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目的:探讨玉屏风散合苍耳子散加减对慢性鼻-鼻窦炎(chronic rhinosinusitis, CRS)术后患者嗅觉功能、鼻腔通气功能、鼻黏膜纤毛功能的影响。方法:将符合入选标准的2016年1月-2019年1月南京市溧水区中医院CRS术后患者90例采用随机数字表法分为2组，每组45例。对照组术后给予布地奈德雷喷鼻剂喷鼻，左氧氟沙星胶囊口服，生理盐水冲洗鼻腔；观察组在对照组基础上服用玉屏风散合苍耳子散加减方。2组均连续治疗12周。分别于治疗前后进行鼻内镜检查量化评估，采用Lund-kennedy法进行水肿、瘢痕、结痂、鼻漏、息肉评分；检测鼻窦CT并进行窦口鼻道复合体、额窦、上颌窦、蝶窦、前后组筛窦评分；采用T&T嗅觉测试(T&T olfactometer test)对嗅觉功能进行评估；采用前鼻压测压器检测鼻腔通气功能；采用糖精实验检测鼻黏膜纤毛清除速度、黏膜纤毛清除率、糖精清除时间。记录治疗过程中患者嗅觉恢复、流涕鼻塞、囊泡消失、黏膜水肿症状缓解时间，评价临床疗效。随访6个月，记录治愈患者的复发情况。结果:观察组总有效率为91.1%(41/45)、对照组为77.8%(35/45)，2组比较差异有统计学意义(n χ2＝13.027，n P<0.01)。治疗后，观察组嗅觉恢复、流涕鼻塞、囊泡消失、黏膜水肿症状缓解时间均早于对照组(n t值分别为7.392、5.740、15.002、3.657，n P值均<0.01)；Lund-kennedy评分、鼻窦CT评分均低于对照组(n t值分别为4.273、5.740，n P值均<0.01)；嗅觉功能评分、鼻腔通气功能均低于对照组(n t值分别为-24.581、16.414，n P值均<0.001)；鼻黏膜纤毛清除速度、黏膜纤毛清除率高于对照组(n t值分别为-4.021、-12.073，n P值均<0.001)，糖精清除时间短于对照组(n t＝6.292，n P<0.01)。随访6个月，观察组复发率为4.0%(1/25)、对照组为25.0%(4/16)，2组比较差异有统计学意义(n χ2＝4.018，n P＝0.045)。n 结论:玉屏风散合苍耳子散加减可明显缓解CRS术后患者临床症状，促进嗅觉功能、鼻腔通气功能、鼻黏膜纤毛功能的恢复，且不易复发。“,”Objective:To investigate the effects of modified n Yupingfeng Powder and n Cangerzi Powder on the smell function, nasal ventilation function and nasal mucosal ciliary function in chronic rhinosinusitis (chronic rhinosinusitis, CRS) patients.n Methods:Ninety CRS patients who met the inclusion criteria from January 2016 to January 2019 in Lishui District Hospital of Traditional Chinese Medicine, were divided into two groups by random number table method, with 45 patients in each group. The control group was given budesonide nasal spray, levofloxacin capsule for oral administration, and normal saline for nasal irrigation. On the basis of the control group, the observation group was added with n Yupingfeng Powder and n Cangerzi Powder. Both groups were treated continuously for 12 weeks. The nasal endoscopy was conducted at baseline and after treatment, and the scores of edema, scar, scab, rhinorrhea and polyps were performed by the Lend-Kennedy method. The CT was used to detect the nasal sinus and score the oral and nasal meatus complex, frontal sinus, maxillary sinus, sphenoid sinus and anterior and posterior ethmoid sinus. Olfactory function was scored according to the olfactory function test developed by T&T olfactometer test. The nasal ventilation function was detected by the antrum pressure gauge. The saccharin experiment was used to detect the clearance speed, clearance rate and clearance time of nasal mucosa cilia. The patients were followed up for 6 months to observe the recurrence of the cured patients, observe and record the remission time of smell recovery, nasal congestion, disappearance of vesicles and mucosal edema during the treatment, and evaluate the clinical efficacy.n Results:The total effective rate was 91.11% (41/45) in the observation group and 77.78% (35/45) in the control group. The difference between the two groups was statistically significant (n χ2=13.027, n P<0.01). After treatment, the relief time of symptoms such as smell recovery, nasal congestion, disappearance of vesicles, and mucosal edema in the observation group were significantly shorter than those in the control group (n t=7.392, 5.740, 15.002, 3.657, all n Ps<0.001). The Lund-Kennedy score and sinus CT scores in the observation group were significantly lower than those in the control group (n t=4.273, 5.740, all n Ps<0.001). Olfactory function and nasal ventilation function scores in the observation group were significantly lower than those in the control group (n t=-24.581, 16.414, all n Ps<0.001). The clearance rate and clearance rate of nasal mucosa cilia in the observation group were significantly higher than those in the control group (n t=-4.021, -12.073, all n Ps<0.001), and the clearance time of sacsacrin was significantly shorter than that of the control group (n t=6.292, n P<0.01). After follow-up for 6 months, the recurrence rate was 4.0% (1/25) in the observation group and 25.0% (4/16) in the control group, and the difference between the two groups was statistically significant (n χ2=4.018, n P=0.045).n Conclusion:The modified n Yupingfeng Powder and n Cangerzi Powder can alleviate the clinical symptoms of patients with chronic rhinosinusitis after operation, promote the recovery of olour function, nasal ventilation function and nasal mucosal ciliary function, and is not easy to relapse.n