Effects of different doses of glucocorticoids in the treatment of patients with eosinophilic chronic rhinosinusitis and nasal polyps
Objective To investigate the effect of different doses of glucocorticoids on nasal mucosa repair and recurrence in patients with eosinophilic chronic rhinosinusitis and nasal polyps after FESS.Methods A total of 120 patients with chronic rhinosinusitis and nasal polyps were selected,all received FESS surgery,and were divided into a low-dose group(15 mg/d)and a high-dose group(30 mg/d)according to the difference in the dose of glucocorticoids used after surgery.60 cases in each group.All had continuous treatment for 2 weeks and follow-up observation for 6 months.The clinical efficacy,visual analogue scale(VAS)of subjective symptoms,nasal mucociliary clearance function before and after treatment,and the recurrence rate during the follow-up period were compared between the two groups.Results After treatment,the total clinical effective rate in the high-dose group was higher than that in the control group;compared with preoperative,TGF-β1 and VEGF decreased,the mucociliary clearance rate significantly increased,and the saccharin clearance time shortened in the two groups 2 weeks after the operation.2 weeks after operation,various indexes of nasal mucosa repair in the high-dose group were better than those in the low-dose group;2 weeks after operation,the symptom scores in both groups were lower than those before operation,and the high-dose group was lower than the low-dose group(P＜0.05);At 3 and 6 months after operation,there was no significant difference in the recurrence rate between the low-dose group and the high-dose group(all P＞0.05).Conclusion High-dose glucocorticoid therapy after FESS surgery can effectively relieve the clinical symptoms of patients and promote the repair of nasal mucosa.The short-term effect is significant,but the long-term recurrence rate is not significantly reduced.
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