鼻渊通窍颗粒对儿童慢性鼻窦炎鼻黏膜纤毛传输功能及炎性因子的影响

Biyuan Tongqiao Granule to Nasal Mucosa Transport Function and Inflammatory Factors' Influence with Chronic Sinusitis in Patients

目的：探讨鼻渊通窍颗粒对儿童慢性鼻窦炎患者的临床疗效及作用机制。方法：将120例患者随机按数字法分为对照组和观察组各60例。对照组采用阿莫西林克拉维酸钾干混悬剂，4-7岁，1包/次，2次/d，7-12岁，1.5包/次，2次/d。疗程4周。氨溴索颗粒，1.2-1.6 mg·kg^-1，分2-3次口服，疗程6周。标准桃金娘油肠溶胶囊（儿童装），120 mg/次，3次/d。疗程6周。观察组在对照组治疗的基础上加鼻渊通窍颗粒，5-10 g/次，3次/d。疗程6周。检测鼻黏膜纤毛传输时间（MTT）；检测血清白细胞介素-2（IL-2）和白细胞介素-6（IL-6）水平；进行鼻内镜检查，采用Lund-Kennedy评分法评价结果；记录治疗前后主要症状、体征评分。结果：观察组疾病疗效总有效率95%，对照组81.7%，观察组优于对照组（P〈0.05）；治疗后观察组IL-2和IL-6水平低于对照组（P〈0.01）；治疗后3个月观察组MTT及Lund-Kennedy评分低于对照组（P〈0.01）；治疗后观察组鼻塞、流脓涕、头痛、嗅觉减退、回吸痰、鼻黏膜充血肿胀等症状、体征评分均低于对照组（P〈0.01）。结论：鼻渊通窍颗粒能抑制儿童慢性鼻窦炎患者促炎因子，促进鼻黏膜纤毛功能，改善患者临床症状、体征，临床有一定疗效。

Objective： Biyuan Tongqiao granule for chronic sinusitis in children clinical effect mechanism of action. Method： One hundred and twenty patients were randomly divided into control group （60 cases） and observation group （60 cases）.Patients the control group were treated with amoxicillin and clavulanate potassium suspension,4-7 years old,1 sack/time,2 times/day,7-12 years old, 1.5 sack/time,2 times/day.The treatment course of the group was 4 weeks. Ambroxol granule,1.2-1.6 mgkg-1,taken orally by 2-3 times.The treatment course of the group was 6 weeks. Standard myrtol standardized enteric coated soft capsules（children pack）,120 mg/time,3 times/day.The treatment course of the group was 6 weeks.The observation group was added Biyuan Tongqiao granule based on the control group,5-10 g/time,3 times/day.The treatment course of the group was 6 weeks. Determining nasal mucosa transport time（MTT）.Detection of serum interleukin-2（IL-2） and interleukin-6（IL-6）,with endoscopy,the results were evaluated by Lund-Kennedy score method,recordding main symptoms and sign grade before and after treatment. Result： The total effective rate of the observation group was 95% superior to 81.7% of the control group（P〈0.05）,after treatment,the level of IL-2 and IL-6 in the observation group were lower than those in the control group（P〈0.01）, after 3 months of treatment,MTT and Lund-Kennedy score in the observation group were lower than those in the control group（P〈0.01）,For the observation group, the symptom such as nasal obstruction,streamed pus nasal discharge,headache, back to the sputum suction and hyperemia swelling of nasal mucosa symptoms and sign grades were all lower than those in the control group（P〈0.01）. Conclusion： Biyuan Tongqiao granule was used to chronic sinusitis in children patients, It can inhibit the proinflammatory factor and promote the nasal mucosa cilia function, improve the clinical symptoms of patients and sign when when,Have certain curative effect in clinic.