鼻腔黏膜干燥、出血及糜烂损伤修复的临床观察与评估

The observation and evaluation of curative effect of nasal mucosa dryness, hemorrhae and erosion

目的:使用桃金娘油、透明质酸、褐藻寡糖、花青素4种植物提取液的鼻喷合剂(商品名:毕罗芬)对161例鼻黏膜干燥、糜烂、出血患者进行前瞻性治疗前后的临床观察,了解该制剂在鼻黏膜保湿、糜烂面修复及控制黏膜出血的效果。方法:(1)诊断:结合患者主诉与鼻内镜检查确定鼻中隔黏膜干燥、糜烂、出血的患者。(2)病情评定:采用VAS评分法对主观症状的严重程度进行0~10分的评估;采用鼻内镜检查对黏膜病变程度进行0~8分的评估。(3)鼻内用药:毕罗芬每天2次,每次每侧鼻腔2喷,根据患者用药后自身症状缓解的感受,和(或)鼻内镜检查结果分别给予持续6~8周的治疗。对同时伴有变应性鼻炎的患者或患儿同时给予白三烯受体拮抗剂常规剂量口服。(4)随访与疗效评定:根据主观症状VAS评分,对全组治疗前后总得分的差异进行统计学处理;根据鼻内镜检查评分,对全组治疗前后总得分的差异进行统计学处理;患者对治疗的自身感受进行评价;医生根据治疗前后主客观评估结果,结合患者对治疗效果的满意度给予最终总体治疗效果的评价。结果:(1)161例患者治疗前、后主观症状VAS评分比较差异有统计学意义(P<0.01);(2)治疗前、后鼻中隔黏膜内镜评分差异有统计学意义(P<0.01);(3)患者对使用该药物的依从性、耐受性以及治疗效果满意度较高(95%左右)。结论:毕罗芬鼻喷剂可有效缓解与改善干燥性鼻炎、鼻出血以及修复鼻黏膜糜烂。

Objective: To observe the curative effects of four kinds of plant extracts nasal spray mixture(myrtle oil, hyaluronic acid, fucoidan, anthocyanin) on 161 patients with nasal mucosa dryness, hemorrhae and erosion. Methods:(1) Diagnosis: patients with nasal dryness, erosive and hemorrhae nasal septum mucosa confirmed by patients’ complaints and nasal endoscopic test;(2) Evaluation: the severity of subjective symptoms was evaluated by VAS score method from 0 to 10 points;the degree of mucosal lesions was divided into 0-8 points by nasal endoscopic test.(3) Intranasal Intranasal administration: 2 times per-day with 2 sprays on each side of the nasal cavity, and no less than 6-8 weeks. In the patients which with allergic rhinitis were also given conventional oral administration of montelukast at the same time.(4) Follow up and curative effect evaluation: VAS and nasal endoscopic test scores that before and after treatment was statistically processed;the patients’ own how feels the treatment were evaluated;finally, doctor made the final evaluation based on the combined results of subjective and objective evaluation results before and after treatment, the patients’ satisfaction with treatment effect. Results:(1) There were significant differences in VAS scores of 161 patients before and after treatment(P<0.01).(2) There were statistically significant differences in nasal endoscopic test scores of 104 patients before and after treatment(P<0.01).(3) Patients’ satisfaction survey showed the satisfied with the compliance, tolerance and treatment effect was 95%. Conclusion: The mixed nasal spray of four plant extracts can effectively improve the dryness, hemorrhae and erosion of nasal mucosal.