| 1 ObjectiveIn this study,the clinical efficacy of Shengjitongqiao powder in patients with chronic rhinosinusitis after nasal endoscopic surgery was observed,and part of the patients' maxillary sinus mucosa was removed during and after surgery for laboratory index detection and pathological observation.To explore the mechanism of Shengjitongqiao powder in inhibiting postoperative scar adhesion in the operative cavity of chronic sinusitis.It provides reference for the further research of Shengjitongqiao powder.2 ResearchSixty patients with CRS who met the diagnostic criteria and the study criteria were randomly divided into control group and observation group.Sixty patients were treated with the same preoperative treatment plan.The patients in both groups were treated with the same surgical method for sinus opening,the control group was treated with expanded sponge filling,and the observation group was treated with Shengjitongqiao powder.After surgery,both groups adopted the same treatment plan and dressing change method.In the observation group,Shengjitongqiao powder was added after dressing change,and the patients were asked to suspend nasal irrigation within 24 hours.(1)Lund-Kennedy endoscopic score: the nasal polyps,edema and rhinorrhea of patients before surgery were evaluated using the Lund-Kennedy endoscopic rating scale.The polyps,edema,rhinorrhea,scab and scar adhesion were quantitatively evaluated 3weeks,6 weeks and 9 weeks after surgery.(2)Use ELISA assay to detect IL-6,IL-10,collagen type ? and collagen type? content in mucosa: remove the patient's part of the maxillary sinus mucosa,detection of two groups of patients in surgery,3 weeks and 9 weeks after surgery,the maxillary sinus mucosa of IL-6,IL-10,type ? and type ? collagen content.(3)Use the r3.6.2 software to analyze the results of Lund-Kennedy score andELISA,evaluation of the clinical curative effect of two groups of patients and patients of IL-6,IL-10,type ? and type ? collagen content and ?/?.(4)The morphological characteristics of the regenerated maxillary sinus mucosa were compared between the control group and the observation group.3 Research results(1)The scores of polyps,edema and rhinorrhea in the control group and the observation group at 3,6,9weeks after the operation were all lower than those before the operation(P<0.05),indicating the significant effect of FESS surgery.The total scores of polyps,edema,rhinorrhea in the observation group 9 weeks after surgery were significantly lower than those in the control group(P<0.05);and the scab score of the observation group 9 weeks after surgery was significantly lower than that of the control group(P<0.05).The scores of scar adhesion in the observation group at 3,6 and 9 weeks after surgery were significantly lower than those in the control group(P<0.05).(2)The expression levels of IL-6,type ? and type ? collagen and ?/? of the observation group were lower than those of the control group,and the expression of IL-10 was higher than that of the control group(P<0.05)at 3 and 9 weeks after surgery.(3)Use Pearson test method to analyze the correlation between the expression of IL-6 and the expression of type ? and type ? collagen,?/?.Use Pearson test method to analyze the correlation between the expression of IL-10 and the expression of type ?and type ? collagen,?/?.The results obtained from the analysis are all greater than0.6,indicating that there is a correlation between them.Establish regression models found that there is a positive correlation between the expression of IL-6 and the expression of type ? and type ? collagen,?/?;And there is a negative correlation between the expression of IL-10 and the expression of type ? and type ?collagen,?/?.(4)Comparison of the tissue morphology of the regenerated maxillary sinus mucosa in the control group and the observation group showed that: HE staining of the regenerated maxillary sinus mucosa in the observation group showed a relativelycomplete upper cortex,a good recovery of ciliated cells,and a mild inflammatory response.Masson staining of regenerated maxillary sinus mucosa in the observation group showed collagen deposition(blue)is low and the structure is slender.HE staining of the regenerated maxillary sinus mucosa in the control group showed cilium cell is few,inflammation response is heavy.Masson's staining showed that the regenerated maxillary sinus mucosa had more collagen deposition(blue),the collagen structure was large and irregular.4 research conclusions(1)FESS surgery has a definite effect.This study showed that the postoperative mucosal morphology score of both the control group and the observation group was lower than that before the surgery,and the clinical efficacy was obvious.(2)Shengjitongqiao powder has a good clinical effect.The results of this study suggest that,after surgery Shengjitongqiao powder was used to replace the operative cavity filling and Shengjitongqiao powder was added during the postoperative dressing change,the clinical efficacy of shengjitongqiaosan was better than that of expansive sponge,Shengjitongqiao powder in the reduction of polyp,mucosal edema,rhinorrhea,scab and scar adhesion aspects of obvious effects.(3)The mechanism of Shengjitongqiao powder inhibiting scar formation may be related to inhibiting inflammatory response,reducing collagen synthesis and regulating collagen ratio.Study found that observation group of IL-6,type ? and type ? collagen and ?/? are lower than the control group,the expression of IL-10 is higher than the control group.IL-6 and type ? and type ? collagen and ?/? was significantly positive correlation.IL-10 and type ? and type ? collagen and ?/? was significantly negative correlation.The degree of infiltration of inflammatory cells and collagen deposition in the regenerated maxillary sinus mucosa in the observation group 9 weeks after surgery was significantly lower than that in the control group. |
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