| Objective:The purpose of this study is to explore the superiority of treating with xingqiao soup during the perioperative period of nasal endoscope surgery of patients with chronic rhinosinusitis through the observation of clinical effects and the detection of related laboratory indicators,providing certain clinical practical support for the application of TCM in the perioperative period of chronic rhinosinusitis.Methods:From March 2017 to February 2018,this subject collected 60 patients who were hospitalized in the Otolaryngology Department of Nanjing Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Nanjing University of Chinese Medicine,these patients conformed to the diagnostic criteria of chronic rhinosinusitis and needed to receive a nasal endoscopic surgery,They were divided into two groups according to 1:1 with 30 cases in the control group and 30 cases in the treatment group.The control group adopted the nasal endoscopic surgery and conventional processing for the perioperative period.On the basis of the control group,the treatment group combined the oral medication with xingqiao soup(provided by Nanjing Integrated Traditional Chinese and Western Medicine Hospital)during the perioperative period.The patients took one dose every day for one week before the surgery,and went on from the first day after the surgery to the twelfth week.This subject carried out the VAS subjective scoring to the clinical symptoms of patients 1 week before surgery and 12 weeks after surgery,the quantitative evaluation of nasal endoscopic examination adopted the scoring method of Lund-Kennedy,and besides,it conducted a short-term comprehensive therapeutic effect evaluation within 12 weeks after surgery.This study selected the posterior marginal mucosal tissue of ostium of maxillary sinus of patients as the material part,regarded the diseased nasal mucosa specimen excised in the surgery as the intraoperative specimen,took the same part as the postoperative sample in the 12th week of reexamination and adopted a real-time fluorescence quantitative PCR to detect the relative expression quantities of MMP-2,MMP-7 and MMP-9 mRNA in the above samples.Results:(1)In the comparison of the scores of various symptoms and the total scores between the two groups within 12 weeks after the surgery,except that the comparative differences of single-item scores of hyposmia had no statistical significance(P>0.05),the rest scores of the treatment group were all lower than those of the control group,whose differences were statistically significant(P<0.05);(2)In the comparison of the scores of various symptoms and the total scores of nasal endoscopic mucosal morphology between the two groups within 12 weeks after the surgery,the differences in the comparison of single-item scores of polyps,cicatricial scars and scabs had no statistical significance(P>0.05),while in the single-item scores and total scores of edema and rhinorrhea,the treatment group was improved significantly compared with the control group,and the difference was statistically significant(P<0.05);(3)According to the evaluation standard of curative effect,the total effective rate was 96.67%and the cure rate was 86.67%in the treatment group;the total effective rate was 83.33%and the cure rate was 60%in the control group.Although the differences between the total effective rates of the two groups were not statistically significant(P>0.05),the cure rate of the treatment group was obviously higher than that of the control group,and their differences had statistical significance(P<0.05).Therefore,in respect of the short-term comprehensive curative effect,the treatment group was superior to the control group.(4)Carried out real-time fluorescent quantitation PCR detection on the selected specimen in twelve weeks after surgery,the relative expression quantities of MMP-2,MMP-7 and MMP-9 mRNA in treatment group were all lower than that in the control group,and their differences were statistically significant(P<0.05).Conclusion:Applying the xingqiao soup to treat patients with chronic rhinosinusitis during the perioperative period of nasal endoscopic surgery can effectively improve the subjective symptoms of the patients and the situation seen under nasal endoscope,especially in the aspects of relieving edema and reducing nasal secretion.Meanwhile,xingqiao soup can also inhibit the remodeling progress of nasal mucosa and promote the epithelization of the mucous membrane of the operation cavity.This study affirms that using the xingqiao soup for treating patients with rhinosinusitis during the perioperative period of nasal endoscopic surgery has certain advantages and exact curative effect,providing a clinical basis for the application of traditional Chinese medicine in the perioperative period. |
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