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目的:观察卡介菌多糖核酸(BCG SPN)和糖皮质激素治疗并发变应性鼻炎、哮喘的慢性鼻窦炎、鼻 息肉的鼻内镜围手术期的临床疗效,探讨其免疫学机制和新的治疗途径。方法:对符合诊断标准的并发变应性鼻 炎和哮喘的慢性鼻窦炎、鼻息肉进行鼻内镜手术的96例患者分为3组,1组采用BCG SPN1ml,肌肉注射,隔日 1次,疗程5周;2组糖皮质激素鼻腔喷雾,每日1次,疗程5周;3组两药联合使用,疗程5周。进行鼻内镜手术后 术腔的黏膜转归观察。结果:随访6个月,1组有效率70.97%,2组有效率73.33%;联合组有效率90.63%。1组 和2组两者治疗效果差异无统计学意义(均P>0.05);联合使用与单独使用疗效相比差异有统计学意义,(均P <0.05)。结论:BCG SPN和糖皮质激素鼻腔喷雾剂均对变应性慢性鼻窦炎、鼻息肉患者鼻内镜手术后术腔黏膜 转归有明显的治疗效果,两者联合使用效果更佳。其机制是从不同的途径调节机体的Th1和Th2细胞亚群的平 衡,阻止机体的变态反应。联合用药为治疗该病提供了新的途径。
OBJECTIVE: To observe the clinical efficacy of BCG-SPN and glucocorticoid in the perioperative period of endoscopic sinus surgery for patients with allergic rhinitis, asthma, chronic rhinosinusitis and nasal polyps. To explore its immunological mechanism and new Therapeutic approach. Methods: Ninety-six patients undergoing endoscopic sinus surgery for chronic rhinosinusitis and nasal polyposis with diagnostic criteria of allergic rhinitis and asthma were divided into three groups. One group received BCG SPN1ml intramuscular injection every other day for 5 courses Week; two groups of glucocorticoid nasal spray, 1 day, treatment for 5 weeks; 3 groups of two drugs used in combination, treatment for 5 weeks. Endoscopic mucosal outcome after endoscopic sinus surgery. Results: After 6 months of follow-up, the effective rate was 70.97% in group 1, 73.33% in group 2 and 90.63% in combination group. There was no significant difference in the curative effect between the two groups (all P> 0.05). The difference between the two groups was statistically significant (all P <0.05). CONCLUSION: Both BCG SPN and glucocorticoid nasal spray have significant therapeutic effect on mucosa of mucosa after endoscopic sinus surgery in patients with allergic chronic sinusitis and nasal polyps. Its mechanism is from different ways to regulate the body’s balance of Th1 and Th2 cell subsets, to prevent the body’s allergy. Combination therapy for the treatment of the disease provides a new way.