标题：龙血竭粉外用联合三联液鼻腔冲洗对慢性鼻-鼻窦炎术后鼻黏膜功能及形态恢复的影响

      作者：刘莉萍，李菁，徐俊艳    陕西中医药大学附属医院耳鼻喉科，陕西 咸阳 712000

      卷次： 2023年34卷7期

      【摘要】 目的 探讨龙血竭粉外用联合三联液鼻腔冲洗对慢性鼻-鼻窦炎(CRS)术后鼻黏膜功能及形态恢复的影响。方法 选取2020年6月至2021年6月在陕西中医药大学附属医院接受治疗的298例CRS患者作为研究对象，按随机数表法分为对照组和观察组各149例。对照组患者鼻内镜手术(ESS)后使用三联液对鼻腔冲洗，观察组患者在对照组治疗的基础上联合龙血竭粉外用，两组均接受治疗8周。比较两组患者治疗前后的临床症状、鼻黏膜功能、鼻黏膜形态、血清学指标，以及采用鼻腔鼻窦结局测试 20 (SNOT-20)量表中文版评价两组患者的生活质量。结果 治疗后，两组患者的鼻塞、流脓涕、头痛、嗅觉障碍等主要临床症状及总体感觉评分较治疗均显著下降，且观察组明显低于对照组，差异均有统计学意义(P<0.05)；治疗后，两组患者的鼻腔黏液纤毛传输时间(MTT)较治疗前显著缩短，鼻纤毛传输速率(MTR)较治疗前显著上升，且观察组患者的MTT为(506.12±92.33) s，明显短于对照组的(594.45±96.12) s，观察组MTR为(8.24±0.54) mm/min，明显高于对照组的(6.47±0.49) mm/min，差异均有统计学意义(P<0.05)；两组患者治疗后 4周、8周时的内镜 Lund-Kennedy评分较治疗前显著下降，且观察组患者的内镜Lund-Kennedy评分明显低于对照组，差异均有统计学意义(P<0.05)；治疗后，两组患者的血清白介素-5 (IL-5)、肿瘤坏死因子-α (TNF-α)水平较治疗前显著下降，且观察组患者的 IL-5、TNF-α水平明显低于对照组，差异均有统计学意义(P<0.05)；治疗后，两组患者SNOT-20量表中文版相关症状、鼻部相关症状、睡眠障碍、情感结局评分较治疗前显著下降，且观察组患者的上述各项评分明显低于对照组，差异均有统计学意义(P<0.05)。结论 龙血竭粉外用联合三联液鼻腔冲洗治疗能促进慢性鼻-鼻窦炎术后患者鼻黏膜功能及形态的恢复，降低炎症反应，提高患者生活质量。
      【关键词】 龙血竭粉；三联液；鼻腔冲洗；慢性鼻-鼻窦炎；鼻黏膜功能；鼻黏膜形态
      【中图分类号】 R765.4+1 【文献标识码】 A 【文章编号】 1003—6350（2023）07—0978—05

Effect of external application of Longxuejie Powder combined with triple liquid for nasal irrigation on therecovery of nasal mucosa function and morphology after endoscopic sinus surgery for chronic rhinosinusitis.
LIULi-ping, LI Jing, XU Jun-yan. Department of Otorhinolaryngology, the Affiliated Hospital of Shaanxi University ofTraditional Chinese Medicine, Xianyang 712000, Shaanxi, CHINA
【Abstract】 Objective To investigate the effect of external application of Longxuejie Powder combined withtriple liquid for nasal irrigation on the recovery of nasal mucosa function and morphology after surgery for chronic rhino-sinusitis (CRS).Methods A total of 298 patients with CRS who were treated in the Affiliated Hospital of Shaanxi Uni-versity of Traditional Chinese Medicine from June 2020 to June 2021 were selected as the research subjects. Accordingto random number table method, the patients were divided into a control group and an observation group, with 149 pa-tients in each group. The patients in the control group were treated with nasal irrigation using triple liquid after endoscop-ic sinus surgery (ESS), and patients in the observation group were additionally treated with external application ofLongxuejie Powder. Both groups received treatment for 8 weeks. Clinical symptoms, nasal mucosa function and mor-phology and serological indicators were compared between the two groups before and after treatment. The Sino-NasalOutcome Test-20 (SNOT-20) was used to evaluate quality of life between the two groups. Results After treatment,the main clinical symptoms such as nasal congestion, purulent discharge, headache, and olfactory disorder and overallsensory scores decreased significantly compared with those before treatment, and the scores in observation group weresignificantly lower than those in the control group, with statistically significant difference (P<0.05). After treatment, thenasal mucociliary transmission time (MTT) was significantly shorter than that before treatment, and the nasal cilia trans-mission rate (MTR) increased significantly compared with that before treatment; the MTT in the observation group was(506.12±92.33) s, which was significantly shorter than (594.45±96.12) s in the control group, while the MTR was (8.24±0.54) mm/min, significantly higher than (6.47±0.49) mm/min in the control group (P<0.05). The endoscopic Lund-Ken-nedy score at 4 weeks and 8 weeks after treatment decreased significantly compared with those before treatment, and theendoscopic Lund-Kennedy score in the observation group was significantly lower than that in the control group, with sta-tistically significant difference (P<0.05). After treatment, the serum levels of interleukin-5 (IL-5) and tumor necrosis fac-tor-α (TNF-α) decreased significantly compared with those before treatment, and the levels of IL-5 and TNF-α in theobservation group were significantly lower than those in the control group, with statistically significant difference (P<0.05). After treatment, the scores of related symptoms of the SNOT-20 scale, nose-related symptoms, sleep disorders,and affective outcomes decreased significantly compared with those before treatment, and the above scores of the obser-vation group were significantly lower than those of the control group, with statistically significant differences (P<0.05).Conclusion External application of Longxuejie Powder combined with triple liquid for nasal irrigation can promotethe recovery of nasal mucosa function and morphology, reduce inflammatory response, and improve the quality of life ofpatients after CRS surgery.
      【Key words】 Longxuejie Powder; Triple liquid; Nasal irrigation; Chronic rhinosinusitis; Nasal mucosa function;Nasal mucosa morphology