摘要
目的观察苍耳子鼻炎胶囊联合改良鼻腔冲洗方案对急性鼻窦炎患者疗效及炎症指标的影响。方法选择2016年1月至2018年5月在温州医科大学附属第一医院就诊的急性鼻窦炎患者120例，按治疗方法不同分为中西医结合治疗组（中西医结合组）和西药对照组，每组60例。西药对照组采用改良鼻腔冲洗方案治疗；中西医结合组在改良鼻腔冲洗方案基础上加用苍耳子鼻炎胶囊（组成：苍耳子、黄芩、辛夷花、石膏、冰片、白芷、薄荷等），每次2粒，每日3次，连续治疗14d。于治疗前和疗程结束后检测患者血清肿瘤坏死因子-α（TNF-α）、超敏C-反应蛋白（hs—CRP）及血常规中性粒细胞比例（N）、白细胞计数（WBC）；记录两组患者症状积分，采用Lund—Kennedy评分进行鼻内镜下黏膜状态评估，采用Lund—Mackay评分对患者进行CT检查量化评估，观察两组患者临床疗效和不良反应发生情况。结果治疗后两组患者hs—CRP、WBC、N、TNF—α、Lund—Kennedy评分、症状积分、Lund—Mackay评分均显著低于治疗前，且以中西医结合组的降低程度较西药对照组更显著[hs—CRP（mg／L）：2．56±0．89比4．75±1．23，WBC（×10^9／L）：5．12±2．21比7．38±2．10，N：0．60±0．02比0．67±0．03，TNF-α（nmol／L）：25．11±10．83比36．52±11．02，Lund—Kennedy评分（分）：2．30±0．59比3．03±0．58，症状积分（分）：0．46±0．23比1．24±0．47，Lund—Mackay评分（分）：2．70±0．63比4．60±0．88，均P〈0．05]。中西医结合组治疗总有效率显著高于西药对照组[96．67％（58／60）比85．00％（51／60），P〈0．05]。中西医结合组和西药对照组不良反应比较差异无统计学意义[5．00％（3／60）比6．67％（4／60），P〉0．05]。结论苍耳子鼻炎胶囊联合改良鼻腔冲洗方案能显著提高急性鼻窦炎患者的临床疗效，改善机体炎症因子水平，且安全性较好。
Objective To explore the effect of Xanthium rhinitis capsule combined with improved nasal irrigation scheme on the efficacy and laboratory indexes in treatment of patients with acute nasosinusitis. Methods One hundred and twenty patients with acute sinusitis who were treated in the First Affiliated Hospital of Wenzhou Medical University from January 2016 to May 2018 were selected. According to the difference in treatment methods, they were divided into an integrative traditional Chinese and western medicine group （combined group） and a western medicine control group （control group）, 60 cases in each group. The control group was only treated with improved nasal irrigation, while the combined group was, on the basis of the treatment in control group, additionally given Xanthium rhinitis capsule （composition： xanthium, scutellaria, magnolia flower, gypsum, borneo1, angelica dahurica, peppermint, etc.）, 2 tablets each time, 3 times a day for consecutive 14 days. Before and after of treatment, the serum tumor necrosis factor- α （TNF- α ）, the level of hypersensitive C-reactive protein （hs-CRP） and the blood routine neutrophils ratio （N） and white blood cell count （WBC） were detected. The patients＇ integral scores of acute sinusitis symptoms were recorded in two groups, Lund-Mackay score was used to quantify the patients＇ CT examination, the Lund-Kennedy score was used to evaluate the mucosal status under nasal endoscopy, and the clinical therapeutic effects and adverse reactions of the two groups were observed. Results After treatment, the levels of hs-CRP, WBC, N, TNF-α, the Lund-Kennedy score, symptom scores and Lund-Mackay scores in the two groups were significantly lower than those before treatment, and the degrees of reduction in the combined group were more significant than those in the control group [hs-CRP （mg/L）： 2.56 ± 0.89 vs. 4.75 ± 1.23, WBC （× 10^9/L）： 5.12± 2.21 vs. 7.38 ± 2.10, N： 0.60 ± 0.02 vs. 0.67± 0.03, TNF- α （nmol/L）： 25.11±10.83 vs. 36.52±11.02, Lund-Kennedy score： 2.30±0.59 vs. 3.03±0.58, symptom score： 0.46±0.23 vs. 1.24± 0.47, Lund-Mackay score： 2.70± 0.63 vs. 4.60± 0.88, all P 〈 0.05]. The total effective rate of the combined group was significantly higher than that of the control group [96.67% （58/60） vs. 85% （51/60）, P 〈 0.05]. There was no statistical significant difference in adverse reactions between the combined group and control group [5.00% （3/60） vs. 6.67% （4/60）, P 〉 0.05]. Conclusion Xanthium sibiricum capsule combined with improved nasal irrigation scheme used for treatment of patients with acute sinusitis can significantly improve the clinical efficacy and lower the levels of inflammatory factors, and the treatment is safe.
作者
李斯斯
张凌浩
张泉波
张悦
贾明辉
Li Sisi;Zhang Linghao;Zhang Quanbo;Zhang Yue;Jia Minghui(Department of Ear-Nose-Throat,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,Zhejiang,China;Department of Pathology,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,Zhejiang,China)
出处
《中国中西医结合急救杂志》
CAS
CSCD
北大核心
2018年第4期434-436,共3页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
基金
浙江省自然科学基金（LY17H130002）
关键词
苍耳子鼻炎胶囊
鼻腔冲洗
鼻窦炎
急性
Xanthium sibiricum capsule
Nasal cavity rinse
Sinusitis
acute
