辛芷复合制剂对鼻窦炎、鼻息肉术后黏膜转归的影响

The Effects of Xinzhi Compoud Fluid on The Outcome of Mucosa after Sinusitis and Nasal Polyps Surgery

目的观察慢性鼻窦炎合并鼻息肉患者术后使用辛芷制剂冲洗鼻腔后鼻腔、窦腔及黏膜上皮的变化。方法选择慢性鼻窦炎并鼻息肉患者63例,在术后1周、2周、4周及12周使用辛芷复合制剂冲洗鼻腔,观察鼻腔内黏膜上皮化的程度并切除鼻腔及鼻窦黏膜少许进行常规病理、电镜检查,观察肥大及嗜酸性粒细胞的变化。并与对照1组(地塞米松与庆大霉素、生理盐水)、2组(生理盐水)冲洗鼻腔对比观察。结果第1周,3组黏膜下水肿仍存在,炎性细胞分布不均匀,3组对比无明显差异(P>0.05)。第2周,黏膜水肿及炎性细胞在实验组及对照1组有减轻、减少表现,对照2组表现不明显。第4周,实验组和对照1组黏膜水肿基本消失,炎性细胞和黏膜下腺体明显减少,局部上皮化,而对照2组未见明显改变。从第2周开始鼻腔分泌物的量及患者自身的症状包括鼻塞的程度,实验组、对照1组较对照2组明显减轻。结论辛芷外用制剂的抗过敏及中药消炎作用有利于慢性鼻窦炎合并鼻息肉患者鼻腔鼻窦黏膜的恢复及上皮化,效果在随访期内等同于激素组,有利于患者病情的改善及恢复,副作用小,可作为配合鼻腔换药的外用治疗方法长期使用。

Objective To study the effects of xinzhi compoud fluid on the mucous membrane of chronic sinusitis and polpy when using it to rinse nasal cavity after surgery. Methods Six-three cases of patients with chronic sinusitis and nasal polyps were enrolled in the experiment. To observe the degree of mucous membrane epithelization after 1 week,2 weeks,4 weeks,12 weeks when using xinzhi compoud fluid to rinse nasal cavity. And the eosinophilic granulocyte and mastocyte of mucous membrane were observed by HE and electron microscope,compared to control group 1（ gentamycin,hexadecadrol,physiological saline） and Control group 2（ physiological saline）. Results In the first week,edema under the mucosal and uneven distribution of inflammatory cells still existed in the three groups,and there were no significant difference between the 3 groups（P〈0. 05）. In the second week,mucosal edema and inflammatory cells in the experimental group and the control group 1 have ease and reduce performance,but the performance of the control group 2 was not obvious. In the 4th week,the mucosal edema of the experimental group and the control group 1 almost disappeared,the inflammatory cells and mucous glands were significantly decreased,and the local epithelium was changed,but in the control group 2 the changes were not significant. From the second weeks nasal secretions quantity and the patient＇s own symptoms included congestion degree in experimental group and comparison group 1 ease compared to two groups. Conclusions Xinzhi external medinice for nasal cavity in the chronic sinuitis and polpy was helpful to nasal sinus mucosa recovery and epithelial change. The effect during the follow-up period equal to hormone group,which is beneficial to the improvement of the patient and restoration,but the side effect is small. Xinzhi external medinice can be used as a nasal dressing with nasal cavity external treatment for a long time.