清热解毒方联合莫西沙星治疗急性鼻窦炎临床疗效及对血清炎性因子hs-CRP、IL-6、TNF-α影响

Clinical Efficacy of Qingre Jiedu Decoction(清热解毒方)Combined with Moxifloxacin in Treatment of Acute Sinusitis and Effects on Serum Inflammatory Factors hs-CRP,IL-6 and TNF-α

目的探究清热解毒方联合莫西沙星治疗急性鼻窦炎的临床疗效以及血清炎性因子超敏c反应蛋白(hs-CRP)、白介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)的影响。方法选择2020年2月—2022年8月来科室就诊的急性鼻窦炎患者92例,根据Excel表格法随机分为研究组和对照组,每组46例,对照组患者给予莫西沙星治疗,研究组在对照组的基础上,采用清热解毒方治疗。7 d为1个疗程,两组患者均治疗2个疗程。比较两组治疗疗效、治疗前后临床症状改善情况、治疗前后鼻窦CT与鼻内镜评分、治疗前后鼻腔鼻窦结局测试-20(SNOT-20量表)评分、治疗前后血清炎性因子hs-CRP、IL-6及TNF-α含量和不良反应发生情况,并进行统计学分析。结果研究结果显示,研究组治疗疗效优于对照组(P<0.05);研究组治疗后鼻塞、流涕、头痛和鼻腔分泌物的症状积分显著低于对照组(P<0.05);研究组治疗后鼻窦CT与鼻内镜评分显著低于对照组(P<0.05);研究组治疗后SNOT-20量表评分中鼻部症状、相关症状、睡眠障碍和情感结局评分低于对照组(P<0.05);研究组治疗后炎性因子hs-CRP、IL-6及TNF-α水平低于对照组(P<0.05);两组不良反应发生率比较差异无统计学意义(P>0.05)。结论清热解毒方治疗急性鼻窦炎效果确切,可有效地改善患者的临床症状,降低鼻窦CT与鼻内镜和SNOT-20评分,降低急性鼻窦炎患者的血清炎症因子含量,和莫西沙星联合应用,可提高治疗效果,且不良反应小,安全性高,值得临床推广应用。

Objective To explore the clinical efficacy of Qingre Jiedu Decoction(清热解毒方)combined with moxifloxacin in the treatment of acute sinusitis and the effects of serum inflammatory factors C-reactive protein(hs-CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α).Methods Ninety-two patients with acute sinusitis who came to the depart-ment from February 2020 to August 2022 were randomly divided into study group and control group according to Excel table meth-od.Forty-six patients in the control group were treated with moxifloxacin.The study group was treated with Qingre Jiedu Decoc-tion on the basis of the control group.7 d was a course of treatment,and the two groups were treated for 2 courses.The therapeu-tic efficacy,clinical symptoms improvement before and after treatment,CT and endoscopy scores of sinuses before and after treat-ment,sino-nasal outcome test-20(SNOT-20)scale scores before and after treatment,serum levels of hs-CRP,IL-6 and TNF-αbefore and after treatment and adverse reactions were compared between the two groups,and statistical analysis was made.Results The results showed that the therapeutic effect of the study group was better than that of the control group(P<0.05).Symptom scores of nasal congestion,runny nose,headache and nasal discharge in the study group were significantly lower than those in the control group after treatment(P<0.05).CT and endoscopic sinus scores in the study group were significantly lower than those in the control group after treatment(P<0.05).The scores of nasal symptoms,related symptoms,sleep disorders and emotional outcome of the SNOT-20 scale in the study group were lower than those in the control group(P<0.05).The lev-els of inflammatory factors hs-CRP,IL-6 and TNF-αin the study group were lower than those in the control group after treat-ment(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Qingre Jiedu Decoction is effective in treating acute sinusitis.It can effectively improve the clinical symptoms,reduce the scores of CT,endoscopy and SNOT-20,reduce the contents of inflammatory factors in serum of patients with acute sinusitis,and combine with moxifloxacin.It can improve the therapeutic effect,with less adverse reactions and high safety.It is worthy of clinical application.