| BackgroundAcute rhinosinusitis(ARS)is the inflammation of the nasal cavity and paranasal sinus,mainly caused by acute rhinitis or nasal inflammation spreading directly to the sinuses,with fever,headache,nasal obstruction and runny as the main symptoms in the clinic,which is one of the most common disease in the department of otolaryngology.It seriously affects the work and quality of life of the patient.Through the combination of many years of clinical treatment experience and the characteristics of traditional Chinese medicine,Professor Sun Shuchen established the Sun’s sequential therapy for nasal diseases,which combined internal treatment with external treatment,and received a good clinical effect in the treatment of sinusitis.ObjectiveTo observe the clinical effect of Sun’s sequential therapy in treating patients with acute nasosinusitis characterized by lung by wind heat,and to evaluate and explore its effect on nasal mucosal transmission function.MethodsAccording to the diagnostic criteria of acute sinusitis and the diagnostic criteria of TCM syndromes,the method of random list was adopted in the order of outpatient registration,combined with nasal examination and sacchanrin test,66 patients with acute nasosinusitis characterized by lung by wind heat in line with the inclusion and exclusion criteria treated in our department of otolaryngology were selected.According to the random table method,they were divided into group A,Sun’s sequential therapy group(n = 33),and group B(n = 33),oral decoction group(n = 33,n = 33).In the Sun’s sequential therapy group:the method of decoction steam fumigation combined with oral administration was used to treat the patients,bid,end of two weeks of continuous use;in the oral decoction group:only decoction,bid,end of two weeks.During the study,the sacchanrin test was carried out on the Oth,7th and 14th day,respectively,filled out nasal obstruction visual analogue scale(VAS),recorded primary and secondary symptoms,and filled out nasal cavity and sino-nasal outcome test-20(SNOT-20),completed nasal endoscopy,the endoscopy images were evaluated by MLK(Modofied Lund-Kenneth)endoscopic score system.Thus comparing the before and after treatment of MTT,VAS,the integral score of main and secondary symptoms and signs,SNOT-20 and MLK endoscopic score.ResultsBefore the treatment,statistics the nasal congestion,runny,turbinate,headache,smell and tenderness symptoms in the two groups,we found that the incidence of nasal congestion and turbinate were the highest,followed by runny,olfactory,headache,tendemess.Among of which,the score of turbinate and runny was relatively high,and the score of tenderness was relatively low.Nasal congestion and runny are the most common symptoms of acute sinusitis,mainly caused by nasal cavity and sinus mucosal inflammation,nasal mucociliary structure and function abnormalities.After 14 days of treatment,there was a difference in the distribution of therapeutic effects between the two groups.In the Sun’s sequential therapy group,of 33 patients,6 were cured(18.2%),excellence 19 cases(57.6%),effective 6 cases(18.2%),invalid 2 cases(6.1%),the effective rate was 93.9%;in the oral decoction group,of 33 patients,2 were cured(6.1%),excellence 12 cases(36,4%),effective 12 cases(36.4%),invalid 7 cases(21.2%),the effective rate was 78.8%.The cure rate of Sun’s sequential therapy group was higher than that of oral decoction group,there was statistical difference in the composition of curative effect between the two groups before and after treatment(P=0.04<0.05),the therapeutic effect of Sun’s sequential therapy group was significantly higher than that of traditional Chinese medicine group.Analysis of the rhinobyon VAS score、SNOT score.MLK score,symptom score and MTT score data of the two groups before and after 7 days of treatment and 14 days of treatment.In both groups,rhinobyon VAS score、SNOT score、MLK score,symptom score and MTT score decreased with time,in which,the descending speed of Sun’s sequential therapy group was higher than that of traditional Chinese medicine group,and the difference was significant,indicating that both groups can improve the clinical symptoms and healthy quality of life of patients with acute sinusitis,promote the recovery of nasal MTT function and reduce the MLK endoscopy score.The Sun’s sequential therapy group is better than the oral Chinese medicine group in these aspects.The correlation analysis of each scoring system before treatment was carried out in all cases,and part of the score presented as pairwise correlation.The correlation between snot-20 score and nasal congestion vas score and symptom score was found.The correlation between snot score and nasal congestion vas score and MLK endoscopic score was also observed.After 7 days of treatment,correlation analysis of the scoring system was carried out,and part of the