鼻渊通窍颗粒对行鼻息肉切除术患者术后的影响

魏永佳 王士雨 范珍 闫赋琴

摘要 目的：探討鼻渊通窍颗粒对行鼻息肉切除术患者术后的影响。方法：选取2019年5月至2020年8月黑龙江省医院耳鼻喉科首次收治的初发鼻息肉患者84例作为研究对象，按照患者术后是否接受鼻渊通窍颗粒治疗分为对照组（n=39）与观察组（n=45）。对照组患者术后接受常规治疗，观察组患者在对照组的基础上同时接受鼻渊通窍颗粒治疗，对2组患者治疗后临床症状积分、生命质量评分、相关因子水平及预后效果进行比较。结果：治疗后，观察组的临床症状评分、生命质量评分与对照组比较，差异有统计学意义（P<0.05）;治疗后组间嗜酸性粒细胞（EOS）计数比较，差异有统计学意义（P<0.01）;治疗前后观察组的IgA、IgM比较，差异有统计学意义（P<0.01）;治疗后，2组的miRNA-125b、miRNA-34a平均表达水平降低，2组比较差异有统计学意义（P<0.01）;对照组复发率为21.05%，观察组复发率6.67%，2组比较差异有统计学意义（χ2=10.233，P<0.01）。结论：鼻渊通窍颗粒可通过介导患者的miRNA-125b、miRNA-34a水平，影响嗜酸性粒细胞及IgA、IgM水平，从而降低术后复发概率。

关键词 鼻渊通窍颗粒;鼻息肉;预后;临床效果;生命质量;临床对照试验

Effects of Biyuan Tongqiao Granules on Patients Undergoing Nasal Polypectomy

WEI Yongjia1，WANG Shiyu2，FAN Zhen2，YAN Fuqin3

（1 Department of Otolaryngology，Heilongjiang Provincial Hospital，Harbin 150000，China; 2 State Key Experiment on Generic Technology of TCM Pharmacy， Linyi 276006， China; 3 General Hospital of the Chinese People′s Liberation Army，Beijing 100039，China）

Abstract Objective：To observe the therapeutic mechanism and prognostic effect of Biyuan Tongqiao Granules on patients undergoing nasal polypectomy.Methods：A total of 84 patients with first-onset nasal polyps who were treated for the first time in the Otolaryngology Department of Heilongjiang Provincial Hospital from May 2019 to August 2020 were selected as the research objects and were divided into a control group and an observation group according to whether the patients received Biyuan Tongqiao Granules treatment after surgery; the clinical symptom score，quality of life score，level of related factors and prognostic effect evaluation of the 2 groups of patients.Results：After treatment，the difference in clinical symptom scores and quality of life scores between the control group and the observation group was statistically significant（P<0.05）; there was a very significant difference in EOS between the groups after treatment（P<0.01）; the comparison of IgA and IgM in the observation group before and after treatment was statistically significant（P<0.01）; after treatment，the average expression levels of miRNA-125b and miRNA-34a in the control group and the observation group decreased，and the differences between the groups were statistically significant（P<0.01）; the recurrence rate of the control group was 21.05%，and the recurrence rate of the observation group was 6.67%.The difference in the recurrence rate between the 2 groups was statistically significant（χ2=10.233，P<0.01）.Conclusion：Biyuan Tongqiao Granules can mediate the levels of miRNA-125b and miRNA-34a in patients and affect the levels of eosinophils and IgA and IgM，thereby reducing the probability of postoperative recurrence.

Keywords Biyuan Tongqiao Granules; Nasal Polyps; Prognosis; Clinical effect; Quality of life; Clinical controlled trial

中图分类号：R276.1文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.16.020

鼻息肉是一种鼻腔或鼻窦黏膜组织的增生现象，多为良性。其主要是因反复感染、药物过敏、免疫紊乱等因素造成的长期炎症，如鼻窦炎，而可能导致鼻黏膜增生，即为鼻息肉[1]。鼻息肉发病早期可通过药物治疗来有效缩小或消除病变，当息肉体积过大或多个聚集时，可对患者造成呼吸困难，嗅觉障碍等严重影响，手术切除是唯一治疗方式，但复发的概率非常高[2-3]。

鼻窦炎-鼻息肉属于中医“鼻渊”的范畴，对于急鼻渊（急性鼻窦炎）多由感受外邪而致，多属实症，治疗以疏风清热，芳香排脓为主，以解毒去瘀为辅[4-5]。鼻渊通窍颗粒来源于中医治疗鼻病的古方“苍耳子散”，由辛夷、炒苍耳子、麻黄、白芷、薄荷、藁本、黄芩、连翘等组方而成，具有疏……