鼻内镜术后中药“五黄液”鼻腔冲洗临床疗效观察及机理研究

Clinical effect and mechanism of nasal washing with WuHuangYe after functional endoscopic sinus surgery in chronic sinusitis patients

目的 观察功能性内镜鼻窦手术后“五黄液”鼻腔冲洗的临床疗效,并探讨其可能的免疫学机制.方法 131例慢性鼻窦炎患者,随机分为试验组69例和对照组62例,试验组在FESS后以“五黄液”冲洗术腔,对照组以生理盐水冲洗术腔,观察临床疗效;并随机选取44例患者,在治疗前、后取鼻腔黏膜进行免疫组化S100染色,同时以10例健康人鼻腔黏膜作为对照,比较观察S100阳性树突状细胞的表达情况.结果 “五黄液”组总有效率为92.75%,生理盐水组总有效率为83.87%,两组间差异具有统计学意义（P＜0.05）;慢性鼻窦炎患者与健康人对照组间、“五黄液”组冲洗治疗前后以及“五黄液”组与生理盐水组冲洗治疗后各组间鼻腔黏膜S100阳性树突状细胞表达差异具有统计学意义（P＜0.05）.结论 功能性内镜鼻窦手术后“五黄液”冲洗鼻腔具有较好临床疗效,其可能具有调节慢性鼻窦炎患者鼻腔黏膜细胞免疫功能的作用.

Objective To study the clinical effect and possible therapeutic mechanism of WuHuangYe nasal irrigation in chronic sinusitis patients after functional endoscopic sinus surgery （FESS）. Methods 131 cases of patients with chronic sinusitis, 69 cases were randomly divided into treatment group and 62 cases into control group. Treatment group after the FESS with WuHuangYe nasal washing, while the control group with saline washing to observe the clinical efficacy. Randomly selected 44 patients pre-and posttreatment,nasal mucosa taken for immunohistochemical S100 staining, while with 10 cases of healthy nasal mucosa as controls to compare observed S100 positive dendritic ceils expression. Results The total effective rate was 92.75% in the WuHuangYe group and 83. 87% in normal saline group, there was statistically significant difference between the two groups （P〈0.05）. Chronic sinusitis patients and healthy control group,the WuHuangYe group before and after nasal washing,as well as the WuHuangYe group and the saline irrigation group after nasal washing, the expression of Si00-positive dendritic ceils in nasal mueosa have a statistically significant difference in each groups （P〈0. 05）. Conclusion WuHuangYe nasal cavity irrigation has better clinical efficacy than nasal saline washing after FESS. It may be play a role in regulating cellular immune function of nasal mucosa in patients with chronic sinusitis.