| Objective:In this study,the clinical efficacy of Huazhuoshengxin ointment in patients with chronic rhinosinusitis after endoscopic sinus surgery was observed,and some nasal mucosa was clamped during and after surgery for laboratory test.To explore the superiority of Huazhuoshengxin ointment in the treatment of epithelialization after operation of chronic sinusitis.lt lays a foundation for clinical application and further study of the oil.Methods:From September 2016 to May 2018,40 patients with CRS diagnosed in otorhinolaryngology Department of our hospital and undergoing functional endoscopic sinus surgery were selected.According to the principle of synchronization and randomization,the patients were divided into two groups:the control group(20 cases)was treated with general dressing change plus Western medicine,and the treatment group(20 cases)was treated with Huazhuo Shengxin Ointment and Western medicine after operation.The control group received Messer-Klinger operation under general anesthesia,and routine treatment was used for perioperative medication and post-operative dressing change.The treatment group was the same as the control group in operation mode,perioperative systemic medication,nasal irrigation and dressing change time.The nasal cavity was filled with expanded sponge of Huazhuoshengxin ointment at the end of operation and removed after 2 to 3 days.Daub Huazhuo Shengxin ointment or fill Huazhuo Shengxin ointment gauze in operation cavity every time.Endoscopic observation and cavity cleaning time:4 weeks,8 weeks and 12 weeks after Operation-Objective efficacy evaluation Lund-Kennedy scoring method.The posterior margin of maxillary sinus ostium was selected as the sampling site during the operation.At 8 weeks after operation,the same part was selected as the sample.T-PCR was performed on the samples before and after operation.The relative expression levels of matrix metalloproteinase-2,7 and 9(MMP-2,7 and 9)in related samples were detected.The data were collected and collated.SPSS 20.0 software was used for statistical analysis and comparison to evaluate the clinical efficacy and the relative expression of target mRNA in the two groups.Results:(1)There was no significant difference in the total score of 8 weeks after operation and nasal leakage at 12 weeks after operation(P>0.05).The polyp score and total score of the two groups at three time points were significantly lower than those before operation(P<0.05).It can be concluded that FESS has a definite effect on patients with chronic rhinosinusitis accompanied by polyps.(2)The relevant items before and after 4,8 and 12 weeks were counted and compared.In the treatment group,edema,polyps,rhinorrhea,scars and scabs,as well as the total scores were significantly lower than those in the control group.The difference was statistically significant(P<0.001);(3)Edema and rhinorrhea in the two groups decreased 4 weeks after operation.There was statistical significance(P<0.001).It is suggested that the physical of surgical instruments may easily lead to short-term mucosal edema and rhinorrhea in the operative cavity;(4)Compared with the control group,the scores of polyps,scabs,scars and total scores in the treatment group were significantly lower than those in the control group,and the scores of edema and rhinorrhea decreased significantly from 4 to 8 weeks after operation compared with those in the control group(P<0.05);(5)There were 0 cases in the two groups with grade 1 and grade 2 at 4 weeks after operation.(0%)and 20 cases(100%)in the two groups reached grade 3.It is suggested that western medicine combined with Huazhuoshengxin ointment has no significant effect on promoting epithelialization in 4 weeks after operation compared with the control group.The grade 3 epithelialization rates of the control group and the treatment group were 11 cases(55%)and 2 cases(10%)at 8 weeks after operation,6 cases(30%)and 1 case(5%)at grade 2,17 cases(85%)in the treatment group and 3 cases(15%)at grade 1 in the control group(P<0.05).It is suggested that Huazhuo Shengxin Ointment has obvious epithelialization promoting effect in 4 weeks to 8 weeks after operation compared with western medicine treatment,and reaches the first-grade epithelialization stage earlier than routine dressing change of Western medicine.The comprehensive curative effect of the two groups reached the maximum at the 12th week after operation(P<0.05),and the grade 3 epithelialization rate was 0%.The difference of grade 1 epithelialization control rate between the treatment group and the control group was larger,and the variation rate was greater than that of the general western medicine treatment and the 8 weeks after dressing change(P<0.05).It is suggested that Huazhuo Shengxin Ointment can exert the maximum effect of promoting epithelial chemotherapy within 4 to 8 weeks after operation,which is more obvious than that of common dressing change.(6)The relative expression of MMP2,7 and 9 in the treated group was significantly lower than that in the control group(P<0.05).Conclusion:Huazhuo Sheng?xin ointment has a definite curative effect It can reduce the occurrence of new pathological changes after endoscopic sinus surgery,reduce edema,rhinorrhea and scab skin,reduce the for:mation of scars in nasal cavity,inhibit the remodeling of nasal mucosa,accelerate epithelialization and improve the curative effect after FESS.Its own fragrance,no obvious adverse reactions.This study confirms the application of Huazhuoshengxin ointment after CRS operation,which is worth further study. |
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