疏风通窍汤联合甲泼尼龙片用于慢性鼻窦炎伴鼻息肉患者术后疗效观察

doi:10.11958/20242365

天津医药 ›› 2025, Vol. 53 ›› Issue (3): 312-316.doi: 10.11958/20242365

疏风通窍汤联合甲泼尼龙片用于慢性鼻窦炎伴鼻息肉患者术后疗效观察

董文荣¹(), 冯全跃², 秦隆朝³, 田立俊⁴, 李倩倩¹

1 石家庄市第三医院耳鼻咽喉科（邮编050011）
2 衡水市中医医院检验科
3 邯郸市中心医院耳鼻咽喉头颈外二科
4 石家庄市第三医院中医科

收稿日期:2024-12-25 修回日期:2025-01-22 出版日期:2025-03-15 发布日期:2025-03-31
作者简介:董文荣（1971），女，副主任医师，主要从事鼻炎、慢性鼻窦炎方面研究。E-mail：2710658200@qq.com
基金资助:
河北省中医药管理局科研计划项目(2024392)

Analysis of the effect of Shufeng Tongqiao decoction combined with methylprednisolone tablets in patients with chronic sinusitis and nasal polyp after operation

DONG Wenrong¹(), FENG Quanyue², QIN Longchao³, TIAN Lijun⁴, LI Qianqian¹

1 Department of Otolaryngology, Shijiazhuang Third Hospital, Shijiazhuang 050011, China
2 Department of Laboratory, Hengshui Traditional Chinese Medicine Hospital
3 Department of Otolaryngology Head and Neck Surgery (Ward Ⅱ), Handan Central Hospital
4 Department of Traditional Chinese Medicine, Shijiazhuang Third Hospital

Received:2024-12-25 Revised:2025-01-22 Published:2025-03-15 Online:2025-03-31

董文荣, 冯全跃, 秦隆朝, 田立俊, 李倩倩. 疏风通窍汤联合甲泼尼龙片用于慢性鼻窦炎伴鼻息肉患者术后疗效观察[J]. 天津医药, 2025, 53(3): 312-316.

DONG Wenrong, FENG Quanyue, QIN Longchao, TIAN Lijun, LI Qianqian. Analysis of the effect of Shufeng Tongqiao decoction combined with methylprednisolone tablets in patients with chronic sinusitis and nasal polyp after operation[J]. Tianjin Medical Journal, 2025, 53(3): 312-316.

摘要/Abstract

摘要：

目的分析疏风通窍汤联合甲泼尼龙片用于慢性鼻窦炎伴鼻息肉（CRSwNP）患者术后的效果。方法前瞻性选取行鼻内镜手术的104例CRSwNP患者，将其随机分为激素组（术后应用甲泼尼龙片）和研究组（术后在激素组基础上联合疏风通窍汤治疗）。经剔除及脱落后激素组纳入50例，研究组纳入49例。比较2组疗效、肺经风热证积分、鼻黏膜恢复情况（采用Lund-Kennedy评分系统评定）、鼻黏膜重塑情况；采用酶联免疫吸附试验检测血清人β防御素（hBD）-2、高迁移率族蛋白B1（HMGB1）水平。结果研究组疾病总控制率高于激素组（95.92% vs. 80.00%，P<0.05）。术后12周，2组肺经风热证积分、Lund-Kennedy评分及血清HMGB1水平均低于术前，且研究组均低于激素组；研究组血清hBD-2水平均高于术前，且研究组高于激素组（P<0.05）。术后12周，研究组上皮损伤改善情况优于激素组，基底膜厚度薄于激素组（P<0.05）。结论 CRSwNP患者术后应用疏风通窍汤联合甲泼尼龙片治疗效果较佳，可明显改善血清hBD-2、HMGB1水平，有效抑制鼻黏膜重塑，显著提高鼻黏膜恢复效果。

关键词: 鼻窦炎, 鼻息肉, 鼻黏膜, 甲泼尼龙, β防御素, HMGB1蛋白质, 疏风通窍汤

Abstract:

