败丹黄复方颗粒局部灌洗辅助治疗真菌性鼻窦炎术后患者60例

Clinical value of local lavage adjuvant therapy of Baidanhuang in patients with fungal sinusitis

目的 探究局部灌洗辅助治疗真菌性鼻窦炎术后患者的临床应用价值。方法 选取2009年1月~2014年1月本科诊治的60例真菌性鼻窦炎患者,随机分成败丹黄组、生理盐水组、无冲洗组,每组20例。3组患者均采用鼻内镜手术治疗。单纯生理盐水组患者于术后采用生理盐水灌洗治疗,败丹黄组患者采用败丹黄灌洗治疗,2组患者均连续灌洗治疗3个疗程,无冲洗组患者术后不进行冲洗。比较3组患者的临床及复发情况,比较败丹黄组和生理盐水组鼻腔灌洗液炎症因子[白细胞介素2（IL-2）、IL-4、IL-5、γ干扰素（IFN-γ）]表达水平。结果 败丹黄组的临床控制率为90.0%（18/20）,治疗总有效率为100%,均明显高于生理盐水组[75%（15/20）,80.0%]和无冲洗组患者[65%（13/20）,75.0%（15/20）]（P值均〈0.05）。无冲洗组有6例复发,复发率为30.0%（6/20）;生理盐水组4例复发,复发率为20.0%（4/20）;败丹黄组1例复发,复发率为5.0%（1/20）,差异有统计学意义（P〈0.05）。败丹黄组和生理盐水组患者鼻腔灌洗液中IL-2表达无明显差异（P〉0.05）,败丹黄组患者IL-4、IL-5、IFN-γ表达水平均明显低于生理盐水组,差异均有统计学意义（P〈0.05）。结论 采用败丹黄局部灌洗真菌性鼻窦炎术后患者能显著提高治疗有效率,并降低鼻腔炎症水平及复发率。（中国眼耳鼻喉科杂志,2016,16：273-275）

Objective To investigate the clinical value of local lavage adjuvant therapy in patients with fungal sinusitis. Methods Sixty eases of fungal sinusitis diagnosed and treated from January 2012 to January 2014 were randomly divided into Baidanhuang group, saline group and the control group, with 20 cases in each group. All patients were treated with endoscopic sinus surgery. After the surgery, the saline group were treated with saline lavage and Baidanhuang group were treated with Baidanhuang lavage. All patients were continuously lavaged for 3 courses of treatment. The clinical efficacy and nasal lavage inflammatory cytokines [ interleulcin （IL-2）, IL-4, IL-5, interferon （IFN-γ） ] expression levels and recurrence were compared among groups. Results The clinical control rate, efficiency and total effective rate of patients in Baidanhuang group were all significantly higher than other groups （P 〈 0.05 ）. There are no differences of IL-2 expression in nasal lavage fluid between Baidanhuang groups （P 〉 0.05）. IL-4, IL-5, IFN-γ expression levels in the Baidanhuang and saline group were all significantly lower than those in the saline group （P 〈 0.05）. The recurrence rate of saline group was 20. 0% （4/20） and Baidanhuang group was 5.0% （1/20）. Conclusions Baidanhuang local lavage can significantly improve the efficiency and reduce the nasal inflammation levels and relapse rate, which should be promoted in future clinical application.