温阳止涕汤治疗肺气虚寒型慢性鼻窦炎的临床研究

Clinical Study on the Treatment of Chronic Sinusitis with Deficiency-Cold of Lung Qi by Wenyang Zhiti Decoction

目的探讨温阳止涕汤治疗肺气虚寒型慢性鼻窦炎的临床疗效及其可能机制。方法160例肺气虚寒型慢性鼻窦炎患者随机分为对照组和治疗组各80例。对照组给予桉柠蒎肠溶软胶囊和糠酸莫米松鼻喷雾剂,治疗组给予温阳止涕汤局部透药,疗程均为28 d。治疗前后评估2组患者临床疗效、VAS评分、中医证候积分、Lund-Mackay评分、鼻黏膜纤毛清除速度及清除率,ELISA法检测血清炎性因子(IL-17、IL-33、IL-37)及血清免疫调节因子(sTim1、sTim3、sTim4)变化,观察不良反应发生率。结果治疗后,治疗组有效率显著高于对照组(P<0.01);2组患者中医证候积分、VAS评分、鼻窦CT Lund-Mackay评分均明显降低(P<0.05,P<0.01),治疗组优于对照组(P<0.01);2组患者鼻黏膜纤毛清除速度及清除率均显著增加(P<0.05,P<0.01),治疗组优于对照组(P<0.01);2组患者血清IL-17、IL-33、sTim1、sTim3、sTim4均明显降低(P<0.05,P<0.01),治疗组优于对照组(P<0.01);2组患者血清IL-37水平均明显升高(P<0.05,P<0.01),治疗组优于对照组(P<0.01)。2组均未见明显不良反应。结论温阳止涕汤可有效改善肺气虚寒型慢性鼻窦炎患者临床症状,其机制可能与调节血清炎性因子及免疫调节因子水平相关。

OBJECTIVE To investigate the clinical efficacy and possible mechanism of Wenyang Zhiti Decoction in the treatment of chronic sinusitis with deficiency-cold of lung qi.METHODS A total of 160 patients with chronic sinusitis with deficiency-cold of lung qi were randomly divided into the control group and the treatment group of 80 patients each.In the control group,enteric soft capsule and mometasone furoate nasal spray were administered.While in the treatment group,Wenyang Zhiti Decoction was given as local administration of drugs.The course of treatment was 28 days.In addition,the clinical efficacy,VAS score,traditional Chinese medicine(TCM)syndrome score,Lund-Mackay score,as well as nasal mucosal cilia clearance speed and rate of the two groups were evaluated before and after treatment.The changes of serum inflammatory factors(IL-17,IL-33,IL-37)and serum immunomodulatory factors(sTim1,sTim3,sTim4)were detected by ELISA to observe the incidence of adverse reactions.RESULTS After treatment,the efficiency of the treatment group was significantly increased than that of the control group(P<0.01).The TCM syndrome score,VAS score and Lund-Mackay score of sinus CT were significantly reduced in both groups(P<0.05,P<0.01),but the results in the treatment group were better than those in the control group(P<0.01).In addition,the clearance speed and rate of nasal mucous membrane cilia were significantly increased in both groups(P<0.05,P<0.01),but the results in the treatment group were better than those in the control group(P<0.01).Besides,the serum IL-17,IL-33,sTim1,sTim3 and sTim4 were significantly reduced in both groups(P<0.05,P<0.01),but the results in the treatment group were better than those in the control group(P<0.01).The serum IL-37 level was significantly increased in both groups(P<0.05,P<0.01),but the result in the treatment group was better than that in the control group(P<0.01).In addition,no significant adverse effects were observed in both groups.CONCLUSION Wenyang Zhiti Decoction can effectively improve the clinical symptoms of patients with chronic sinusitis with deficiency-cold of lung qi,and its mechanism may be related to the regulation of serum inflammatory factors and immunomodulatory factors.