Modified Jiegeng Yuansentang Combined with Conventional Therapy Improves Postoperative Mucosal Edema of Chronic Rhinosinusitis Patients with Nasal Polyps and Its Mechanism of Action / 中国实验方剂学杂志

ABSTRACT

Objective:To explore the curative effect and mechanism of modified Jiegeng Yuansentang combined with conventional therapy for postoperative mucosal edema in patients with cchronic rhinosinusitis with nasal polyps due to pulmonary Qi stagnation， and to explore its mechanism of action. Method:The 90 patients were randomly divided into control group and observation group， 45 cases in each group.All patients were given conventional therapy after nasal endoscopy.Patients in control group were also given mometasone furoate combined with clarithromycin， and patients in observation group were given modified Jiegeng Yuansentang for internal administration and local irrigation.The course of the treatment was 6 weeks.The sino nasal outcome test-20 （SNOT-20）， nasal situation Lund-Kennedy， rhinoconjunctivitis quality of life questionnaire （RQLQ）， traditional Chinese medicine （TCM） syndrome， serum and nasal secretions inflammatory cytokines ［tumor necrosis factor-alpha （TNF-<italic>α</italic>）， interleukin-1<italic>β</italic> （IL-1<italic>β</italic>）， interleukin-5 （IL-5），interleukin-17 （IL-17）］， serum protein ［aquaporin-1 （AQP-1）， aquaporin-3 （AQP-3）， aquaporin-5 （AQP-5）， fibronectin （Fn）］ were observed before and after treatment in two groups.The clinical symptoms， safety and recurrence after a follow-up of 12 months were compared between two groups. Result:The total effective rate was 97.73% （43/44） in observation group， which was higher than 80.95% （34/42） in control group （<italic>χ</italic>²=4.726， <italic>P</italic><0.05）.The patients were followed up for at least 12 months， and the recurrence rate was 4.65% （2/43） in observation group， which was lower than 32.35% （11/34） in control group （<italic>χ</italic>²=4.129， <italic>P</italic><0.05）.Compared with control group after treatment， the SNOT-20， Lund-Kennedy， RQLQ， TCM syndrome， TNF-<italic>α</italic>， IL-1<italic>β</italic>， IL-5， IL-17， AQP-5 were significantly decreased in observation group （<italic>P</italic><0.05）， while AQP-1， AQP-3， Fn were significantly increased in observation group （<italic>P</italic><0.05）.The incidence of adverse reactions was 2.27% （1/44） in observation group， lower than 57.14% （24/42） in control group （<italic>χ</italic>²=5.243， <italic>P</italic><0.05）. Conclusion:Modified Jiegeng Yuansentang can significantly improve postoperative mucosal edema in patients with chronic rhinosinusitis with nasal polyps due to pulmonary Qi stagnation， and the mechanism may be related to the regulation of inflammatory factors in serum and nasal secretions.