中医药改善慢性鼻窦炎内镜术后鼻黏膜重塑研究进展

Research Progress in TCM for the Improvement of Nasal Mucosa Remodeling after Endoscopy in Chronic Sinusitis

中医药改善慢性鼻窦炎内镜术后鼻黏膜重塑是有效预防术腔黏膜发生新病变及复发的关键。本文综述慢性鼻窦炎内镜术后鼻黏膜重塑的机制及中医药治疗的独特优势。虚、痰、瘀三者互为因果导致“肺失治节”是鼻黏膜重塑迁延不愈的主要原因。治疗以“补虚祛痰,益气活血”为原则,针药并用、内外兼治以调节Th17/Treg平衡,减少炎症浸润;阻断MAPK和NF-κB途径的磷酸化抑制TGF-β1诱导的肌成纤维细胞,减少胶原沉积及抑制其重塑等,促进黏膜上皮化进程,可为中医药防治鼻黏膜重塑进程的理论和临床治疗研究提供思路。

TCM for the improvement of nasal mucosa remodeling after chronic sinusitis endoscopy is the key to the effective prevention of new lesions and recurrence in the surgical cavity mucosa.This article reviewed the mechanism of the nasal mucosa remodeling phenomenon after chronic sinusitis endoscopy and the unique advantages of TCM treatment.Deficiency,phlegm and blood stasis leading to“lung loss”is the perennial root of nasal mucosa remodeling.The treatment is“tonifying deficiency and removing phlegm,invigorating qi and promoting blood circulation”,using acupuncture and medicine,and both internal and external treatment to regulate Th17/Treg balance and reduce the inflammatory infiltration;blocking the phosphorylation of MAPK and NF-κB pathway to inhibit TGF-β1-induced myofibroblasts,reduce collagen deposition and inhibit their remodeling,and promote the process of mucosal epithelialization,which can provide ideas for the theoretical and clinical treatment of TCM prevention and treatment of nasal mucosa remodeling.