慢性鼻-鼻窦炎围手术期应用黏液促排剂的临床研究

Effectiveness of mucolytic agent treating with chronic rhinosinusitis：a randomized clinical research

目的 观察围手术期应用黏液促排剂辅助治疗慢性鼻-鼻窦炎的临床疗效.方法 根据慢性鼻-鼻窦炎诊断和治疗指南,将符合纳入标准的84例慢性鼻-鼻窦炎患者按数字表法随机分为两组,对照组41例,观察组43例.对照组采用常规治疗;观察组在常规治疗的基础上,术后取出鼻腔堵塞物后口服黏液促排剂桉柠蒎肠溶软胶囊300 mg,3次/d,治疗8周.随防6个月,比较两组治疗前后主观病情（VAS）评分、客观病变范围（Lund-Mackay）评分及临床疗效.结果 两组治疗前VAS评分及Lund-Mackay评分差异均无统计学意义.治疗后对照组VAS评分、Lund-Mackay评分分别为（3.63±1.71）分、（8.34±4.68）分,观察组分别为（2.03±1.67）分、（6.48±3.59）分,两组差异均有统计学意义（t=4.338、2.049,均P＜0.05）.对照组病情完全控制19例、部分控制14例、未控制8例,总有效率为80.5％;观察组病情完全控制24例、部分控制17例、未控制2例,总有效率为95.3％;观察组总有效率明显高于对照组,差异有统计学意义（Х^2=4.420,P＜0.05）.结论 应用黏液促排剂可改善患者主观症状及控制客观病变范围,有利于鼻窦生理功能的恢复,能提高慢性鼻-鼻窦炎治疗效果.

Objective To investigate the effect of mucolytic agents during endoscopic sinus surgery.Methods 84 patients of chronic rhinosinusitis were employed in the study,which were randomly divided into the control group（41 subjects） and study group（43 subjects） according to the digital table.The patients in the control group adopted regular therapies,and study group were received regular therapies as well as mucolytic agents（eucalyptol-limonene-pinene soft capsule,300 mg,three times a day） application for 8 weeks.Followed visiting lasted for 6 months.The VAS scores,Lund-Mackay scores and efficient rate were compared.Results The VAS scores and Lund -Mackay scores in the control group after treatment were （3.63 ± 1.71）points and （8.34 ±4.68） points,and which in study group were （2.03 ± 1.67） points and （6.48 ± 3.59） points,and the difference was statistic significant （t =4.338 and t =2.049,P 〈 0.05）.According to CPOS-2012,in the control group,19 cases were controlled,14 cases were partly controlled,and 8 cases were uncontrolled,the whole efficient rate was 80.5%.in the study group,24 cases were controlled,17 cases were partly controlled,and 2 cases were uncontrolled,the whole efficient rate was 95.3%.Compared to the control group,the efficient rate of the study group was higher,the result showed statistical significance （Х^2 =4.420,P 〈 0.05）.Conclusion Using mucolytic agent after surgery can improve the controlled rate and affect the success of treatment of chronic rhinosinusitis.