号】：R765.41

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