凉血止衄汤联合鼻内镜手术治疗老年鼻衄的疗效及安全性观察

Efficacy and safety of Liangxue Zhinv decoction combined with endoscopic sinus surgery in the treatment of senile epistaxis

目的探讨凉血止衄汤联合鼻内镜手术治疗老年鼻衄的疗效及安全性。方法选择2018年1月~2021年1月于我院收治的120例老年鼻衄患者为研究对象,随机分为对照组和观察组各60例,分别予以鼻内镜手术治疗、凉血止衄汤联合鼻内镜手术治疗。比较两组临床疗效,观察两组治疗前后凝血功能[纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、凝血酶原时间(PT)]和血清炎性因子水平[白介素-4(IL-4)、白介素-6(IL-6)、高敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)],并分析两组并发症发生率及治疗结束2个月内复发情况。结果观察组总有效率为93.33%,明显高于对照组的70.00%(P<0.05)。两组干预后FIB、APTT、TT、PT均显著低于治疗前(P<0.05),且观察组干预后上述指标均显著低于对照组(P<0.05)。两组干预后IL-B4、IL-6、hs-CRP、TNF-α均显著低于治疗前(P<0.05),且观察组干预后上述指标均显著低于对照组(P<0.05)。观察组并发症发生率为6.67%,对照组并发症发生率为8.33%,差异无统计学意义(P>0.05)。观察组复发率为5.00%,明显低于对照组的16.67%(P<0.05)。结论凉血止衄汤联合鼻内镜手术治疗老年鼻衄疗效确切,能有效改善凝血功能,降低炎性细胞因子水平,且并不会增加不良反应,复发率较低,值得推广使用。

Objective To investigate the efficacy and safety of Liangxue Zhinv decoction combined with endoscopic surgery in the treatment of senile epistaxis.Methods A total of 120 elderly patients with epistaxis admitted to our hospital from January 2018 to January 2021 were selected as the research objects and randomly divided into the control group and the observation group,with 60 cases in each group.The patients of the control group were treated with nasal endoscopic surgery,and those of the observation group were treated with Liangxue Zhinv decoction combined with nasal endoscopic surgery,respectively.Clinical curative effect of two groups were compared.The coagulation function[fibrinogen(FIB),activated partial thrombin time(APTT),thrombin time(TT),prothrombin time(PT)]and serum inflammatory factors[interleukin-4(IL-4),interleukin-6(IL-6),high-sensitive C-reactive protein(hs-CRP),tumor necrosis factorα(TNF-α)]before and after treatment in the two groups were also observed.The incidence of complications and recurrence within 2 months after treatment were analyzed.Results The total effective rate of the observation group was 93.33%,which was significantly higher than 70.00%of the control group(P<0.05).FIB,APTT,TT and PT in the two groups after intervention were significantly lower than those before treatment(P<0.05),and the above indexes in the observation group after intervention were significantly lower than those in the control group(P<0.05).After intervention,IL-4,IL-6,hs-CRP and TNF-αin the two groups were significantly lower than those before treatment(P<0.05),and the above indexes in the observation group were significantly lower than those in the control group after intervention(P<0.05).The incidence of complications was 6.67%in the observation group and 8.33%in the control group,with no significant difference(P>0.05).The recurrence rate of the observation group was 5.00%,which was significantly lower than 16.67%of the control group(P<0.05).Conclusion Liangxue Zhinv decoction combined with nasal endoscopic surgery has definite curative effect in the treatment of senile epistaxis,which can effectively improve the coagulation function,reduce the level of inflammatory cytokines,and it will not increase adverse reactions.The recurrence rate is low,and it is worthy of promotion.