Therapeutic Effects Of Vitamin D Supplementation On Hormone-resistant Chronic Rhinosinusitis

Objective:1.To investigate the relationship between serum 25-hydroxyvitamin D levels and hormone-resistant chronic rhinosinusitis and its severity.2.Follow-up was performed to observe the effect of oral vitamin D on functional endoscopic surgery in patients with hormone-resistant chronic rhinosinusitis.Methods:1.Randomized controlled trials:73 patients with hormone-resistant chronic rhinos inusitis were followed up and their serum 25-hydroxyvitamin D levels were tested.According to the inclusion and exclusion criteria,57 patients with vitamin D deficiency who were voluntary consent were enrolled.Accord ing to the principle of randomized control,they were divided into experimental group(vitamin D supplement group)and control group.2.All of the 57 subjects enrolled in the study recorded gender,age,height,and body weight.3.All subjects admitted to the hospital were assigned a Lund-Kennedy endoscopic scoring,the visual analogue scale(VAS)and SNOT-20(sino-nasal outcome test)were filled through the guidance of the same researchers.4.All enrolled subjects underwent functional endoscopic surgery in accordance with Messerklinger’s procedure and were treated in groups according to the above-mentioned groups.The control group was rinsed nasal cavity(physiological sodium chlorid e solution 500ml/time 2 times/day)+budesonide nasal spray(64ug/spray 1 spray/time2times/day),The experimental group was given oral vitamin D drops(Sino Pharm Holdings Xingsha Pharmaceutical 400IU/grain 800IU/time/day for 12 weeks)+nasal rinse+budesonide nasal spray.Follow up for 12 weeks.After 12 weeks,serum 25-hydroxyvitamin D in the subjects was re-examined,and Lund-Kennedy scores,VAS scores,and symptoms of SNOT-20 were recorded again.5.After all statistical data of the experimental data are completed,SPSS22.0 software is used for analysis.The quantitative data meets the normal distribution and the variance is expressed as the mean±standard deviation.The comparison between groups uses the independent samplet-test,and the pairedt-test is used at different time points.Satisfy the use of median(quartile)that the comparison between groups using the rank sum test,at different time points compared using the rank-sum test.Test level α=0.05.Results:1.Seventy-three patients with hormone-resistance chronic rhinosinusitis were selected to test serum 25-hydroxyvitamin D,of which 68 patients had VD deficiency(Serum 25-hydroxyvitamin D<50nmol/L is defined as VD deficiency).The prevalence of vitamin D deficiency in patients with hormone-resistance chronic rhinosinusitis is high.2.There was a linear relationship between the preoperative serum VD level and the Lund-Kennedy score of nasal endoscope,which was negatively correlated.It indicated that the lower the serum 25-hydroxyvitamin D level was,the higher the L-K score was,that is,the more severe the inflammation of the nasal sinus mucosa.3.There was no significant difference in the clinical characteristics of age,gender and body mass index between the experimental group and the control group(P>0.05).The results were comparable and the results were reliable.4.The serum 25-hydroxyvitamin D levels in the two groups before surgery were not statistically significant(P>0.05).The serum 25-hydroxyvitamin D levels in the experimental group were significantly higher than those in the control group after surgery(P<0.05),suggesting that oral supplementation with VD can effectively improve vitamin D deficiency.5.After comprehensive treatment in the two groups of patients,the symptoms VAS scores,symptoms SNOT-20 and Lund-Kennedy endoscopic scores were significantly lower in the experimental group than in the control group,with statistical significance(P<0.05).It is suggested that the comprehensive treatment plan of oral vitamin D supplementation can significantly improve the patient’s symptoms and inflammation of nasal mucosa and sinus mucosa.Conclusions:1.The prevalence of vitamin D deficiency in patients with hormone-resistant chronic sinusitis is high.2.The level of serum 25-hydroxyvitamin D was negatively correlated with the Lund-Kennedy score of endoscopes,suggesting that serum 25-hydroxyvitamin D levels may be related to inflammation of the nasal mucosa and sinus mucosa.3.After giving vitamin D to patients for 12 weeks can significantly correct the lack of 25-OH vitamin D levels in the patient’s serum.4.The comprehensive treatment plan of the two groups of patients can improve their subjective symptoms and mucosal status of nasal cavity and sinuses.5.The comprehensive treatment of vitamin D3 supplementation can effectively improve the subjective symptoms and nasal and sinus mucosal recovery in patients with hormone-resistant chronic rhinosinusitis,indicating that vitamin D can improve GC resistance and enhance the response of CRS patients to GC.