阿奇霉素联合中药鼻腔灌洗在鼻窦炎内窥镜术后恢复中的应用研究

Application of azithromycin combined with traditional Chinese medicine by nasal lavage in the recovery of sinusitis after endoscopic surgery

目的观察阿奇霉素联合中药鼻腔灌洗在鼻窦炎内窥镜术后恢复中的应用效果。方法将80例行鼻窦炎内窥镜术患者随机分为观察组40例和对照组40例,对照组术后48 h开始给予阿奇霉素鼻腔灌洗,观察组在对照组治疗基础上给予鼻窦炎口服液鼻腔灌洗,2组均治疗到术后1个月,观察2组治疗前及随访术后3个月的主观症状体征评分、LundKennedy内镜黏膜形态评分、Lund-Mackay(L-M)评分、生活质量(SNOT20)评分以及血清炎性因子的变化情况。结果 2组术后3个月鼻塞、脓鼻涕、头昏头痛、嗅觉评分及总积分均明显降低(P均<0.05),Lund-Kennedy内镜黏膜形态评分、L-M评分、SNOT20评分均明显改善(P均<0.05),血清白细胞介素-6(IL-6)、C反应蛋白(CRP)、转化生长因子-β_1(TGF-β_1)水平均明显降低(P均<0.05),且观察组上述指标改善情况均明显优于对照组(P均<0.05)。结论阿奇霉素联合鼻窦炎口服液鼻腔灌洗能够显著改善鼻窦炎内窥镜术后患者的临床症状体征,促进鼻黏膜纤毛结构恢复,抑制机体炎性反应,并提高生活质量。

Objective It is to observe the effect of azithromycin combined with traditional Chinese medicine by nasal lavage in the recovery of sinusitis after endoscopic surgery.Methods 80 patients with sinusitis undergoing endoscopic surgery were randomly divided into observation group （40 cases） and control group （40 cases）.In 48 h after surgery,the control group was treated with azithromycin by nasal lavage,the observation group was treated with azithromycin combined with sinusitis oral liquid by nasal lavage.Both groups were treated for one month.The changes of scores of subjective symptoms and signs,Lund-Kennedy endoscopic mucosal morphology,Lund Mackay （L-M）,quality of life （SNOT20） and the change of serum inflammatory factors were observed before treatment and after following up for 3 months.Results In 3 months after endoscopic surgery,the scores of nasal congestion,purulent nasal discharge,dizziness-headache,smell and total scores were significantly decreased,that of Lund-Kennedy endoscopic mucosal morphology,L-M,SNOT20 were significantly improved,the levels of serum interleukin-6 （IL-6） and C-reactive protein （CRP）,transforming growth factor β_1 （TGF-β_1） were significantly reduced in both groups,and the improvements of above indicators in observation group were obviously better than that of control group （P〈0.05）.Conclusion Azithromycin combined with traditional Chinese medicine sinusitis oral liquid by nasal lavage can significantly improve clinical symptoms and signs,promote the recovery of nasal mucosa cilia structure,inhibit the body＇s inflammatory response,and improve the quality of life in patients with sinusitis after endoscopic surgery.