Effects Of Fumigation With Modified Xanthium Powder On Mucosal Remodeling,ciliary Movement And Olfactory Function After Surgery For Chronic Rhinosinusitis

Objective: To explore the effect of fumigation with modified Xanthium Powder on mucosal remodeling,cilial movement and olfactory function after the operation of chronic sinusitis(CRS)through clinical experiments.Combined with the integration of traditional Chinese medicine(TCM)syndrome,the efficacy of TCM syndrome and the nasal sinus outcome test(SNOT-20),to explore the efficacy of Chinese herbal fumigation and the effect of Chinese herbal fumigation on serum inflammatory factors and immune factors after CRS surgery.Based on the pH value of the nasal mucosa and the hypothalamus-pituitary-adrenal cortical axis,the possible mechanism of Chinese herbal fumigation affecting the effect after CRS surgery,laying the foundation for the clinical promotion and application of Chinese herbal fumigation after CRS surgery.Method:1.Using a single-center,prospective and randomized controlled study method,80 patients diagnosed with CRS and proposed functional endoscopic sinus surgery were collected in the Department of Otolaryngology,Sanming Integrated Medicine Hospital Affiliated to Fujian University of Traditional Chinese Medicine from November 2021 to December 2022.According to the random number table method,80 patients were divided into the control group and the observation group.The control group was given conventional western medicine treatment during the perioperative period,and the observation group added fumigation with modified Xanthium Powder on treatment on the basis of the control group.There is 1 course of treatment in 2 weeks,and there are 2courses of treatment in the two groups.Compare the changes of TCM syndrome points,TCM syndrome efficacy,Lund-Kennedy endoscopy mucosal morphological score,saccharin test(MTT),olfactory rod test(OSIT-J)and nasal sinus outcome test(SNOT-20)of the two groups before treatment,4 weeks of treatment and 12 weeks of treatment were compared.2.The serum inflammatory factors(IL-6,IL-10,IL-17,IFN-γ,TNF-α)of CRS patients were detected by flow immunofluorescence method to observe the effect of Chinese herbal fumigation on serum inflammatory factors after CRS surgery.3.The serum immune factors(Ig A,Ig G and Ig M)of CRS patients were detected by immuntransmission specific turbidity method,and the effect of Chinese herbal fumigation on serum immune factors after CRS surgery was observed.4.The pH test paper was used to detect the pH value of the nasal mucosa,and analyzed with the total score of Lund-Kennedy and MTT to study the possible mechanism of Chinese herbal fumigation affecting mucosal remodeling and cilia movement after CRS surgery.5.Chemiluminescence immunoassay was used to detect the levels of stress hormones(ACTH,Cort)in the hypothalamus-pituitary-adrenal cortex axis,and the correlation analysis with the olfactory rod test(OSIT-J)to study the possible mechanism of Chinese herbal fumigation affecting the olfactory function of CRS after surgery.Results:1.72 patients finally completed the experiment and included in the statistics,including35 in the control group and 37 in the observation group.There were no obvious adverse reactions during the experiment.2.Baseline analysis: the two groups of patients were well balanced in terms of sex,age,course of disease,Lund-Mackay sinus CT score,Western medicine typing,TCM syndrome type,etc(P>0.05),which is comparable.3.Chinese herbal fumigation reduces the postoperative TCM syndrome points of patients with lung qi deficiency cold type and spleen qi deficiency type of CRS,and improves the efficacy of medical syndromes;Chinese herbal fumigation improves postoperative nasal mucosal remodeling in CRS patients and improves cilia movement and olfactory function;Chinese herbal fumigation improves the quality of life of CRS patients after surgery(P<0.05).4.Chinese herbal fumigation regulates the secretion of serum inflammatory factors after surgery in CRS patients and inhibits the postoperative inflammatory reaction of CRS patients.5.Chinese herbal fumigation regulates the secretion of serum immune factors in CRS patients after surgery and improves the immune function of CRS patients after surgery.6.Chinese herbal fumigation reduced the pH value of the nasal mucosa in patients with CRS after surgery.The pH value of the nasal mucosa in the observation group was positively correlated with the total score of Lund-Kennedy and MTT(P<0.05).The decrease in pH of the nasal mucosa may be the mechanism of Chinese herbal fumigation to improve the postoperative mucosal remodeling and ciliary function of CRS patients.7.Chinese herbal fumigation improves the postoperative stress hormone level of CRS patients,and the postoperative stress hormone level of CRS patients in the observation group is positively correlated with OSIT-J(P<0.05).Improving the level of postoperative stress hormone in CRS patients may be the mechanism of Chinese herbal fumigation to improve the postoperative olfactory function of CRS patients.Conclusion: Fumigation with modified Xanthium Powder reduces postoperative TCM syndrome points in patients with lung qi deficiency cold type and spleen qi deficiency type of CRS,improves the efficacy of medical syndromes,inhibits inflammatory reactions,improves immune function,and improves quality of life.There are no obvious adverse reactions,which is worthy of clinical popularization and application.Fumigation with modified Xanthium Powder improves postoperative mucosal remodeling and improves ciliary movement and olfactory function in CRS patients.The mechanism may be achieved by reducing the pH value of the nasal mucosa,activate the hypothalamus-pituitary-adrenal cortex axis,and releasing ACTH and Cort.