郑晶琼　虞义建　潘兆虎

[摘要] 目的 探讨舍雷肽酶肠溶片治疗慢性鼻窦炎疾病肿胀的临床疗效及安全性。 方法 纳入172例慢性鼻窦炎患者，均具有完整的临床资料，收集时间为2014年10月～2016年10月。按照就诊顺序进行分组，分为对照组（85例）和观察组（87例），分别给予克拉霉素治疗和克拉霉素联合舍雷肽酶肠溶片治疗。观察两组治疗前后的临床症状和体征评分及生活質量评分，判定疗效并记录不良反应情况。 结果 治疗后两组患者的临床症状和体征评分与本组治疗前进行比较，均出现显著下降，差异有统计学意义（P<0.05），且治疗后观察组评分显著低于对照组，组间比较差异有统计学意义（P<0.05）；观察组显效50例，有效31例，总有效率为93.10%，显著高于对照组的82.35%（P<0.05）；治疗前与治疗后不同时间分别对两组患者进行鼻腔鼻窦结局测量20条（SNOT-20）评分比较，与本组治疗前比较，治疗后1个月、2个月、3个月评分均出现显著的下降（P<0.05），且治疗后不同时间点观察组评分显著低于对照组，组间比较差异有统计学意义（P<0.05）；研究过程中两组患者均未出现不良反应。 结论 对慢性鼻窦炎患者实施舍雷肽酶肠溶片治疗可以有效改善患者的临床肿胀等症状，提高治疗效果以及患者的生活质量，且无不良反应，是一种安全有效的治疗方案。

[关键词] 慢性鼻窦炎；舍雷肽酶肠溶片；肿胀；安全性

[中图分类号] R765.4 [文献标识码] B [文章编号] 1673-9701（2017）12-0084-04

[Abstract] Objective To investigate the clinical efficacy and safety of serrapeptase enteric-coated tablets on swelling of chronic sinusitis. Methods A total of 172 patients with chronic sinusitis were included in the treatment， and all had complete clinical data collected from October 2014 to October 2016. The patients were divided into control group（n=85） and observation group（n=87）， according to the order of treatment. The control group was treated with clarithromycin and the observation group was given clarithromycin combined with serrapeptase enteric-coated tablets. The clinical symptoms and signs scores and quality of life scores in the two groups before and after treatment were observed to determine the efficacy and record adverse reactions. Results The scores of clinical symptoms and signs in patients of the two groups after treatment were significantly lower than those before treatment， and there was statistically significant difference（P<0.05）. There was statistical difference in the scores between the two groups after treatment（P<0.05）. And the scores of the observation group were significantly lower than those of the control group. By determining the efficacy， 50 cases were cured， 31 cases were effective in the control group， and the total effective rate was 93.10%， which was significantly higher than that of the control group 82.35%（P<0.05）. The sino-nasal outcome test-20 was measured respectively in the patients of two groups before treatment and at different time after treatment， and it was found that the score at 1 month， 2 months， 3 months after treatment significantly decreased compared with that of this group before treatment（P<0.05）. And there were also statistical differences between groups at different time after treatment（P<0.05）. The score of the observation group was significantly lower than that of the control group. There were no adverse reactions in both groups during the course of the study. Conclusion The serrapeptase enteric-coated tablets in the treatment of patients with chronic sinusitiscan can effectively improve the clinical symptoms such as swelling and improve the treatment effect and the quality of life of patients with no adverse reactions， which is a safe and effective treatment program.

[Key words] Chronic sinusitis； Serrapeptase enteric-coated tablets； Swelling； Safety

慢性鼻窦炎是常见的耳鼻喉科慢性疾病，病程较长，患者长期存在鼻塞、流鼻涕、鼻涕倒流、呼吸困难、嗅觉减退、头痛、咳嗽等症状，使患者注意力无法集中、记忆力减退及睡眠不足，严重影响到患者的日常生活和工作，常规治疗大多采用克拉霉素等抗生素类药物[1]。舍雷肽酶是一种酶类制剂，为沙雷氏菌属细菌所产生的蛋白分解酶口服制剂，具有多重作用，可以发挥出很强的抗炎、消肿、祛痰功效[2]。本院自2014年起尝试对慢性鼻窦炎疾病肿胀患者实施舍雷肽酶肠溶片治疗。经过一段时期的临床应用与疗效观察，效果显著，现报道如下。

1 资料与方法

1.1 一般资料

研究纳入172例慢性鼻窦炎患者，其中男92例，女80例；年龄最小19岁，最大51岁，平均（34.81±10.15 ）岁。资料收集时间为2014年10月～2016年10月。均为本院收治的住院患者，均具有完整的临床资料。……