加味化疔漏芦汤治疗慢性鼻-鼻窦炎伴分泌性中耳炎毒热证患者术后的康复及机制

张灵敏; 李静波; 蔡纪堂; 王俊杰; 陈文明

doi:10.13422/j.cnki.syfjx.20201726

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加味化疔漏芦汤治疗慢性鼻-鼻窦炎伴分泌性中耳炎毒热证患者术后的康复及机制

临床 | 更新时间：2020-09-09

- 加味化疔漏芦汤治疗慢性鼻-鼻窦炎伴分泌性中耳炎毒热证患者术后的康复及机制
- Effect of Modified Huading Loulutang on Postoperative Recovery of Chronic Rhinosinusitis with Secretory Otitis Media Due to Toxic Heat Syndromes
- 中国实验方剂学杂志 2020年26卷第17期页码：77-82
- 作者机构：
  
  河南省中医院，郑州 450002
- 作者简介：
  
  张灵敏，硕士，副主任医师，从事中西医结合治疗耳鼻咽喉疾病的研究，E-mail：mianhuabao959595@163.com
  蔡纪堂，主任医师，从事中医药治疗耳鼻咽喉疾病的研究，Tel：0371-69915379，E-mail：dumin871013@163.com
- 基金信息：
  
  河南省高等学校重点科研项目(15A360005);河南省中医药科学研究专项(2018ZY1010)
- DOI：10.13422/j.cnki.syfjx.20201726
  中图分类号： R22;R242;R2-031;R287
- 网络出版日期：2020-07-06，
  
  纸质出版日期：2020-09-05
- 稿件说明：
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张灵敏,李静波,蔡纪堂等.加味化疔漏芦汤治疗慢性鼻-鼻窦炎伴分泌性中耳炎毒热证患者术后的康复及机制[J].中国实验方剂学杂志,2020,26(17):77-82.

ZHANG Ling-min,LI Jing-bo,CAI Ji-tang,et al.Effect of Modified Huading Loulutang on Postoperative Recovery of Chronic Rhinosinusitis with Secretory Otitis Media Due to Toxic Heat Syndromes[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(17):77-82.
张灵敏,李静波,蔡纪堂等.加味化疔漏芦汤治疗慢性鼻-鼻窦炎伴分泌性中耳炎毒热证患者术后的康复及机制[J].中国实验方剂学杂志,2020,26(17):77-82. DOI： 10.13422/j.cnki.syfjx.20201726.

ZHANG Ling-min,LI Jing-bo,CAI Ji-tang,et al.Effect of Modified Huading Loulutang on Postoperative Recovery of Chronic Rhinosinusitis with Secretory Otitis Media Due to Toxic Heat Syndromes[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(17):77-82. DOI： 10.13422/j.cnki.syfjx.20201726.

摘要

目的

观察加味化疔漏芦汤对慢性鼻-鼻窦炎伴分泌性中耳炎毒热证患者术后康复效果

及血清、鼻分泌液、耳分泌液中嗜酸性粒细胞阳离子蛋白（ECP），免疫球蛋白E（IgE），细胞间黏附分子-1（ICAM-1）的影响。

方法

90例患者按照随机数字表法分为对照组和观察组，各45例。所有患者在鼻内窥镜术后给予头孢曲松钠+羟甲唑啉，对照组口服鼻渊通窍颗粒，观察组给予加味化疔漏芦汤，疗程均为6周。分别于治疗前后，随访6，18周观察两组患者鼻内镜检查量化评估量表（Lund-Kennedy），中医证状和不同频率听力阈值。治疗前后分别检测血清、鼻分泌液、耳分泌液中ECP，IgE，ICAM-1的含量。比较两组患者临床症状、并发症和随访12个月复发情况。

结果

观察组患者总控制率97.7%（43/44，95%CI [95.6，98.6]），高于对照组的78.6%（33/42，95%CI [72.4，83.5]

）（

=6.946，

0.05）。随访12个月，观察组患者复发率4.5%（2/44，95%CI[3.7，5.8]），低于对照组的19.0%（8/42，95%CI [16.8，21.3]

）（

=4.531，

0.05）。治疗后，随访6，18周观察组患者Lund-Kennedy和中医证状评分较对照组明显降低（

0.05）。治疗后观察组患者不同频率听力阈值较对照组明显降低（

0.05）。治疗后观察组患者血清、鼻分泌液、耳分泌液中ECP，IgE，ICAM-1含量较对照组明显降低（

0.05）。观察组患者并发症发生率6.8%（3/44，95%CI [5.3，8.1]），低于对照组的28.6%（12/42，95%CI [25.3，30.2]

）（

0.05）。

结论

加味化疔漏芦汤可明显改善慢性鼻-鼻窦炎伴分泌性中耳炎毒热证患者术后临床症状，复发率低。

Abstract

Objective

To observe the efficacy of modified Huading Loulutang on postoperative recovery of chronic rhinosinusitis with secretory otitis media due to toxic heat syndromes and the effect of eosinophil cationic protein (ECP)

immunoglobulin E (IgE) and intercellular adhesion molecule-1 (ICAM-1) in serum

nasal secretion and otitis media.

Method

According to the random number table method

90 cases were divided into control group and observation group

with 45 cases in each group. All patients were given ceftriaxone sodium + hydroxymezoline after nasal endoscopy. In addition

control group was given Biyuan Tongqiao granule

while observation group was given modified Huading Loulutang for 6 weeks. Lund-Kennedy nasal assessment scale

traditional Chinese medicine symptoms and threshold of hearing at different frequencies were observed in two groups before and after treatment and during 6-week and 18-week follow-up visits. The levels of ECP

IgE and ICAM-1 in serum

nasal and ear secretions were detected before and after treatment. Clinical symptoms

adverse reactions and 12-month recurrence rate were compared.

Result

Total control rate was 97.7%

(43/44

95%CI [95.6，98.6]) in observation group

which was higher than 78.6% (33/42

95%CI [72.4，83.5]

) in control group (

=6.946

0.05). During the 12-month follow-up visit

the recurrence rate was 4.5% (2/44

95%CI [3.7，5.8]) in observation group

which was lower than 19.0% (8/42

95%CI[16.8，21.3]

) in control group (

0.05). After treatment

Lund-Kennedy and traditional Chinese medicine symptoms score during 6-week and 18-week follow-up visits in observation group were significantly lower than those in control group (

0.05). Hearing threshold in observation group at different frequencies was significantly lower than that in control group (

0.05). ECP

IgE and ICAM-1 levels in serum

nasal and auricular secretions in observation group were significantly lower than those in control group (

0.05). The incidence of adverse reactions was 6.8% (3/44

95%CI [5.3，8.1]) in observation group

which was lower than 28.6% (12/42

95%CI [25.3，30.2]

) in control group (

0.05).

Conclusion

Modified Huading Loulutang can significantly improve postoperative clinical symptoms of chronic rhinosinusitis and otitis media due to toxic heat syndromes with secretion

with a low recurrence rate and fewer complications.

关键词

Keywords

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