论文部分内容阅读
目的 探讨中药联合鼻内窥镜手术治疗慢性鼻窦炎的临床效果. 方法 将173例慢性鼻窦炎患者根据治疗方法不同分为两组,研究组口服中药汤剂联合鼻内窥镜手术治疗,对照组单纯采用鼻内窥镜手术治疗,术后观察1周,随访3个月.治疗过程中详细记录患者手术各项指标;治疗前后采用糖精试验测定患者鼻黏液纤毛传输速度,采用鼻腔鼻窦结局测试-20量表评定鼻腔鼻窦结局状况;于术后3个月采用Lund-Kennedy量表评定术后自我感受状况.结果 研究组术中出血量、手术时间、术后鼻腔渗血量、术后疼痛视觉模拟评分和住院时间均显著少于对照组(P<0.05);治疗后两组鼻黏液纤毛传输速度均显著快于治疗前(P<0.01),研究组显著快于对照组(P<0.01);两组鼻腔鼻窦结局测试-20评分均显著低于治疗前(P<0.01),研究组显著低于对照组(P<0.01);研究组Lund-Kennedy评分显著低于对照组(P<0.01).研究组治愈率为81.6%、总有效率为99.1%,对照组分别为67.9%、92.9%,研究组治愈率、总有效率显著高于对照组(P<0.05).结论 中药联合鼻内窥镜手术治疗慢性鼻窦炎临床疗效显著,患者术后自我感受好,住院时间短,显著优于单用鼻内窥镜手术治疗,值得在临床推广应用.“,”Objective To explore the clinical effect of traditional Chinese medicine (TCM) combined with endoscopic sinus surgery (ESS) in patients with chronic rhinosinusitis.Methods A total of 173 patients with chronic rhinosinusitis were assigned to two groups according to different treatment methods, research group took orally TCM decoctions plus ESS, the control received single endoscopic sinus surgery, observed for 1 weeks after operation, and followed up for 3 months.All indexes during operation were recorded;Mucociliary transport rates (MTR) were detected with the Saccharin Test (ST) before and after treatment and sino-nasal outcomes with the Sino-Nasal Outcomes Test-20 (SNOT-20);self-perception conditions were assessed with Lund-Kennedy score (LK) in month 3 after operation.Results Intraoperative blood loss, operative time, postoperative nasal bleeding, postoperative Visual Analogue Scale (VAS) score and length of stay were significantly fewer in research than in control group (P<0.05);MTRs of both groups were significantly quicker after operation compared with pre-operation (P<0.01) and so was that in research than in control group (P<0.01);SNOT-20 scores of both groups were significantly lower after operation (P<0.01) and so was that in research than in control group (P<0.01);LK score was significantly lower in research than in control group (P<0.01);cure and total effective rate were respectively 81.6% and 99.1% in research and 67.9% and 92.9% in control group, the former significantly higher than then latter (P<0.05).Conclusion TCM combined with ESS has an evident effect, postoperative self-perception is better, and length of stay shorter compared with single ESS in the treatment of chronic rhinosinusitis and deserves clinical generalization and application.