Objective To analyze the effect of Shufeng Tongqiao decoction combined with methylprednisolone tablets in patients with chronic sinusitis and nasal polyp (CRSwNP) after operation. Methods A total of 104 patients with CRSwNP underwent endoscopic nasal surgery were prospectively selected, and patients were randomly divided into the hormone group (n=52, postoperative methylprednone tablets) and the study group (n=52, postoperative combined treatment with Shufeng Tongqin Decoction). After removal and shedding, 50 cases were included in the hormone group, and 49 cases were included in the study group. The curative effect, lung wind-heat syndrome score, nasal mucosa recovery (assessed by Lund-Kennedy score system) and nasal mucosa remodeling were compared between the two groups. Serum levels of human β-defensin (HBD) -2 and high mobility group protein B1 (HMGB1) were detected by enzyme-linked immunosorbent assay. Results The total control rate was higher in the study group than that of the hormone group （95.92% vs. 80.00%, P<0.05). At 12 weeks after surgery, the lung meridian wind heat syndrome scores, Lund-Kennedy scores and serum HMGB1 level were lower than before surgery in both groups (P<0.05), and the study group was lower than the hormone group (P<0.05). At 12 weeks after surgery, the epithelial injury grading was better in the study group than that in the hormone group (P<0.05), and the basement membrane thickness was thinner than that in the hormone group (P<0.05). Conclusion The joint of Shufeng Tongqiao decoction and methylprednisolone tablets has a better effect on postoperative CRSwNP patients, and it can greatly improve the levels of serum hBD-2 and HMGB1, effectively inhibit nasal mucosal remodeling, and greatly improve the recovery of nasal mucosa.

Key words: sinusitis, nasal polyps, nasal mucosa, methylprednisolone, beta-defensin, HMGB1 protein, Shufeng Tongqiao decoction

中图分类号:

R765.41

图/表 5

参考文献 21

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组别	n		性别（男/女）	年龄/岁		病程/年
激素组	50		29/21	42.08±6.96		2.83±0.79
研究组	49		27/22	41.57±6.73		3.09±0.85
χ²或t			0.085	0.371		1.577
组别		疾病分期（Ⅰ型/Ⅱ型/Ⅲ型）			体质量指数/（kg/m²）
激素组		14/27/9			23.19±2.73
研究组		16/23/10			23.37±2.85
χ²或t		0.195			0.321

组别	n		性别（男/女）	年龄/岁		病程/年
激素组	50		29/21	42.08±6.96		2.83±0.79
研究组	49		27/22	41.57±6.73		3.09±0.85
χ²或t			0.085	0.371		1.577
组别		疾病分期（Ⅰ型/Ⅱ型/Ⅲ型）			体质量指数/（kg/m²）
激素组		14/27/9			23.19±2.73
研究组		16/23/10			23.37±2.85
χ²或t		0.195			0.321

组别	n	完全控制	部分控制	未控制	总控制
激素组	50	24（48.00）	16（32.00）	10（20.00）	40（80.00）
研究组	49	33（67.35）	14（28.57）	2（4.08）	47（95.92）
Z或χ²		2.307^＊			5.887^＊

组别	n	完全控制	部分控制	未控制	总控制
激素组	50	24（48.00）	16（32.00）	10（20.00）	40（80.00）
研究组	49	33（67.35）	14（28.57）	2（4.08）	47（95.92）
Z或χ²		2.307^＊			5.887^＊

组别	n		肺经风热证积分
组别	n		术前		术后12周		t
激素组	50		18.58±4.16		7.36±2.24		36.904^＊＊
研究组	49		19.76±4.30		5.18±1.62		42.705^＊＊
t			1.388		5.539^＊＊
组别		Lund-Kennedy评分
组别		术前		术后12周		t
激素组		11.64±2.74		5.08±1.16		31.195^＊＊
研究组		12.02±2.80		3.47±0.75		36.085^＊＊
t		0.682		8.183^＊＊

疏风通窍汤联合甲泼尼龙片用于慢性鼻窦炎伴鼻息肉患者术后疗效观察

Analysis of the effect of Shufeng Tongqiao decoction combined with methylprednisolone tablets in patients with chronic sinusitis and nasal polyp after operation

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组别	n	上皮损伤				基底膜厚度/ μm
组别	n	0级	1级	2级	3级	基底膜厚度/ μm
激素组	50	31（62.00）	11（22.00）	7（14.00）	1（2.00）	9.23±2.58
研究组	49	40（81.63）	6（12.24）	3（6.12）	0（0.00）	7.49±2.06
Z或t		2.209^＊				3.704^＊＊

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组别	n		hBD-2/（mg/L）
组别	n		术前		术后12周		t
激素组	50		132.58±12.33		146.41±9.78		15.592^＊＊
研究组	49		130.62±11.46		151.23±11.59		22.889^＊＊
t			0.819		2.353^＊
组别		HMGB1/（μg/L）
组别		术前		术后12周		t
激素组		80.35±7.14		60.27±6.59		37.652^＊＊
研究组		81.79±7.46		56.58±5.71		46.690^＊＊
t		0.981		2.975^＊＊

组别	n		hBD-2/（mg/L）
组别	n		术前		术后12周		t
激素组	50		132.58±12.33		146.41±9.78		15.592^＊＊
研究组	49		130.62±11.46		151.23±11.59		22.889^＊＊
t			0.819		2.353^＊
组别		HMGB1/（μg/L）
组别		术前		术后12周		t
激素组		80.35±7.14		60.27±6.59		37.652^＊＊
研究组		81.79±7.46		56.58±5.71		46.690^＊＊
t		0.981		2.975^＊＊