自拟中药内服在慢性鼻窦炎鼻内镜术后的辨证施治效果分析

黄业武　冯时滨　李东　李杰恩

第一附属医院耳鼻咽喉头颈外科，南宁 530000）

【摘要】目的观察慢性鼻窦炎鼻内镜术后应用自拟中药内服的疗效。方法选择慢性鼻窦炎患者90例（155侧）， 随机分为观察组45例（75侧）和对照组45例（80侧）。对照组鼻窦炎鼻内镜术后常规给予抗生素、激素治疗，而观察组术后在对照组基础上加自拟中药方剂内服。对比观察术后两组患者鼻塞、流脓涕及嗅觉恢复情况，血痂、黏膜水肿改善情况，术腔黏膜上皮化时间以及临床疗效。结果观察组术腔上皮化时间为（9.18±0.12）天，对照组为（11.64±0.22）天，两组比较差异有统计学意义（P<0.01）。术后1周两组患者鼻塞、流脓涕、嗅觉减退等改善率比较差异无统计学意义（P>0.05），无黏膜水肿、血痂、术腔上皮化等情况发生；术后2周两组患者6项症状体征改善率比较差异均无统计学意义（P>0.05）；术后4周观察组鼻塞改善率、血痂改善率显著高于对照组（P<0.05或0.01）；术后8周观察组的鼻塞、血痂改善率及术腔上皮化率均显著高于对照组（P<0.05或0.01）；术后12周观察组的症状体征改善率均显著高于对照组（P<0.05或0.01）。术后3个月两组临床疗效的比较差异有统计学意义（P<0.01），观察组疗效显著优于对照组。结论对慢性鼻窦炎鼻内镜术后患者不同阶段进行辨证分型，并运用自拟中药施治，促进鼻内镜术后黏膜早日恢复，可以有效地减少鼻内镜术后并发症，疗效确切可靠，为慢性鼻窦炎鼻内镜术后用药提供一条新思路、新途径。

【关键词】慢性鼻窦炎；鼻内镜手术；辨证施治；术后并发症

中图分类号：R259 文献标识码：ADOI：10.3969/j.issn.10031383.2015.03.016

Analysis of syndrome differentiation treatment effect of selfmade traditional

Chinese herbs for chronic sinusitis after endoscopic surgery

HUANG Yewu1，FENG Shibin1，LI Dong1，LI Jieen2

（1.OtolaryngologyHead and Neck Surgery，Pubei Hospital of Traditional Chinese Medicine，

Pubei 535300；2.Otolaryngology-Head and Neck Surgery，The First Affiliated Hospital of

Guangxi Medical University，Nanning 530000，Guangxi，China）

【Abstract】ObjectiveTo observe effect of selfmade traditional Chinese herbs for chronic sinusitis after endoscopic surgery.Methods90 patients（155 sides） with chronic sinusitis were randomly divided into control group（45 cases，80 sides） and observation group（45 cases，75 sides）.The control group were treated with conventional antibiotics and hormone after endoscopic surgery，and based on which the observation group were added self-made traditional Chinese herbs for oral administration.Then，nasal obstruction，purulent nasal discharge，recovery of olfaction，improvement of dried blood and mucosal edema，time of the epithelization of surgical cavity mucosa and clinical effects of the two groups were observed and compared.Results The time of the epithelization of surgical cavity mucosa in the observation group was（9.18±0.12）days，and that of the control group was（11.64±0.22）days，so difference was statistically significant（P<0.01）.One week after treatment，difference of improvement rate of nasal obstruction，purulent nasal discharge and hyposphresia was not statistically significant between groups（P>0.05），no mucosal edema，dried blood and epithelization of surgical cavity mucosa，etc.were found.Two weeks after treatment，differences of improvement rate of the 6 abovementioned symptoms and signs were not statistically significant between groups（P>0.05）.Four weeks after treatment，improvement rate of nasal obstruction and dried blood of the observation group was significantly higher than those of the control group（P<0.05 or 0.01）.Eight weeks after treatment，improvement rates of nasal obstruction，dried blood and epithelization of surgical cavity mucosa of the observation group were significantly higher than those of the control group（P<0.05 or 0.01）.Twelve weeks after treatment，improvement rates of all symptoms and signs of the observation group were significantly higher than those of the control group（P<0.05 or 0.01）.Three months after treatment，difference of clinical effects of the two groups was statistically significant（P<0.01），and that of the observation group was significantly better than that of the control group.ConclusionThe syndrome differentiation of traditional Chinese medicine and selfmade traditional Chinese herbs for different periods of chronic sinusitis after endoscopic surgery can promote recovery of mucosa，and effectively reduce postoperative complications.It has exact and reliable curative effect，and provides a new idea and pathway for postoperative medication of endoscopic sinus surgery for chronic sinusitis.endprint