自擬中藥內(nèi)服在慢性鼻竇炎鼻內(nèi)鏡術(shù)后的辨證施治效果分析

黃業(yè)武　馮時(shí)濱　李東　李杰恩

第一附屬醫(yī)院耳鼻咽喉頭頸外科，南寧 530000）

【摘要】目的觀察慢性鼻竇炎鼻內(nèi)鏡術(shù)后應(yīng)用自擬中藥內(nèi)服的療效。方法選擇慢性鼻竇炎患者90例（155側(cè)）， 隨機(jī)分為觀察組45例（75側(cè)）和對(duì)照組45例（80側(cè)）。對(duì)照組鼻竇炎鼻內(nèi)鏡術(shù)后常規(guī)給予抗生素、激素治療，而觀察組術(shù)后在對(duì)照組基礎(chǔ)上加自擬中藥方劑內(nèi)服。對(duì)比觀察術(shù)后兩組患者鼻塞、流膿涕及嗅覺(jué)恢復(fù)情況，血痂、黏膜水腫改善情況，術(shù)腔黏膜上皮化時(shí)間以及臨床療效。結(jié)果觀察組術(shù)腔上皮化時(shí)間為（9.18±0.12）天，對(duì)照組為（11.64±0.22）天，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.01）。術(shù)后1周兩組患者鼻塞、流膿涕、嗅覺(jué)減退等改善率比較差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05），無(wú)黏膜水腫、血痂、術(shù)腔上皮化等情況發(fā)生；術(shù)后2周兩組患者6項(xiàng)癥狀體征改善率比較差異均無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）；術(shù)后4周觀察組鼻塞改善率、血痂改善率顯著高于對(duì)照組（P<0.05或0.01）；術(shù)后8周觀察組的鼻塞、血痂改善率及術(shù)腔上皮化率均顯著高于對(duì)照組（P<0.05或0.01）；術(shù)后12周觀察組的癥狀體征改善率均顯著高于對(duì)照組（P<0.05或0.01）。術(shù)后3個(gè)月兩組臨床療效的比較差異有統(tǒng)計(jì)學(xué)意義（P<0.01），觀察組療效顯著優(yōu)于對(duì)照組。結(jié)論對(duì)慢性鼻竇炎鼻內(nèi)鏡術(shù)后患者不同階段進(jìn)行辨證分型，并運(yùn)用自擬中藥施治，促進(jìn)鼻內(nèi)鏡術(shù)后黏膜早日恢復(fù)，可以有效地減少鼻內(nèi)鏡術(shù)后并發(fā)癥，療效確切可靠，為慢性鼻竇炎鼻內(nèi)鏡術(shù)后用藥提供一條新思路、新途徑。

【關(guān)鍵詞】慢性鼻竇炎；鼻內(nèi)鏡手術(shù)；辨證施治；術(shù)后并發(fā)癥

中圖分類(lèi)號(hào)：R259 文獻(xiàn)標(biāo)識(shí)碼：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，F(xiàn)ENG 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