摘要
目的观察耳穴贴压联合鼻痔散加减对重度萎缩性鼻炎患者术后炎性因子水平、生活质量及并发症情况的影响。方法将72例将行鼻腔填塞术的重度萎缩性鼻炎患者随机平均分为两组,对照组(36例)和观察组(36例)。对照组术后予鼻喷重组牛碱性成纤维细胞生长因子外用溶液,观察组在对照组基础上予耳穴贴压联合鼻痔散加减。观察两组患者治疗前后鼻腔鼻窦结局测试-20(sino-nasal outcome test-20,SNOT-20)、鼻腔内窥镜评价量表(Lund-Kennedy nasal endoscopy scoring scale,Lund-Kennedy)、萎缩性鼻炎患者症状及体征评价量表(sign evaluation scale for patients with atrophic rhinitis,SSPAR)和中医证候积分的评分变化。比较两组治疗前后影像学检查指标及鼻黏液纤毛传输速率。比较两组患者治疗前后血清和鼻分泌液中炎性因子、免疫球蛋白E(immunoglobulin E,IgE)及嗜酸性粒细胞阳离子蛋白(eosinophil cationic protein,ECP)的水平。比较两组临床疗效和术后并发症发生率。结果观察组总有效率优于对照组(P<0.05)。与对照组比较,观察组治疗后SNOT-20、Lund-Kennedy、SSPAR和中医证候积分的评分均降低(P<0.05),影像学检查指标及鼻黏液纤毛传输速率均改善(P<0.05),血清和鼻分泌液中炎性因子、IgE和ECP水平均降低(P<0.05)。对照组术后出现发热2例、切口肿胀3例、切口感染1例、头昏头痛1例;观察组出现切口肿胀1例。观察组术后并发症发生率低于对照组(P<0.05)。结论在外用西药治疗基础上,耳穴贴压联合鼻痔散加减可有效改善重度萎缩性鼻炎患者术后的临床症状,提高生活质量,降低血清及鼻分泌液中炎性因子水平,减少并发症的发生。
Objective To observe the effects of auricular point sticking plus modified Bi Zhi San on the postoperative inflammatory factor level,quality of life,and complications in patients with severe atrophic rhinitis.Method Seventy-two patients with severe atrophic rhinitis going to receive nasal packing surgery were evenly randomized into two groups,a control group(36 cases)and an observation group(36 cases).After the surgery,the control group was prescribed the nasal spray of recombinant bovine basic fibroblast growth factor solution for external use,and the observation group received additional auricular point sticking plus modified Bi Zhi San.Before and after the treatment,the sino-nasal outcome test-20(SNOT-20)score,Lund-Kennedy nasal endoscopy scoring scale(Lund-Kennedy)score,sign evaluation scale for patients with atrophic rhinitis(SSPAR)score,and symptom score of traditional Chinese medicine(TCM)were observed.The imaging examination outcomes,nasal mucociliary transport rate,and the levels of inflammatory factors,immunoglobulin E(IgE),and eosinophil cationic protein(ECP)in the serum and nasal secretions were compared before and after the intervention.The clinical efficacy and the postoperative complication rate were also compared between the two groups.Result The observation group had a higher total effective rate than the control group(P<0.05).Compared with the control group,the SNOT-20,Lund-Kennedy,SSPAR,and TCM symptom scores dropped in the observation group after the treatment(P<0.05),together with improvements in the imaging examination indicators and nasal mucociliary transport rate(P<0.05)and decreased levels of inflammatory factors,IgE,and ECP in the serum and nasal secretions.There were 2 cases of postoperative fever,3 cases of incision swelling,1 case of incision infection,and 1 case of dizziness and headache in the control group;1 case of incision welling occurred in the observation group.The postoperative complication rate was lower in the observation group than in the control group(P<0.05).Conclusion Based on the external use of Western medicine,auricular point sticking plus Bi Zhi San can effectively improve postoperative symptoms and quality of life,down-regulate inflammatory factor levels in the serum and nasal secretions,and reduce the incidence of complications in patients with severe atrophic rhinitis.
作者
徐冰
王俊杰
XU Bing;WANG Junjie(Henan Province Hospital of Traditional Chinese Medicine(The Second Affiliated Hospital of Henan University of Chinese Medicine),Zhengzhou 450002,China)
出处
《上海针灸杂志》
CSCD
2023年第10期1005-1011,共7页
Shanghai Journal of Acupuncture and Moxibustion
基金
河南省中医药科学研究专项课题(20-21ZY2206)。
关键词
耳穴贴压
鼻炎
萎缩性
术后
炎性因子
生活质量
并发症
Auricular point sticking
Rhinitis,Atrophic
Postoperative
Inflammatory factors
Quality of life
Complications
