Pathological Observation And Preliminary Study Of Immune Mechanism Of Yu-jiang Detoxification Mixture In The Treatment Of Chronic Rhinosinusitis

Objective:1.To observe the effect of Yujiang Paidu mixture on the expression of GM-CSF,TNF-α,pluc and IL-8 in nasal mucosa fibrosis degree,basement membrane change degree of CRS patients with excess heat syndrome(i.e.lung meridian wind heat type,gallbladder viscera stagnation heat type,spleen stomach damp heat type).2.to explore the mechanism of caviar detoxification mixture in the treatment of CRS and lay a foundation for further research.Methods:1.A total of 64 CRS patients with heat syndrome were enrolled and randomly divided into treatment group(32 cases)and control group(32cases).The treatment group was lavaged with fish sauce Paidu mixture,while the control group was lavaged with normal saline,both groups were given 20 ml twice a day for 2 weeks.Before the beginning of treatment,the mucosa near the sinus complex in the unilateral nasal cavity of all subjects was taken;after the end of treatment,the mucosa near the sinus complex in the ipsilateral nasal cavity of all subjects was taken.2.After treatment,the basement membrane thickness was observed by VG staining;the degree of mucosal fibrosis was observed by Masson staining;the average number of positive cells was calculated by immunohistochemical staining results under random and non overlapping 5high power microscope(5x400)field of vision,and the comparison within and between groups was made to draw a conclusion.3.Spss25.0 was used to analyze the data,with P < 0.05 as the differenceResults1.Masson staining: the Masson staining scores of the two groups decreased after treatment,and the difference was statistically significant after 2 weeks of treatment(P < 0.05).2.VG staining: the VG staining scores of the two groups were changed in varying degrees after treatment,and the difference was not statistically significant after 2 weeks of treatment(P > 0.05).3.GM-CSF results: GM-CSF positive cells were found in the cytoplasm or membrane of both groups.After treatment,the number of GM-CSF immunohistochemical positive cells in both groups decreased,and the difference was statistically significant after 2 weeks of treatment(P< 0.05).4.TNF-α results: TNF-α positive staining cells were found in epithelial cells,vascular endothelial cells and inflammatory cells in both groups.After treatment,the number of TNF-α immunohistochemical positive cells in both groups decreased,and the difference was statistically significant after 2 weeks of treatment(P < 0.05).5.PLUNC results: PLUNC was expressed in the membrane and cytoplasm of the mucosa epithelium and submucosa gland.There was no significant change in the number of pluc immunohistochemical positive cells between the two groups after treatment,and there was no significant difference in the number of pluc immunohistochemical positive cells between the two groups after 2 weeks of treatment(P > 0.05).6.LI-8 results: The positive expression of IL-8 was observed in epithelial cells,glandular epithelial cytoplasm,and the interstitium around vascular endothelium in both groups.After treatment,the number of LI-8immunohistochemical positive cells in the two groups decreased,and the difference was statistically significant after 2 weeks of treatment(P < 0.05).ConclusionThe mechanism of therapeutic effect of Yujiang Paidu mixture on CRS may be the decrease of the expression of GM-CSF,TNF-α and IL-8 in mucous membrane tissue,which can improve the degree of nasal mucosal fibrosis in CRS patients,but it has no obvious effect on the expression of plurc and the improvement of basement membrane thickness.