摘要
目的观察辛前甘桔汤联合内舒拿治疗功能性鼻内镜手术(FESS)后的慢性鼻窦炎(CRS)的临床疗效。方法纳入166例FESS术后患者,随机分为对照组和治疗组,每组各83例。两组患者均予内舒拿喷鼻,对照组患者在此基础上给予标准桃金娘油肠溶胶囊口服,治疗组患者在此基础上给予辛前甘桔汤加减口服,两组疗程均为12周。比较两组患者的症状总评分及单个症状评分;评价两组的临床疗效;采用鼻内镜Lund-Kennedy评分、副鼻窦CT平扫Lund-Mackay评分评价两组的影像学疗效;术后随访2年,比较两组患者的复发情况。结果①治疗后,治疗组的临床总有效率为92.77%,对照组为78.31%,治疗组的疗效优于对照组,差异有统计学意义(P<0.01)。②术后8周、12周,治疗组患者的临床症状总评分低于对照组(P<0.05,P<0.01)。治疗后,两组患者的鼻塞、流涕、头痛、嗅觉减退症状评分较术前均降低(P<0.05);术后4周、8周、12周,治疗组患者的鼻塞症状评分低于对照组(P<0.05,P<0.01);术后8周、12周,治疗组患者的流涕症状评分低于对照组(P<0.05)。③治疗后,两组患者的Lund-Kennedy评分较术前均明显下降(P<0.01);但不同时点两组患者的评分比较,差异均无统计学意义(P>0.05)。治疗后,两组患者的Lund-Mackay评分较术前均明显下降(P<0.01);但不同时点两组患者的评分比较,差异均无统计学意义(P>0.05)。④随访2年中,治疗组有3例复发,复发率为3.61%;对照组有9例复发,复发率为10.84%。治疗组的复发率低于对照组,差异有统计学意义(P<0.05)。结论辛前甘桔汤联合内舒拿治疗能有效改善FESS术后CRS患者的鼻部症状,降低术后复发率,具有较好的临床疗效。
Objective To observe the clinical efficacy of Xinqian Ganjie Decoction combined with mometasone furoate in the treatment of chronic sinusitis(CRS) patients undergoing functional endoscopic sinus surgery(FESS). Methods One hundred and sixty-six CRS patients after FESS were randomly divided into the control group and treatment group, 83 cases in each group. Both groups were treated with nasal spray of mometasone furoate. Based on this, the patients in the control group were orally treated with standard Myrtle oil enteric coated capsule, and the patients in the the treatment group were orally treated with modified Xinqian Ganjie Decoction, with a course of 12 weeks. The total symptom score and single symptom score of the two groups were compared. The clinical efficacy of the two groups was evaluated. The imaging efficacy of the two groups was evaluated by Lund-Kennedy score of nasal endoscopy and Lund-Mackay score of paranasal sinus CT plain scan. The recurrence of the two groups was compared after follow-up for 2 years. Results(1)After treatment,the total clinical effective rate of the treatment group was 92.77%,and that of the control group was 78.31%. The efficacy of the treatment group was better than that of the control group,with statistically significant difference( P<0.01).(2) Eight and twelve weeks after operation,the total score of clinical symptoms in the treatment group was lower than that in the control group( P<0.05,P<0.01). After treatment,the scores of nasal obstruction,runny nose,headache and olfactory decline in the two groups were decreased compared with operation before( P<0.05). Four,eight and twelve weeks after operation,the score of nasal obstruction in the treatment group was lower than that in the control group( P<0.05,P<0.01). Eight and twelve weeks after operation,the score of runny nose in the treatment group was lower than that in the control group( P<0.05).(3)After treatment,the Lund-Kennedy score of the two groups was significantly decreased compared with operation before( P<0.01),but at different time points,there was no statistically significant difference between the two groups( P>0.05). After treatment,the Lund-Mackay score of the two groups was significantly decreased compared with operation before( P<0.01),but at different time points,there was no statistically significant difference between the two groups( P>0.05).(4)During the 2-year followup,there were 3 recurrence cases in the treatment group and 9 recurrence cases in the control group. The recurrence rate was 3.61% in the treatment group and 10.84% in the control group. The recurrence rate of the treatment group was lower than that of the control group,with statistically significant difference( P<0.05). Conclusion Xinqian Ganjie Decoction combined with mometasone furoate can effectively improve the nasal symptoms of chronic sinusitis patients after FESS,and reduce the recurrence rate,which shows better clinical efficacy.
作者
施陈燕
章静怡
滕磊
蔡蔚然
张治军
SHI Chenyan;ZHANG Jingyi;TENG Lei;CAI Weiran;ZHANG Zhijun(Department of Otolaryngology,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Department of Otolaryngology,Jiading District Hospital of Traditional Chinese Medicine,Shanghai 201800,China)
出处
《上海中医药杂志》
2020年第S01期118-121,共4页
Shanghai Journal of Traditional Chinese Medicine
基金
上海市科委医学和农业领域科技支撑项目(15401971300)
上海中医药大学附属曙光医院四明青年基金项目(SGKJ-201818).
关键词
慢性鼻窦炎
功能性鼻内镜手术
辛前甘桔汤
内舒拿
chronic sinusitis
functional endoscopic sinus surgery
Xinqian Ganjie Decoction
mometasone furoate
作者简介
施陈燕,女,硕士,主治医师,主要从事中西医结合治疗耳鼻喉疾病临床研究工作;通信作者:张治军,主任医师。E-mail:zjzhang2007@sina.com
