Clinical Observation On Combination Therapy Of Zhi Xin Nasal Irrigation And Bi Yuan Shu For Chronic Rhinosinusitis

Objective:This study aimed to explore the clinical efficacy and safety of Zhi Xin nasal irrigation in the treatment of chronic rhinosinusitis(CRS).The symptoms of CRS that we observed included main symptoms—nasal congestion,nasal discharge,headache,hyposmia,as well as accompanying symptoms of Traditional Chinese Medicine(TCM)—anxiety,dry throat with a bitter taste,tinnitus and vertigo,constipation and reddish urine.Nasal endoscopy examinations,and computed tomography(CT)results were also recorded.All the conditions above were compared within and between groups.Methods: We collected a sample of 72 CRS patients who met the entry standards and the dialectical type,and visited the Otorhinolaryngology Department at Yunnan TCM Hospital between Jan.1,2020 and Dec.31,2020.The sample was randomly divided into two groups—36 in the experimental group and 36 in the control group.The experimental group received Zhi Xin nasal irrigation and took the Bi Yuan Shu oral liquid,while the treatment given to the control group was nasal irrigation with normal saline and oral intake of Bi Yuan Shu oral liquid.The symptoms and medical examinations were recorded and coded into scores for both groups before treatment,and in the follow-ups respectively two weeks and four weeks after the start of the treatment.We then performed statistical analysis to assess the improvements of patients’ health in order to evaluate the efficacy of Zhi Xin nasal irrigation on CRS without nasal polyps.Results1.The between-group comparison indicated no statistically significant difference(p<0.05)before treatment in the demographics,symptoms,accompanying symptom index of TCM,Lund-Kenney score of nasal endoscopy examination,and Lun-Mackay score of CT.Thus,the experimental group and the control group were exchangeable.2.We found a statistically significant decrease(p<0.05)after two weeks in both accompanying symptom index of TCM and visual analogue scale index via within-group comparison,whereas the between-group showed no difference in these two indices.The total effective rate of the experimental group was 64.5%,and of the control group 57.6%.The difference was not statistically significant(p<0.05).Both Zhi Xin nasal irrigation and nasal irrigation with normal saline were proved similarly effective.3.After four weeks,the total effective rate of the experimental group was87.1%,and of the control group 75.8%.Both groups had a statistically significant decrease in main symptoms,accompanying symptoms index of TCM,nasal endoscopy index,and CT index compared to the prior to the treatment.The only exception was that the hyposmia index of the control group did not significantly decrease.The experimental group showed statistically significant improvement compared to the control group(p<0.05).Zhi Xin nasal irrigation was more effective in terms of improvement in symptoms and physical signs.4.A few patients reported mild discomforts including burning sensation and prickling sensation within the nose,prickling sensation in the head or face,and ear pain,which went away later.With adjustments to irrigation methods,the discomforts no longer appeared.No severe adverse reaction was found during the treatment.Conclusion1.The first period of nasal irrigation treatment for CRS took effect mostly through physical flushing,which were achieved in both the experimental group and the control group.Symptoms such as nasal congestion,headache and hyposmia were eased to similar extents in both groups.The application of herbal medicine manifested obvious effect after four weeks.2.The experimental group enjoyed significantly better improvements in main symptoms,olfactory sensation,accompanying symptoms of TCM,Lun-Kennedy score of nasal endoscopy examination,and Lun-Mackay score of CT than the control group.3.Zhi Xin nasal irrigation was proved advantageous with better efficacy with ideal safety.No severe adverse reaction was found during the study,which is an essential advantage of external treatment with herbal medicine.Besides,the treatment can be simply administered,and thus is worth a wide use.