地氯雷他定联合鼻窦内窥镜术治疗慢性鼻窦炎的疗效

Effect of desloratadine combined with endoscopic sinus surgery in the treatment of chronic sinusitis

目的探讨地氯雷他定联合鼻窦内窥镜术治疗慢性鼻窦炎的疗效。方法选取滨州市中心医院2019年1月至2020年1月收治的慢性鼻窦炎患者94例,用随机数字表法分为对照组和研究组,各47例。对照组男28例,女19例,年龄(40.6±2.7)岁;研究组男29例,女18例,年龄(41.4±2.3)岁。对照组应用鼻窦内窥镜术治疗,研究组应用地氯雷他定联合鼻窦内窥镜术治疗。对两组患者的治疗效果、疾病症状评分、免疫学指标以及鼻腔鼻窦结局测试-20(SNOT-20)评分进行比较。结果研究组治疗总有效率为95.7%(45/47),高于对照组74.5%(35/47),差异有统计学意义(χ^(2)=6.318,P<0.05)。研究组治疗后头晕头痛、鼻分泌物、鼻塞、嗅觉障碍评分分别为(2.1±0.3)分、(2.5±1.4)分、(3.9±1.2)分、(2.1±0.4)分,均低于对照组(3.5±0.6)分、(4.6±1.2)分、(5.2±1.5)分、(3.4±0.5)分,差异均有统计学意义(均P<0.05)。研究组上皮细胞损伤轻于对照组,基底膜厚度为(7.6±1.3)μm,薄于对照组(9.1±3.5)μm,转化生长因子-β1(TGF-β1)灰度值为(167.2±7.8)kD,高于对照组(143.4±6.5)kD,差异均有统计学意义(均P<0.05)。治疗前,两组慢性鼻窦炎患者嗅觉功能比较,差异无统计学意义(P>0.05);治疗后,研究组嗅觉功能评分为(15.5±0.8)分,低于对照组(18.6±1.3)分,差异有统计学意义(P<0.05)。结论慢性鼻窦炎患者在治疗时,应用地氯雷他定联合鼻窦内窥镜术治疗,具有明显效果,创伤小,安全性高,治愈率较高,明显改善患者的临床症状,同时,有效抑制黏膜组织重塑,改善鼻声反射功能,进而提高患者的嗅觉功能,值得在临床进一步推广应用。

Objective To investigate the efficacy of desloratadine combined with endoscopic sinus surgery in the treatment of chronic sinusitis.Methods A total of 94 patients with chronic sinusitis admitted to Binzhou Central Hospital from January 2019 to January 2020 were divided into a control group and a study group by the random number table method,with 47 patients in each group.There were 28 males and 19 females in the control group,with an age of(40.6±2.7)years old.There were 29 males and 18 females in the study group,with an age of(41.4±2.3)years old.The control group was treated with endoscopic sinus surgery,and the study group was treated with desloratadine combined with endoscopic sinus surgery.The therapeutic effect,disease symptom score,immunological index,and Sino-Nasal Outcome Test-20(SNOT-20)score were compared between the two groups.Results The total effective rate of the study group was 95.7%(45/47),higher than that of the control group[74.5%(35/47)](χ^(2)=6.318,P<0.05).The scores of dizziness and headache,nasal secretion,nasal obstruction,and olfactory dysfunction in the study group after the treatment were(2.1±0.3)points,(2.5±1.4)points,(3.9±1.2)points,and(2.1±0.4)points,which were lower than those in the control group[(3.5±0.6)points,(4.6±1.2)points,(5.2±1.5)points,and(3.4±0.5)points](all P<0.05).The injury of epithelial cells in the study group was lighter than that in the control group,the thickness of basal membrane in the study group was(7.6±1.3)μm,which was thinner than that in the control group[(9.1±3.5)μm],and the gray value of transforming growth factor-β1(TGF-β1)was(167.2±7.8)kD,which was higher than that in the control group[(143.4±6.5)kD],with statistically significant differences(all P<0.05).Before the treatment,there was no statistically significant difference in the olfactory function between the two groups(P>0.05);after the treatment,the olfactory function score of the study group was(15.5±0.8)points,lower than that of the control group[(18.6±1.3)points](P<0.05).Conclusions The application of desloratadine combined with endoscopic sinus surgery in the treatment of chronic sinusitis has obvious effect,small trauma,high safety,and a high cured rate,which obviously improves patients'clinical symptoms,at the same time,effectively restrains mucosa tissue remodeling,improves the function of acoustic rhinometry,thus improves the olfactory function in patients,worthy of further popularization and applicationinclinical.