鼻渊汤鼻腔冲洗配合西药治疗肺脾气虚型儿童慢性鼻-鼻窦炎的临床观察

摘要

目的 观察鼻渊汤鼻腔冲洗配合西医疗法治疗肺脾气虚型儿童慢性鼻-鼻窦炎的临床疗效.方法 肺脾气虚型慢性鼻-鼻窦炎患儿随机分为治疗组和对照组,每组各30例.治疗组在常规西医治疗基础上加用鼻渊汤鼻腔冲洗,对照组在常规西医治疗基础上加用生理盐水鼻腔冲洗,疗程均为4周.分别在治疗前、治疗4周及治疗后12周,采用视觉模拟量表评估其症状,鼻内镜观察评估鼻腔病变情况,糖精法测量鼻黏液纤毛传输速率;治疗前及治疗后12周时采用Lund-Mackay评分法评估鼻窦CT影像,比较两组疗效.结果 虽然两组病例均显示明显疗效,治疗后症状视觉模拟量表评分、鼻内镜评分均明显下降,黏液纤毛传输速率均较治疗前明显加快,但治疗组疗效更优于对照组,差异具有统计学意义(P＜0.05).结论 鼻渊汤鼻腔冲洗对肺脾气虚型儿童慢性鼻-鼻窦炎有辅助治疗意义.%Objective To observe the therapeutic effect of combined routine medical treatment therapy with nasal douche by Biyuan Decoction on children chronic rhino-sinusitis in the pattern of Lung-Spleen Qi deficiency based on a clinical trial. Methods Included in this study were 60 children cases with chronic rhino-sinusitis (CRS) in the pattern of Lung-Spleen Qi deficiency, randomly divided into treating group (TG) and controlling one (CG) with 30 cases in each. The cases in TG were treated by routine medical treatment combined with nasal douche by Biyuan Decoction, while those in CG treated by the routine medical treatment combined with nasal douche by normal saline, all lasted for 4 weeks. Then, the measurement of visual analog scale (VAS) was taken to assess the changes in their symptoms, nasal endoscopy was utilized to observe the recovering process of nasal mucosa, and the mucociliary transport rate (MTR) was measured to evaluate the functional changes of nasal mucosa, carried out before the therapy, by the end of therapeutic course lasted for 4 weeks and at the 12th week after the therapy respectively. Moreover, Lund-Mackay score was used to evaluate the CT image changes in nasal sinuses, done before treatment and at the 12th week after treatment to compare the difference in the therapeutic effects between these two groups. Results All cases in both groups showed significant therapeutic effects, with obviously reduced VAS and nasal endoscopic scores and accelerated MTR following the treatment as compared with the values measured before the therapy. However, the therapeutic scores of TG was significantly superior to that seen in CG (P<0.05). Conclusion As a kind of adjuvant treatment, nasal douche with Biyuan Decoction is effective for the treatment of children chronic rhino-sinusitis in the pattern of Lung-Spleen Qi deficiency, when combined with other routine therapies.