【目的】 分析益气通窍饮（玉屏风散加味）对慢性鼻-鼻窦炎（CRS）鼻内镜术后患者的鼻黏膜功能恢复及复发率的影响。 【方法】 选取2022年6月~2023年12月在陕西中医药大学附属医院就诊的CRS鼻内镜术后肺脾气虚证患者116例，采用随机 数字表法将患者随机分为对照组和观察组，每组各58例。对照组给予常规康复方案治疗，观察组在常规康复方案基础上加 用益气通窍饮治疗，疗程为1个月并随访6个月。观察2组患者术前与术后1个月中医证候积分、鼻黏膜纤毛功能、嗅觉功 能的变化情况，评估2组患者的临床疗效和复发情况。【结果】（1）脱落情况方面，2组患者均能完成全部疗程的治疗，但随访 过程中对照组脱落 2 例、观察组脱落 3 例。（2）疗效方面，治疗 1 个月后，观察组的总有效率为 96.55%（56/58），对照组为 82.76%（48/58），组间比较（χ2 检验），观察组的疗效明显优于对照组（P＜0.05）。（3）中医证候积分方面，术后1个月，2组患者 的流脓涕、鼻塞、嗅觉减退、鼻黏膜充血积分均较治疗前降低（P＜0.05），且观察组的降低幅度均明显优于对照组（P＜0.05 或P＜0.01）。（4）鼻黏膜纤毛功能方面，术后1个月，2组患者的纤毛清除速度、纤毛清除率均较术前改善（P＜0.05），且观察 组的改善幅度均明显优于对照组（P＜0.05或P＜0.01）。（5）嗅觉功能方面，术后1个月，2组患者的嗅觉功能评分均较术前改 善（P＜0.05），且观察组的改善幅度明显优于对照组（P＜0.01）。（6）复发率方面，观察组的复发率为2.04%（1/49），明显低于 对照组的21.05%（8/38），组间比较，差异有统计学意义（P＜0.05）。【结论】 益气通窍饮干预有利于促进CRS鼻内镜术后患者 的鼻黏膜功能恢复，改善嗅觉功能，降低复发率，加快患者术后恢复。

Objective To observe the effects of Yiqi Tongqiao Decoction （composed of Yupingfeng San with additions） on nasal mucosal function recovery and recurrence rate in patients with chronic rhinosinusitis （CRS） after endoscopic sinus surgery. Methods A total of 116 CRS patients with lung-spleen qi deficiency syndrome who have undergone endoscopic sinus surgery at the Affiliated Hospital of Shaanxi University of Chinese Medicine from June 2022 to December 2023 were enrolled. The patients were randomly divided into control group and observation group using a random number table， with 58 patients in each group. The control group received conventional rehabilitation treatment，while the observation group received Yiqi Tongqiao Decoction in addition to conventional treatment. The two groups were treated for 1 month and then were followed-up for 6 months. Before operation and one month after operation，we observed changes in traditional Chinese medicine （TCM） syndrome scores，nasal mucociliary function，and olfactory function of the patients in the two groups. After treatment，clinical efficacy and recurrence rates in the two groups were evaluated. Results （1） All patients completed the full treatment course， but 2 patients from the control group and 3 patients from the observation group were lost to follow-up.（2）After treatment for one month，the total effective rate of the observation group was 96.55% （56/58），and that of the control group was 82.76%（48/58），and the therapeutic efficacy of the observation group was significantly better than that of the control group （tested by chi-square test，P＜0.05）.（3）One month after operation，both groups showed significant reductions in the scores of TCM syndrome of nasal purulent discharge， nasal obstruction， hyposmia，and nasal mucosal congestion compared to that before operation （P＜0.05），with greater reductions in the observation group （P＜0.05 or P＜0.01）.（4） One month after operation，both groups showed improvement in the speed of mucociliary transport and mucociliary clearance rate compared to that before operation（P＜0.05）， with greater improvement in the observation group （P＜0.05 or P＜0.01）.（5） One month after operation，both groups showed improvement in the olfactory function score compared to that before operation（P＜0.05）， with significantly greater improvement in the observation group（P＜0.01）.（6） The observation group had significantly lower recurrence rate （2.04%，1/49） than the control group （21.05%，8/38），the difference being statistically significant（P＜0.05）. Conclusion Yiqi Tongqiao Decoction is helpful for promoting nasal mucosal function recovery，improving olfactory function，reducing recurrence rate，and accelerating postoperative recovery of CRS patients after endoscopic sinus surgery.

R276.1

国家自然科学基金资助项目（编号：81874495）