| Objective:1. Through clinical experiment, verify the Shengjitongqiao powder nasal packing on the repair of the surgical cavity mucosa after FESS.2. Detecting of Epidermal Growth Factor(EGF) and Vascular Endothelial Growth Factor(VEGF) expression of the positive cells expression sites 、 number and extentin different periods, to demonstrate Shengjitongqiao powder regulating effect on EGF, VEGF and the possible mechanism of Shengjitongqiao powder promotes the repair of mucosa in different periods of sinus mucosa.3. Making use of the specific scoring criteria,for nasal symptoms and signs of subjective and objective quantification in patients with different stages, validation of Shengjitongqiao powder better effect to improve the postoperative nasal symptoms and signs.4. To play the advantage of the characteristics of traditional Chinese medicine, which combined with nasal packing, improved nasal packing materials, to proof of the twooptimization of Combinatorial has higher clinical value in patients after FESS.Methods:1. Clinical treatment:The same preoperative treatment was performed before operation, anesthesia induced hypotension during the operation.At the end of surgery, the ethmoid sinus cavity in the treatment group using 1 expansive sponge filling,surface evenly 30 g shengjitongqiao powder, the control group of ethmoid sinus cavity using only 1 expansion sponge.After the operation, the same anti infection treatment, after discharge with intranasal corticosteroid nasal spray and oral antibiotic treatment.Patients in need of endoscopic cleaning operation site,respectively, in the 1, 3, 6, 9 weeks after the operation.VAS scores were recorded in patients with nasal subjective symptoms, Lund-Kennedy modified endoscopicscores were recorded under nasal endoscope nasal cavity mucosa repair; and at the same time take the nasal cavity mucosa specimens of ethmoid sinus mucosa.2. The inflammatory state and repair of the mucosa in the cavity were observed by HE staining of the cavity mucosa.3. The expression of VEGF and EGF in the mucosa of the cavity was detected by immunohistochemistry.4. Statistical methods:Using SPSS17.0 statistical software for statistical data analysis,a = 0.05. For count data with chi square test, measurement data t or t’- test.Results:1. Symptom VAS score The two groups of patients before the clinical symptoms score no significant difference(P > 0.05), before and after operation in the group and postoperative period with a comparison between groups, except for 1 weeks after the operation, hyposmia scores were compared between groups, no significant difference(P > 0.05), the other between group and within group comparisons, the differences were statistically significant(P <0.05), and the treatment group was better than control group in clinical symptoms.2. Modified Lund-Kennedy endoscopy score①The two group of patients before Lund-Kennedy total score no significant difference(P > 0.05), compared between the Lund-Kennedy total score of the same period before and after operation in the group and after operation, the difference was statistically significant(P < 0.01).②Comparison of two groups of patients with Lund-Kennedy score, in addition to 1weeks after the operation, scab and scar adhesion, after 3 weeks, 6 weeks after the operation, scabby edema, 9 weeks after the operation, rhinorrhea were no statistically significant differences(P > 0.05), the comparison between the remaining group, the difference was statistically significant(P < 0.05).3. The expression of EGF and VEGF The different periods of EGF and VEGF expression intensity between groupcomparison, before and after the operation, 1, 9 weeks were no significant difference(P > 0.05), there is statistical significance after 3, 6 weeks(P < 0.01) difference.4. Results of HE staining sections HE staining results indicated that, the treatment group than the control group of mucosa hemorrhage and necrosis of tissue less, mild inflammation reaction,granulation tissue growth early, shorten the time of epithelization.Conclusion:1. Shengjitongqiao powder has promote the surgical repair of FESS cavity nasal mucosa after surgery effect in surgery nasal cavity packing.2. With Shengjitongqiao powder on the operation of nasal cavity, the nasal cavity mucosa and inhibit the inflammatory reaction after operation of FESS.3. With Shengjitongqiao powder on the operation of nasal cavity, can regulate the operation of FESS EGF and VEGF expression in nasal mucosa function.4. Shengjitongqiao powder promotes mucosal repair, regulation of expression of EGF and VEGF, may be related to the inhibition of mucosa inflammation. |
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