Li Y Q, Zhang C H, Zang C P, Gu S Y
Department of Otorhinolaryngology,Eye and ENT Hospital,Fudan University,Shanghai,200031,China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2020 Jan;34(1):5-9. doi: 10.13201/j.issn.1001-1781.2020.01.002.
To investigate the clinical efficacy of "Zhuyuan soup" by combination with fumigation and oral administration on chronic rhinosinusitis(CRS), further exploring effective Chinese medicine for the disease, and giving full play to the unique advantages of external treatment of traditional Chinese medicine. By using randomized and positive drug controlled methods, patients with moderate-to-severe chronic rhinosinusitis were randomly divided into western medicine group and traditional Chinese medicine group, 30 cases in each group. In the western medicine group, the nasal spray hormone Budesonide was used, and the patients in the traditional Chinese medicine group were treated with the traditional Chinese medicine prescription"Zhuyuan soup"by combination with fumigation and oral administration. All of the above patients were followed up for 2 weeks, and 1 course for 1 month. Visual analogue scores were taken at each follow-up, and CT and nasal endoscopy were performed before and after treatment. The total effective of "Zhuyuan soup" group was 67.1%, which was higher than that of western medicine group(59.6%), but there was no statistically significant difference(>0.05). After treatment, there were no significant differences between the two groups with regard to the symptom of nasal congestion, dizziness, facial pain or fullness, dysosmia, nasal discharge or postnasal drip, total sensation, total symptom score(>0.05). According to the total symptom score, the effect of the two groups of patients was not significantly correlated with the gender, age, course of disease, alcohol and tobacco hobbies, previous medication and surgery(>0.05). Based on the results of the study, we found that the Chinese medicine group is superior to the western medicine group in improving the total feeling of the disease, dizziness or headache, facial pain or fullness, and postnasal drip, olfactory disorder. Both traditional Chinese medicine and western medicine are effective methods for treating chronic rhinosinusitis. Clinically, individualized comprehensive treatment should be carried out according to the patient's condition. The above methods may be applied alone or in combination with Chinese and Western medicine. Further optimization and improvement of the combination of traditional Chinese and Western medicine in chronic sinusitis can help improve the clinical efficacy and satisfaction of patients, which deserves further study.
为探讨“助渊汤”熏洗联合口服治疗慢性鼻-鼻窦炎(CRS)的临床疗效,进一步探寻治疗该病的有效中药,发挥中医外治疗法的独特优势。采用随机、阳性药物对照方法,将中重度慢性鼻-鼻窦炎患者随机分为西药组和中药组,每组30例。西药组采用鼻用激素布地奈德喷鼻,中药组采用中药方剂“助渊汤”熏洗联合口服治疗。以上所有患者随访2周,1个月为1个疗程。每次随访时采用视觉模拟评分法,治疗前后行鼻窦CT及鼻内镜检查。“助渊汤”组总有效率为67.1%,高于西药组(59.6%),但差异无统计学意义(P>0.05)。治疗后,两组在鼻塞、头晕、面部疼痛或闷胀、嗅觉障碍、流涕或鼻后滴漏、总体感觉、总症状评分方面差异均无统计学意义(P>0.05)。根据总症状评分,两组患者的疗效与性别、年龄、病程、烟酒嗜好、既往用药及手术情况均无明显相关性(P>0.05)。根据研究结果,我们发现中药组在改善疾病总体感觉、头晕或头痛、面部疼痛或闷胀、鼻后滴漏、嗅觉障碍方面优于西药组。中西医都是治疗慢性鼻-鼻窦炎的有效方法。临床上,应根据患者病情进行个体化综合治疗。上述方法可单独应用,也可中西医结合应用。进一步优化和改进中西医结合治疗慢性鼻窦炎,有助于提高临床疗效和患者满意度,值得进一步研究。