Objective It is to observe the effects of balloon sinuplasty (BSP) combined with Qingdou Tongqiao decoction by oral administration+fumigation on olfaction, nasal airway and mucociliary clearance in patients with chronic rhinosinusitis (CRS), and to explore its related mechanisms. Methods Seventy-five patients with CRS were randomly divided into two groups. 38 patients in the control group were treated with BSP plus normal postoperative therapy. 37 patients in the observation group were treated with Qingdou Tongqiao decoction by oral administration+fumigation for 3 months based on the control group. The improvement of clinical symptoms, nasal mucosa and quality of life after treatment were observed, and the changes of olfaction, nasal ventilation, mucociliary clearance and serum inflammatory factors were recorded. Results The visual analogue scores of clinical symptoms (nasal congestion, rhinorrhea, sneezing, salivation, olfactory decline, dizziness and headache), Lund-Kennedy scores and SNOT-20 scores were significantly decreased after treatment in the two groups (P＜0.05), the above scores were lower in the observation group than the control group (P＜0.05); the classification of T&T subjective olfactory test were significantly improved after treatment, and the improvement was better than that of the control group (P＜0.05); the nasal mucociliary transport time (MTT), nasal resistance, nasal minimum distance from cross-sectional area to anterior nares (DCAN) were significantly reduced (P＜0.05), cilia clearance rate, cilia clearance speed, nasal volume (NCV), nasal minimum cross-section area (NMCA) were significantly increased (P＜0.05), and the improvement of the above indicators in the observation group was better than that of the control group (P＜0.05). The levels of serum IL-5 and TNF-α were significantly lower than that before treatment in the two groups (P＜0.05), and the levels in the observation group were more lower compared with the control group (P＜0.05). Conclusion BSP combined with Qingdou Tongqiao decoction by oral administration+fumigation can significantly improve clinical symptoms, improve quality of life, and promote the recovery of olfactory function, nasal ventilation and nasal cilia clearance in the treatment of CRS, one of the mechanisms may be related to down-regulation of the expression of IL-5, TNF-α.%目的 观察鼻窦球囊扩张术(BSP)联合清窦通窍方口服+熏蒸对慢性鼻-鼻窦炎(CRS)患者嗅觉、鼻通气和鼻黏膜纤毛清除能力的影响,探讨其相关机制.方法 将75例CRS患者随机分为2组,对照组38例行BSP术,术后给予常规处理;观察组37例于BSP术后给予常规处理及清窦通窍方口服+熏蒸3个月.观察2组治疗后临床症状、鼻腔黏膜、生活质量的改善情况,并记录嗅觉、鼻通气和鼻黏膜纤毛清除能力、血清炎性因子的变化情况.结果 2组治疗后临床症状(鼻塞、鼻漏、喷嚏、流涕、嗅觉下降、头晕头痛)的视觉模拟评分、Lund-Kennedy评分、SNOT-20评分均显著降低(P均＜0.05),观察组以上评分均明显低于对照组(P均＜0.05);2组治疗后T&T主观嗅觉测试法分级均显著改善,观察组分级改善情况显著优于对照组(P＜0.05);2组治疗后鼻黏膜纤毛传输时间(MTT)、鼻阻力、鼻腔最小横截面积到前鼻孔距离(DCAN)均显著减少(P均＜0.05),纤毛清除率、纤毛清除速率、鼻腔容积(NCV)、鼻腔最小横截面积(NMCA)均显著增大(P均＜0.05),观察组以上指标改善情况均显著优于对照组(P均＜0.05);2组治疗后血清白细胞介素-5(IL-5)和肿瘤坏死因子-α(TNF-α)水平显著降低,观察组以上指标水平均显著低于对照组(P均＜0.05).结论 BSP联合清窦通窍方内口服+熏蒸治疗CRS能够显著改善临床症状,提高生活质量,并促进嗅觉功能、鼻腔通气和鼻纤毛清除功能恢复,其机制之一可能与下调IL-5、TNF-α的表达有关.
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