摘要
目的观察消风宣窍汤联合阿奇霉素分散片治疗儿童慢性鼻窦炎风热犯肺证的临床疗效。方法选取2018年3月至2020年3月温州市中西医结合医院耳鼻喉科116例慢性鼻窦炎风热犯肺证患儿,采用随机数字表法分为对照组和治疗组,各58例。2组给予健康教育、饮食指导等基础干预治疗,对照组在基础干预治疗方法的基础上给予阿奇霉素分散片,治疗组在对照组治疗方法的基础上联合消风宣窍汤治疗,2组均治疗2周后,统计临床疗效、中医症状评分,并检测治疗前、后血清炎症因子指标[白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、白细胞介素-17(IL-17)]水平、鼻黏膜纤毛输送率(MTR)和鼻黏膜纤毛清除率(MCC)的变化。结果治疗组总有效率为96.55%(56/58),显著高于对照组的81.03%(47/58),2组比较,差异有统计学意义(P<0.05)。治疗前,2组的MTR、MCC比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组MTR、MCC较同组治疗前上升(P<0.05),且治疗组升高更显著,差异有统计学意义(P<0.05)。治疗前,2组鼻塞、黏性和脓性鼻涕、头面部胀痛、嗅觉减退或丧失评分比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组上述中医症状评分较同组治疗前均下降(P<0.05),且治疗组降幅更显著,差异有统计学意义(P<0.05)。治疗前,2组血清炎症因子IL-2、IL-6和IL-17水平比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组上述血清炎症因子水平较同组治疗前均显著降低(P<0.05),且治疗组降幅更显著(P<0.05)。对照组出现腹泻1例,占1.72%(1/58);治疗组出现恶心呕吐1例,头晕头痛1例,占3.45%(2/58)。2组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论消风宣窍汤联合阿奇霉素分散片治疗儿童慢性鼻窦炎可有效改善临床症状,降低炎症反应,提高鼻黏膜纤毛传输功能,且用药安全,值得临床推广应用。
Objective To observe the clinical efficacy of Xiaofeng Xuanqiao Tang(消风宣窍汤)combined with azithromycin dispersible tablets in the treatment of chronic nasosinusitis in children with wind-heat invading lung syndrome.Methods From March 2018 to March 2020,116 cases of chronic nasosinusitis in children with wind-heat invading lung syndrome consulted in otolaryngology department of Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine were divided into control group and treatment group according to random number table method,with 58 cases in each group.The 2 groups were given health education,dietary guidance and other basic intervention treatment,the control group was given azithromycin dispersible tablets on the basis of the basic intervention treatment,while the treatment group was combined with Xiaofeng Xuanqiao Tang on the basis of the treatment of the control group.After 2 weeks of treatment for the 2 groups,we kept statistics about the clinical efficacy,TCM symptom score,and detected inflammatory factor indexes[the levels of interleukin-2(IL-2),interleukin-6(IL-6)and interleukin-17(IL-17)],the changes of nasal mucociliary transport rate(MTR)and nasal mucosal ciliary clearance(MCC)rate before and after treatment.Results The total effective rate of the treatment group was 96.55%(56/58),which was significantly higher than 81.03%(47/58)of the control group,and the difference was statistically significant between the 2 groups(P<0.05).Before treatment,there was no significant difference in MTR and MCC between the 2 groups(P>0.05),and they were comparable.After treatment,MTR and MCC of the 2 groups increased compared with those in the same group before treatment(P<0.05),and the increase of the treatment group was more significant,and the difference was statistically significant(P<0.05).Before treatment,the difference was not statistically significant in nasal obstruction,sticky and purulent nasal discharge,craniofacial distending pain,hyposmia or anosmia score between the 2 groups(P>0.05),and they were comparable.After treatment,the above-mentioned TCM symptom score of the 2 groups decreased compared with that in the same group before treatment(P<0.05),moreover,the treatment group decreased more significantly,and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in the levels of serum inflammatory factors IL-2,IL-6 and IL-17 between the 2 groups(P>0.05),and they were comparable.After treatment,the serum inflammatory factors levels in the 2 groups significantly decreased than those in the same group before treatment(P<0.05),moreover,the decrease in the treatment group was more significant(P<0.05).One case of diarrhea occurred in the control group,accounting for 1.72%(1/58),and 1 case of nausea and vomiting,1 case of dizziness and headache occurred in the treatment group,accounting for 3.45%(2/58).There was no significant difference in the total incidence of adverse reactions(P>0.05).Conclusion It can effectively improve the clinical symptoms,reduce the inflammatory reactions,improve the nasal mucociliary transport function with safe medication to use Xiaofeng Xuanqiao Tang combined with azithromycin dispersible tablets in the treatment of chronic nasosinusitis in children with wind-heat invading lung syndrome,which is worthy of clinical promotion and application.
作者
叶建
YE Jian(Department of Otolaryngology,Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine,Wenzhou,Zhejiang,325000,China)
出处
《中医儿科杂志》
2021年第4期62-66,共5页
Journal of Pediatrics of Traditional Chinese Medicine
关键词
儿童慢性鼻窦炎
消风宣窍汤
阿奇霉素分散片
炎症因子
临床观察
chronic nasosinusitis in children
Xiaofeng Xuanqiao Tang(消风宣窍汤)
azithromycin dispersible tablets
infammatory factors
clinical observation
