布地奈德鼻喷雾剂联合鼻渊通窍颗粒治疗儿童慢性鼻-鼻窦炎的效果

Clinical Study on Budesonide Nasal Spray Combined with Biyuan Tongqiao Granule in the Treatment of Chronic Rhinosinusitis,Upper Respiratory and Orbital Complications in Children

目的探讨布地奈德鼻喷雾剂联合鼻渊通窍颗粒治疗儿童慢性鼻-鼻窦炎(CRS)疗效及对上呼吸道和眶内并发症的影响。方法收集2013年10月-2015年10月石家庄市藁城中西医结合医院就诊的儿童CRS患者106例为研究对象,随机分为研究组与对照组各53例。对照组采用布地奈德鼻喷雾剂每天清晨喷鼻,口服头孢克肟颗粒,研究组在对照组治疗的基础上口服鼻渊通窍颗粒;2组患儿疗程均为3个月。观察临床疗效、主观症状(鼻塞、鼻涕倒流或流脓涕、面部疼痛、嗅觉障碍、头昏或头痛)和客观症状(水肿、息肉、瘢痕、结痂、鼻漏)评分、不良反应发生情况;治疗前后抽取患儿清晨空腹静脉血,采用酶联免疫吸附(ELISA)法测定血清白细胞介素-5(IL-5)、白细胞介素-6(IL-6)、白细胞介素-17(IL-17)、白细胞介素-1β(IL-1β)水平。结果疗程结束后研究组治疗总有效率高于对照组(P<0.05),鼻塞、流涕、面部疼痛、嗅觉障碍、头昏或头痛评分、水肿、瘢痕、结痂评分及不良反应发生率均低于对照组(P均<0.05);疗程结束后研究组患儿血清IL-5、IL-6、IL-17、IL-1β水平均低于对照组(P均<0.05)。结论联合鼻渊通窍颗粒治疗儿童CRS,可减轻机体炎症反应,促进鼻腔黏膜的修复,提高临床疗效,有效控制上呼吸道和眶内并发症发病率,具有较高的临床应用价值。

Objective To explore the efficacy of budesonide nasal spray combined with Biyuan tongqiao granule in the treatment of chronic rhinosinusitis(CRS)in children and the effect on the upper respiratory tract and orbital complications.Methods A total of 106 children with CRS who were admitted in our hospital from October,2013 to October,2015 were included in the study and randomized into the study group and the control group with 53 cases in each group.The patients in the control group were given nasal spray of budesonide every morning and orally administrated with cefixime granules.On the above basis,the patients in the study group were given Biyuan tongqiao granule.The patients in the two groups were treated for 3 weeks.The clinical efficacy,subjective symptom and objective symptom scores,and adverse reactions in the two groups were observed.The morning fasting venous blood before and after treatment was collected.ELISA was used to detect the serum IL-5,IL-6,IL-17 and IL-1β.Results The total effective rate after treatment in the study group was significantly superior to that in the control group(P<0.05).Subjective symptom and objective symptom scores,and adverse reactions after treatment in the study group were significantly lower to those in the control group(P all<0.05);the serum IL-5,IL-6,IL-17 and IL-1βlevels after treatment in the study group were significantly lower than those in the control group(P all<0.05).Conclusion Combination of budesonide nasal spray with Biyuan Tongqiao Granule in the treatment of CRS in children can alleviate inflammation,promote the repair of nasal mucosa,improve clinical efficacy,effectively control the incidence of upper respiratory tract and intraorbital complications,and has high clinical application value.