Effect of Wenyang Huashi Prescription on Inflammatory Factors and Immune Function of Patients After Allergic Fungal Rhinosinusitis

Yong-wen LI; Jing-bo LI; Jun-jie WANG

doi:10.13422/j.cnki.syfjx.20200231

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Effect of Wenyang Huashi Prescription on Inflammatory Factors and Immune Function of Patients After Allergic Fungal Rhinosinusitis

Clinic | 更新时间：2021-02-09

- Effect of Wenyang Huashi Prescription on Inflammatory Factors and Immune Function of Patients After Allergic Fungal Rhinosinusitis
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 26, Issue 10, Pages: 82-87(2020)
- 作者机构：
  
  河南省中医院(河南中医药大学　第二附属医院)，郑州　 450002
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20200231
  CLC： R289;R276;R276.1
- Received：16 September 2019，
  
  Published Online：20 November 2019，
  
  Published：20 May 2020
- 稿件说明：
移动端阅览
Yong-wen LI, Jing-bo LI, Jun-jie WANG. Effect of Wenyang Huashi Prescription on Inflammatory Factors and Immune Function of Patients After Allergic Fungal Rhinosinusitis[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(10): 82-87.
DOI：

Yong-wen LI, Jing-bo LI, Jun-jie WANG. Effect of Wenyang Huashi Prescription on Inflammatory Factors and Immune Function of Patients After Allergic Fungal Rhinosinusitis[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(10): 82-87. DOI： 10.13422/j.cnki.syfjx.20200231.

摘要

目的：

评价温阳化湿方对变应性真菌性鼻-鼻窦炎(AFRS)术后的康复效果，及对炎性因子和免疫功能的影响。

方法：

将144例AFRS采用随机数字按表法分为对照组和观察组各72例。对照组采用Messerklinger方式彻底清除病灶，术后给予抗感染治疗3 d，口服醋酸泼尼松片，10 mg/次，2次/d；丙酸氟替卡松吸入气雾剂，2喷/次，1次/d，连续治疗4周；口服伊曲康唑胶囊，0.2 g/次，1次/d，连续服用7 d为1个疗程，分别于术后1，5和9周服用。观察组在对照组治疗的基础上采用温阳化湿方内服和局部冲洗；对照组中药口服通窍鼻炎胶囊，4粒/次，3次/d。两组患者均连续治疗12周。于术前、术后4和12周进行主观病情评估；于治疗前、术后12，24，48周进行鼻内镜检査的Lund-Kennedy评分和鼻腔鼻窦结局测试-20(SNOT-20)评分；记录术后48周内的复发情况；检测治疗前后外周血肿瘤坏死因子-

(TNF-

)，白细胞介素-1

(IL-1

)，核转录因子

B (NF-

B)和细胞间黏附分子-1(ICAM-1)；检测治疗前后T淋巴细胞亚群(CD3

＋

，CD4

＋

，CD8

＋

，CD4

＋

/CD8

＋

)水平。

结果：

经秩和检验分析，观察组临床疗效优于对照组(

＝2.016，

0.05)；观察组患者在术后后4和12周鼻塞，头昏，鼻涕混浊，嗅觉障碍评分均低于对照组(

0.01)；观察组在术后12，24，48周，Lund-Kennedy评分和SNOT-20量表评分均低于同期对照组(

0.01)；治疗后观察组外周血TNF-

，IL-1

，NF-

B和ICAM-1水平均低于对照组(

0.01)；治疗后观察组CD3

＋

，CD4

＋

水平和CD4

＋

/CD8

＋

均高于对照组，CD8

＋

水平低于对照组(

0.05)；在1年的随访期间，观察组复发率为7.81%(5/64)，低于对照组的22.58%(14/62)(

＝5.363 ，

0.05)。

结论：

在西医综合干预的基础上，采用温阳化湿方内服和局部冲洗，用于AFRS术后患者，可改善近期和远期症状，提高了综合疗效和生活质量，并可提高机体免疫功能，减轻炎性损伤，降低了复发率，改善了预后，值得进一步的研究和使用。

Abstract

Objective:

To assess the efficacy of Wenyang Huashi prescription on rehabilitation of patients after allergic fungal rhinosinusitis (AFRS) operation

and its effect on inflammatory factors and immune function.

Method:

One hundred and forty-four patients were randomly divided into control group and observation group by random number table

with 72 cases in each group. Patients in control group was treated with Messerklinger to remove lesions completely

and got anti-infective therapy for three days

prednisone acetate tablets

10 mg/time

2 times/days

fluticasone propionate inhaled aerosol for a continued 4 weeks

2 sprays/time

1 time/day

itraconazole capsules at the first

fifth and ninth week after treatment (one course of treatment was 7 days)

0.2 g/time

1 time/day. In addition to the therapy of meloxicam tablets

patients in observation group were also given local rinsing and oral administration of Wenyang Huashi prescription. The courses of treatment of both groups were 12 weeks. Before the operation and at the fourth and 12

week after the operation

subjective conditions were assessed. And before the operation and at the 12

and 48

week after the operation

Lund-Kennedy detected by endoscopic sinus surgery and nasal and paranasal sinus outcomes test-20 (SNOT-20) were scored. And the relapse was recorded during 48 weeks after the operation. And levels of tumor necrosis factor-alpha (TNF-alpha)

interleukin-1bet (IL-1bet)

nuclear factor kappa B (NF-kappa B)

intercellular adhesion molecule in peripheral blood-1 (ICAM-1)

T lymphocyte subsets (CD3

CD4

CD8

and CD4

/CD8

) were detected.

Result:

By rank sum test

the clinical efficacy in observation group was better than that in control group (

=2.016

0.05). At the fourth and 12

week after the operation

scores of nasal obstruction

dizziness

runny nose and dysosmia in observation group were lower than those in control group (

0.01). And scores of lund-kennedy and SNOT-20 were lower than those in control group (

0.01). And levels of TNF-

IL-1

NF-κB and ICAM-1 were lower than those in control group (

0.01). After treatment

levels of CD3

CD4

/CD8

and CD4

were higher than those in control group

and level of CD8

was lower than that in control group (

0.05). During the one-year follow-up

the relapse rate in observation group was 7.81%(5/64)

which was lower than 22.58%(14/62) in control group (

=5.363

0.05).

Conclusion:

Wenyang Huashi prescription can improve short-term and long-term symptoms

improve the comprehensive curative effect

the quality of life and the immune function of the body

alleviate inflammatory injury

reduce the recurrence rate and improve the prognosis

and so is worth further study and use.

关键词

Keywords

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