中药超声雾化鼻吸入联合鼻腔冲洗治疗鼻咽癌放疗后鼻窦炎临床研究

Clinical Study on TCM Ultrasonic Atomizing Nasal Inhalation Combined with Nasal Irrigation for Treatment of Sinusitis After Radiotherapy for Nasopharyngeal Carcinoma

目的探讨中药超声雾化鼻吸入联合鼻腔冲洗治疗鼻咽癌放疗后鼻窦炎肺经风热证临床疗效。方法采用随机数字表法将80例患者分为观察组和对照组各40例。对照组予鼻腔冲洗;观察组在对照组基础上予中药超声雾化鼻吸入,每次30 min,每日1次,交替轮换鼻腔,治疗5 d后间隔2 d。2组均连续治疗4周。观察2组治疗前后症状评分、慢性鼻窦炎鼻息肉患者内镜评分系统(Lund-kennedy)评分、纤毛传输速率及炎症因子水平,比较2组临床疗效。结果与本组治疗前比较,2组治疗后嗅觉减退、鼻塞、鼻腔分泌物评分及Lund-kennedy评分降低,超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)水平降低,纤毛传输速率升高,差异有统计学意义(P<0.05)。2组治疗后比较,观察组嗅觉减退、鼻塞、鼻腔分泌物评分及Lund-kennedy评分低于对照组,hs-CRP、TNF-α水平低于对照组,纤毛传输速率高于对照组,差异有统计学意义(P<0.05)。观察组总有效率为92.50%(37/40),对照组为75.00%(30/40),观察组明显优于对照组(P<0.05)。结论中药超声雾化鼻吸入联合鼻腔冲洗治疗鼻咽癌放疗后鼻窦炎肺经风热证疗效满意,可改善机体炎症反应及鼻窦功能。

Objective To discuss the clinical efficacy of TCM ultrasonic atomizing nasal inhalation combined with nasal irrigation for the treatment of sinusitis(pattern of wind-heat in lung channel) after radiotherapy for nasopharyngeal carcinoma. Methods Totally 80 patients with nasopharyngeal carcinoma were divided into observation group and control group through random number table method, with 40 cases in each group. The control group was treated with nasal irrigation, and observation group was treated with TCM ultrasonic atomizing for nasal inhalation on the basis of control group, 30 min each time, once a day, alternate rotation of the nasal cavity, rest for 2 days after treatment for 5 days. The treatment for both groups lasted for four weeks. The symptom scores, the endoscopic scoring system(Lund-kennedy) score, the cilia transmission rate and the inflammatory factor level s of the two groups before and after treatment were observed. The clini cal efficacy of both groups was compared. Results Compared with before treatment, hyposmia, nasal congestion, nasal secretion symptom score, Lund-kennedy score, levels of high-sensitivity C-reactive protein(hs-CRP) and tumor necrosis factor-α(TNF-α) decreased, and cilia transmission rate increased, with statistical significance(P<0.05). After treatment, hyposmia, nasal congestion, nasal secretion symptom score and Lund-kennedy score were lower in the observation group than that in the control group. The hs-CRP and TNF-α levels were lower than the control group, and the cilia transmission rate was higher than that of the control group, with statistical significance(P<0.05). The total effective rate was 92.50%(37/40) in the observation group and 75.00%(30/40) in the control group. The observation group was significantly better than the control group(P<0.05). Conclusion TCM ultrasonic atomizing nasal inhalation combined with nasal irrigation for the treatment of sinusitis(pattern of wind-heat in lung channel) after radiotherapy for nasopharyngeal carcinoma has satisfied efficacy, which can improve inflammatory response and sinus function.