CAJ | 학술논문

目的：探讨清热利湿祛瘀汤局部冲洗对鼻窦炎术后鼻黏膜愈合以及纤毛清除功能的影响。方法将60例慢性鼻窦炎患者随机分为试验组30例和对照组30例。在术后第5天，试验组用清热利湿祛瘀汤进行鼻窦腔内冲洗，每次100 mL，每天2次，连续2周；对照组用0．9％氯化钠500 mL＋庆大霉素40万单位冲洗液冲洗鼻窦，每次100 mL，每天2次，连续2周。比较2组的临床疗效、术后鼻纤毛传输速率、术后鼻黏膜上皮损伤情况以及不良反应发生率。结果术后3，6个月，试验组有效率分别为86．67％和90．00％显著高于对照组60．00％和63．33％（P＜0．05）。术后3，6个月，试验组鼻纤毛传输速率显著快于对照组（P＜0．05）。术后3，6个月，试验组黏膜上皮损伤较对照组轻（P＜0．01）。术后3，6个月，试验组黏膜上皮转化生长因子－β1阳性细胞数以及胶原Ⅲ阳性基底膜厚度＞20μm的比例均显著低于对照组（ P＜0．05）。2组均无严重不良反应发生。结论鼻窦炎术后患者用清热利湿祛瘀汤冲洗鼻窦，能够提高临床疗效，促进黏膜愈合，恢复纤毛清除功能。
목적：탐토청열리습거어탕국부충세대비두염술후비점막유합이급섬모청제공능적영향。방법장60례만성비두염환자수궤분위시험조30례화대조조30례。재술후제5천，시험조용청열리습거어탕진행비두강내충세，매차100 mL，매천2차，련속2주；대조조용0．9％록화납500 mL＋경대매소40만단위충세액충세비두，매차100 mL，매천2차，련속2주。비교2조적림상료효、술후비섬모전수속솔、술후비점막상피손상정황이급불량반응발생솔。결과술후3，6개월，시험조유효솔분별위86．67％화90．00％현저고우대조조60．00％화63．33％（P＜0．05）。술후3，6개월，시험조비섬모전수속솔현저쾌우대조조（P＜0．05）。술후3，6개월，시험조점막상피손상교대조조경（P＜0．01）。술후3，6개월，시험조점막상피전화생장인자－β1양성세포수이급효원Ⅲ양성기저막후도＞20μm적비례균현저저우대조조（ P＜0．05）。2조균무엄중불량반응발생。결론비두염술후환자용청열리습거어탕충세비두，능구제고림상료효，촉진점막유합，회복섬모청제공능。
Objective To discuss effect of post-operative local irriga-tion with Qingre Lishi Quyu soup on nasal healing and mucociliary clearance function for patients with sinusitis.Methods A total of 60 ca-ses with sinusitis were divided randomly into treatment group and control group with each of 30 cases.Five days after surgery, patients′sinus cavi-ties in treatment group were rinsed by Qingre Lishi Quyu soup for 2 weeks, 100 mL per time, bid, and those in control group were rinsed by 0.9%sodium chloride 500 mL plus gentamicin 400 000 U for 2 weeks, 100 mL per time,bid .The data of clinical efficacy, postoperative nasal mucociliary transport rate and postoperative nasal epithelial damage of two groups were compared. Results Efficiency of treatment group was 86.67% three months after surgery and 90.00% six months after surgery, which were higher than those in control group 60.00% and 63.33%(P<0.05).Nasal mucociliary transport rate of treatment group 3 months and 6 months after surgery were faster ( P<0.05 ) .Postopera-tive nasal epithelial damage of treatment group 3 months and 6 months af-ter surgery were lighter than those in control group( P<0.01).Epithelial transforming growth factor -β( TGF-β1) positive cells and Ⅲ collagen -positive basement membrane thickness >20 μm proportion were lower than those in control group (P<0.05).There were no serious adverse events in two groups.Conclusion Postoperative local irrigation with Qin-gre Lishi Quyu soup for patients with sinusitis can improve clinical efficacy, promote mucosal healing and mucociliary clearance function recovery.