第29卷第6期2011年6月中华中医药学刊CHINESEARCHIVESOFTRADITIONALCHINESEMEDICINEVol.29No.6Jun.2011中华中医药1438学刊慢性鼻窦炎-鼻息肉内窥镜术后中医辨证分型及疗效观察翟性友(河南大学第一附属医院耳鼻咽喉科,河南开封475001)摘要:目的:观察中医药辨证治疗对慢性鼻窦炎-鼻息肉(Ⅱ型和Ⅲ型)鼻内镜术后临床症状、体征和术腔清洁时间及上皮化时间等的改善情况,从中寻找辨证规律。方法:对慢性鼻窦炎-鼻息肉住院患者52例(100侧),按就诊单、双数顺序法分为治疗组26例(50侧)和对照组26例(50侧)。中医辨证可分为湿热蕴结型、脾虚湿困型。结果:治疗组在术腔清洁时间、囊泡持续时间及上皮化时间较之对照组有显著性差异(P<0.05),并且在术后临床症状改善以及内窥镜检查局部体征,治疗组较对照组有所提高(P<0.05)。术后气虚、夹瘀、夹湿持续时间治疗组较对照组明显缩短。结论:中医辨证治疗可减轻慢性鼻窦炎-鼻息肉ESS术后局部症状,促进术腔清洁及上皮化,中医药治疗显示出其整体治疗的优势。关键词:中医药;辨证治疗;慢性鼻窦炎-鼻息肉;内窥镜鼻窦手术;疗效评价中图分类号:R765.41文献标识码:B文章编号:1673-7717(2011)06-1438-03ClinicalStudyonEffectofChineseHerbaIMedicineTherapytoChronicNasalSinusitisorNasalPloypsafterEndoscopicSurgeryZHAIXing-you(TheDepartmentofOtolaryngologyinFirstAffiliatedofHenanUniwersity,Kaifeng475001,Henan,China)Abstract:Objective:ToobservetheeffectofChineseherbalmedicinetochronicsinusitis-nasalpolyps(ⅡandⅢ)patientsafterendoscopicsinussurgery(ESS),improvetheconditionintheclinicalsymptoms,physicalsigns,cleaningtimeandepithelizationtimeinnasalcavityafterESS,andlookfortheregularityofsyndormesdifferentiastion.Methods:Chronicsinusitis-nasalhospitalized52patients(100sides)wererandomlyallocatedtreatmentgroup,26patients(50sides)andthecontrolgroup,26patients(50sides)bysingle,doublethenumberoftheorder.Wesummarizedto2syn-dromesinthesepatientsasfollowed:syndromeofdampandheatongallbladder、lungandspleed-stomach,syndromeofsplenasthenicfluid-retention.Results:Thereweresignificantdifferencebetweenthetwogroupsoncleaningtimeinthesurgicalcavity,thelastingtimeofvesiclesandmucosaedemaandthetimeofcompleteepithelization(P<0.05),andsomewhatsublimebetweenthegroupsontheclinicalsymptomaswellasnasalobjectivesignaftersplanchnoscopy(P<0.05).Thetimeofthevitalenergysubordinate、syndromeofbloodstasisandthesubordinatesyndromeofexcessivedampnessinthetreatmentgroupwassignificantlyshorterthanthecontrolgroup.Conclusion:TraditionalChineseMedicinewithdifferentialtreatmentcanreducechronicsinusitis-nasalpolypsafterESSlocalsymptoms,andpromotecleanandepitheliumofthesurgicalcavity,Chinesemedicinetreatmentshowedtheadvantageoftheiroveralltreatment.Keywords:TraditionalChineseMedicine;DifferentialTreatment;ChronicNasalSinusitisorNasalPloyps;Endo-scopicsinusSurgery;Effectevaluation收稿日期:2011-01-06作者简介:翟性友(1973-),男,河南商丘人,主治医师,硕士,研究方向:中西医结合治疗鼻窦炎。慢性鼻窦炎-鼻息肉(chronicnasalsinusitisornasalpolyp简称CNSNP)是以鼻塞,流脓涕、嗅觉障碍、头痛等为主要症状的鼻科常见病和多发病。常因反复发作或久治不愈而影响人们的生活质量,甚至导致鼻-眶和鼻颅并发症。由于其发病机制至今仍未阐明,以及病因多元性导致功能性鼻内镜(ESS)术后仍有30%~50%患者术后恢复不理想。术后术腔粘膜转归阶段中发生的新生病变,如二次感染、粘膜水肿、囊泡、炎性肉芽组织、窦口缩小、息肉再生等,以及难以控制的变态反应因素导致的粘膜水肿、鼻息肉病,这些病变是阻碍术腔上皮化最重要的原因。因此,如何提高ESS的治愈率,成为近年来广大学者研究的重点和热点。CNSNP...