通气散联合二陈汤加减治疗分泌性中耳炎的临床研究

Clinical study of modified Tongqi San and Erchen Decoction in treatment of secretory otitis media

目的观察通气散联合二陈汤加减治疗分泌性中耳炎的疗效及对白细胞介素(IL)/可溶性生长刺激表达基因2蛋白(sST2)信号通路的影响。方法选择分泌性中耳炎患者90例为研究对象,按照随机数字表法将患者分为观察组和对照组,每组45例。对照组予以常规综合治疗,观察组在对照组基础上予以通气散联合二陈汤加减治疗。观察2组治疗后临床疗效和不良反应,并比较治疗前后纯音听阈、中文版慢性耳病调查量表(CCES)评分、IL-33、sST2、核因子-κB(NF-κB)、IL-5、干扰素(INF)-γ和IL-13水平变化。结果观察组总有效率为91.11%,高于对照组的73.33%,差异有统计学意义(P<0.05)。2组治疗后不良反应发生率比较,差异无统计学意义(P>0.05)。治疗后,2组纯音听阈和CCES评分均较治疗前升高,IL-33、sST2、NF-κB、IL-5、INF-γ和IL-13水平较治疗前降低,差异有统计学意义(P<0.01)。观察组纯音听阈和CCES评分高于对照组,IL-33、sST2、NF-κB、IL-5、INF-γ和IL-13水平低于对照组,差异有统计学意义(P<0.01)。结论通气散联合二陈汤加减治疗分泌性中耳炎疗效显著,能促进听力恢复,减少机体炎症介质释放,可能与调节IL-33/sST2信号通路有关。

Objective To observe the efficacy of modified Tongqi San and Erchen Decoction on secretory otitis media and its impact on interleukin(IL)/soluble suppression of tumorigenicity 2(sST2)signalingpathway.Methods A total of 90 patients with secretory otitis media were selected as study objects,and were divided into observation group and control group according to random number table method,with 45 cases in each group.The control group was given routine comprehensive treatment,and the observation group was given modified Tongqi San and Erchen Decoction on the basis of the control group.The efficacy and adverse reactions were observed in the two groups after treatment,and the pure tone hearing threshold,Chinese Version of Chronic Ear Survey(CCES),IL-33,sST2,nuclear factor-κB(NF-κB),IL-5,interferon(INF)-γ,and IL-13 levels were also compared in two groups before and after treatment.Results The total effective rate in the observation group was 91.11%,which was significantly better than 73.33%in the control group(P<0.05).The incidence of adverse reactions after treatment showed no statistically significant difference between the two groups(P>0.05).After treatment,the pure tone hearing threshold and CCES score in two groups were significantly higher than before treatment,and the IL-33,sST2,NF-κB,IL-5,INF-γand IL-13 levels in two groups were significantly decreased than before treatment(P<0.01).The pure tone hearing threshold and CCES score were higher than those of the control group,and the levels of IL-33,SST2,NF-κB,IL-5,INF-γand IL-13 in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.01).Conclusion Modified Tongqi San and Erchen Decoction has obvious efficacy on secretory otitis media,and it can promote hearing recovery and reduce the release of inflammatory mediators in the body,which may be related to the regulation of IL-33/sST2 signaling pathway.