score presented as pairwise correlation.MLK score was correlated with the nasal congestion vas score,the snot-20 score and the symptom score,there was a correlation between MTT score and vas score,snot-20 score and symptom score.After 14 days of treatment,correlation analysis was performed on all case scoring systems,and all scores were correlated in pairs.lt can be seen that MTT score was consistent with nasal obstruction vas score and MLK endoscopic score before and after treatment.The correlation between the improvement of symptoms and the change of MTT was analyzed.The improvement of some symptoms was highly correlated with the change of MTT(nasal obstruction,runny),indicating that the function of nasal mucosal cilia was gradually restored on the basis of nasal congestion and reduced runny.The correlation between different symptoms and MTT in two groups was analyzed.Before treatment,MTT score was correlated with partial symptom(nasal congestion)score,after treatment,MTT score was significantly correlated with most symptom score(nasal obstruction,runny nose,turbinate).The study found that MTT score was consistent with nasal congestion score before and after treatment.Analysis of the nasal congestion,runny,headache,turbinate,olfactory,tenderness score data of the two groups before and after 7 days of treatment and 14 days of treatment.In both groups,asal congestion,runny,headache,turbinate,olfactory,tenderness score data decreased with time,the scores of nasal congestion,headache,turbinate,olfactory and tenderness in the two groups had no significant difference over time.Among of which,The runny score in Sun’s sequential therapy group was higher than that in oral decoction group,and the difference was statistically significant,indicating that the two groups were effective in alleviating the symptoms of acute sinusitis,nasal congestion,runny,headache,turbinate,olfactory and tenderness,and the Sun’s sequential therapy group was better than the oral decoction group in reducing the runny.Conclusion1.The cure rate of Sun’s sequential therapy group was higher than that of oral decoction group,and the total effective rate of Sun’s sequential therapy group was significantly higher than that of oral decoction group.2.After two weeks of treatment,Sun’s sequential therapy group and oral decoction group were able to improve the clinical symptoms and healthy quality of life of patients with acute sinusitis,promote the recovery of nasal mucosal cilia transmission function,and reduce the MLK endoscopy score.In this study,Sun’s sequential therapy group was better than the oral decoction group in improving clinical symptoms and healthy quality of life,promoting the recovery of nasal mucosal cilia transmission function and reducing MLK endoscopy score.3.The correlation analysis of each scoring system before and after treatment showed that the MTT score was consistent with the nasal congestion vas score and the MLK endoscopic score before and after treatment,indicating that all three methods can objectively evaluate the curative effect of acute sinusitis.4.Between two groups of symptoms and improvement of MTT through the analysis of the change of symptoms and MTT were highly correlated(nasal congestion,runny nose).Results showed that inflammatory function and mucociliary transport system is closely related to an important objective index and nasal mucosal inflammation were observed,sinusitis severity and treatment effect,provide the basis for clinical.The process in the treatment of nasal mucosa cilia transmission function gradually restored,inflammation of nasal mucosa is also gradually subsided,nasal mucus secretion is reduced,so as to relieve nasal congestion and runny nose symptoms.5.The correlation between the two groups of different single symptoms and MTT was analyzed.The MTT score before and after treatment had a significant correlation with the score of nasal and runny congestion.Mucociliary transport function is low,can not provide enough protection to the nasal mucosa,nasal mucosa and will air in direct contact with various harmful factors and has lead to inflammation,swelling and nasal symptoms caused by nasal mucosa.After treatment of nasal mucociliary transport function recovered gradually,nasal inflammation gradually subsided,nasal symptoms.6.After two weeks of treatment,the Sun’s sequential therapy group and the oral decoction group improved the symptoms of nasal congestion,runny,headache,turbinate,smell and tenderness to varying degrees.In this study,Sun’s sequential therapy group was better than oral decoction group in improving the symptoms of runny.7.No adverse reactions and adverse events were found in the Sun’s sequential therapy group suggesting that the Sun’s sequential therapy is safe and effective,and deserves to be popularized in clinic. |
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