中医序贯疗法联合鼻腔冲洗治疗儿童慢性鼻窦炎临床研究

Clinical Study of Sequential Chinese Medicine Therapy Combined with Nasal Irrigation for Chronic Rhinosinusitis in Children

摘要:

目的：观察中医序贯疗法联合鼻腔冲洗治疗儿童慢性鼻窦炎（CRS） 的临床疗效。方法：选取2022年9月—2024年9月丽水市人民医院康复医学科收治的138例CRS患儿，采用随机数字表法分为对照组和联合组各69例。对照组给予鼻腔冲洗治疗，联合组给予中医序贯疗法联合鼻腔冲洗治疗，2组疗程均为12周。评价2 组临床疗效， 比较2 组治疗前后主观症状评分［儿童版鼻窦炎专用生活质量量表（SNOT-20）、Lund-Kennedy 评分］、血清炎症指标［白细胞介素-6 （IL-6）、白细胞介素-8 （IL-8）、肿瘤坏死因子-α（TNF-α）］ 及免疫功能指标［免疫球蛋白A（IgA）、免疫球蛋白G（IgG）］，统计不良反应发生情况。结果：联合组总有效率为95.65% （66/69），高于对照组85.51% （59/69）（P＜0.05）。治疗后，2组SNOT-20评分、Lund-Kennedy 评分较治疗前降低（P＜0.05），且联合组SNOT-20 评分、Lund-Kennedy 评分低于对照组（P＜0.05）。治疗后，2组血清IL-6、IL-8、TNF-α水平较治疗前降低（P＜0.05），且联合组血清IL-6、IL-8、TNF-α水平低于对照组（P＜0.05）。治疗后，2组血清IgA、IgG水平较治疗前升高（P＜0.05），且联合组血清IgA、IgG水平高于对照组（P＜0.05）。2组不良反应发生率比较，差异无统计学意义（P＞0.05）。结论：中医序贯疗法联合鼻腔冲洗治疗儿童CRS疗效确切，可显著改善患儿临床症状，减轻炎症反应，调节机体免疫功能，提高生活质量，且安全性良好。

Abstract:

Abstract： Objective： To observe the clinical efficacy of sequential Chinese medicine therapy combined with nasal irrigation for chronic rhinosinusitis （CRS） in children. Methods：A total of 138 children with CRS admitted to the Department of Rehabilitation Medicine of Lishui People's Hospital from September 2022 to September 2024 were selected and randomly divided into a control group and a combination group using a random number table method， with 69 cases in each group. The control group received nasal irrigation， while the combination group received sequential Chinese medicine therapy combined with nasal irrigation. Both groups were treated for 12 weeks. Clinical efficacy was evaluated，and subjective symptom scores [Sino-Nasal Outcome Test-20 （SNOT-20） and Lund-Kennedy score]，serum inflammatory markers [interleukin-6（ IL-6），interleukin-8（ IL-8），tumor necrosis factor-α（TNF-α）]， and immune function indicators [immunoglobulin A （IgA） and immunoglobulin G （IgG）] were compared between the two groups before and after treatment. The incidence of adverse reactions was also recorded. Results：The total effective rate was 95.65% （66/69） in the combination group， higher than that of 85.51% （59/69） in the control group （P＜ 0.05）. After treatment， SNOT-20 scores and Lund-Kennedy scores decreased in both groups compared to before treatment （P＜0.05），and the combination group had lower scores than the control group （P＜0.05）. After treatment， serum levels of IL-6，IL-8，and TNF-α decreased in both groups compared to before treatment （P＜0.05），and the combination group had lower levels of these inflammatory markers than the control group （P＜0.05）. After treatment， serum IgA and IgG levels increased in both groups compared to before treatment （P＜0.05），and the combination group had higher levels than the control group （P＜0.05）. There was no statistically significant difference in the incidence of adverse reactions between the two groups （P＞0.05）. Conclusion： Sequential Chinese medicine therapy combined with nasal irrigation has definite efficacy in treating CRS in children. It significantly improves clinical symptoms， reduces inflammatory responses， regulates immune function， enhances quality of life， and exhibits a good safety profile.