| [Objective]:To observe the effect of chinese herbal medicine(CHM) therapy to chronic nasal sinusitis or nasal polyps (ⅡandⅢ)patients after endoscopic sinus surgery(ESS), improve the condition in the clinical symptom, physical sign,cleaning tiame and epithelization time in nasal cavity after ESS, put out preliminary assessment for its therapeutic effect and look for the regularity of the syndromes Differentiastion.[Methods]:52 (100 nasal and sinus cavities) chronic nasal sinusitis or nasal ployps in-patients from the first affiliated hospital of Guangzhou University of TCM were randomly allocated to treatment group(n=26, 50 nasal and sinus cavities)and control group(n=26, 50 nasal and sinus cavities) from 2006. 6 to 2007. 2. All the cases were administrated with the treatment plan refer to xu-geng's, herbal drug was add to treatment group post operation for at least 8 weeks, and control group without herbal drug. We summarized to 2 syndromes in these patients as followed: syndrome of damp and heat on the gallbladder,lung and spleen-stomach, syndrome of splenasthenic fluid-retention. endoscope examine was done each week during the first 4 weeks and each two or four weeks during the last after operation, and The TCM syndrome type, the clean of nasal and sinus cavity, mucosa edema, vesicles, granulation tissue, mini-polyps, fibrous hyperplasia, and complete epithelization etc was recorded. 3 month later the therapy effect was evaluated separately reference to the Haikou's standard in 1997, according to amendment percentage in pretherapy and post-treatment syndrome,physical sign sum scoring.[Results]:1. There were significant difference between the two groups(P＜0.05)on the time of the clean of nasal and sinus cavity, the lasting time of vesicles and mucosa edema, the time of complete epithelization(P＜0.05). And somewhat sublime between the two groups(P＜0.05)on the clinical symptom as well as nasal objective sign after splanchnoscopy, however, There were no statistics difference between the two groups(P＞0.05)on the curative effect during 3 months. This is to be followed-up visit and observation further.2. The Curative effect between the 2 syndromes show that: the 2 syndromes of damp and heat on the gallbladder,lung and spleen-stomach was higher than syndrome of splenasthenic fluid-retention, is 67.31％and 32.69％respectively, carrid on the covariance, by x~2 test, the 2 syndromes show no different Curative effect(9＞0.05).3. The time of the deficiency of vital energysubordinate,syndrome of blood stasis and the subordinate syndrome of excessive dampness in treatment group show that the lasting time was shorter than the control group(P＜0.05).[Conclusions]:1. Chinese herbal medicine(CHM) therapy may release the discomfort syndrome in region and the whole body, and promote the cleaning of nasal and sinus cavity, and complete epithelization, particularly in stageⅡandⅢ. Chinese herbal medicine(CHM) shows the advantage on its all round treatment.2. We found some unvarying regularity of the syndrome changes in recovery phase of ESS between two groups. The first 2 weeks after operation most patients showed the deficiency of vital energy,subordinate syndromes of blood stasis and subordinate syndromes of moist; The stage of active mucous membrane regenerating, Most cases combining deficiency of vital energy with splenic asthenia, and did not change the main syndromes after the therapy 3 months late. There was statistic difference between the 2 groups on the days of the deficiency of vital energy,the subordinate syndrome of blood stasis stage and the subordinate syndrome of excessive dampness stage due to weekness of the spleen, treatment group showed the less time than the control group. |
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