目的 探讨千柏鼻炎片联合罗红霉素治疗慢性鼻窦炎的临床疗效。方法 纳入2022年2月—2025年1月西藏自治区人民医院收治的120例慢性鼻窦炎患者，按随机数字表法分为对照组和治疗组，每组各60例。对照组给予罗红霉素片口服治疗，150 mg/次，早晚各1次。治疗组患者在此基础上口服千柏鼻炎片治疗，4片/次，3次/d。两组疗程2周。观察两组临床疗效，比较治疗前后主观量表[鼻腔鼻窦结局测试-20（SNOT-20）、嗅觉障碍生活质量负陈述调查问卷（QOD-NS）、症状自评量表（SCL-90）]评分、客观量表评分[鼻内镜检查Lund-Kennedy和鼻窦CT检查Lund-Mackay评分]、中性粒细胞与淋巴细胞比值（NLR）和血清白细胞介素-17（IL-17）、嗜酸性粒细胞阳离子蛋白（ECP）、高迁移率族蛋白1（HMGB1）水平。结果 治疗组总有效率是95.00%，显著高于对照组的83.33%（P＜0.05）。治疗后，两组SNOT-20、SCL-90评分均较前显著降低，QOD-NS评分均增加（P＜0.05）；治疗后，治疗组主观量表评分优于对照组（P＜0.05）。治疗后，两组Lund-Kennedy、Lund-Mackay评分均降低（P＜0.05）；治疗后，治疗组客观量表评分低于对照组（P＜0.05）。治疗后，两组NLR和血清IL-17、ECP、HMGB1水平均显著下降（P＜0.05），且治疗组低于对照组（P＜0.05）。结论 慢性鼻窦炎应用千柏鼻炎片联合罗红霉素治疗有较好疗效，能进一步调控患者机体的免疫炎症反应，减轻病变严重程度和嗅觉障碍，利于整体疗效提升及身心健康状态好转。

Objective To investigate the clinical efficacy of Qianbai Biyan Tablets combined with roxithromycin in treatment of chronic sinusitis. Methods A total of 120 patients with chronic sinusitis admitted to People’s Hospital of Xizang Autonomous Region from February 2022 to January 2025 were included and divided into control group and treatment group according to random number table method, with 60 cases in each group. Patients in control group were po administered with Roxithromycin Tablets, 150 mg/time, once in morning and once in evening. Patients in treatment group were treated with oral Qianbai Biyan Tablets on the basis of control group, 4 tablets/time, three times daily. The treatment course for both groups is two weeks. The clinical efficacy of two groups was observed, and the scores of subjective scales [Nasal and Paranasal Sinus Outcome Test -20 (SNOT-20), Negative Statement of Quality of Life Questionnaire for Olfactory Disorders (QOD-NS), Symptom Checklist 90 (SCL-90)] and objective scales [Lund-Kennedy score of nasal endoscopy and Lund-Mackay score of paranasal sinus CT], the neutrophil-to-lymphocyte ratio (NLR) and the levels of serum interleukin-17 (IL-17), eosinophil cationic protein (ECP), and high mobility group protein 1 (HMGB1) in two groups before and after treatment were compared. Results The total effective rate of the treatment group was 95.00%, significantly higher than that of the control group (83.33%, P < 0.05). After treatment, the SNOT-20 and SCL-90 scores of both groups were significantly lower than before, and the QOD-NS scores were increased (P < 0.05). After treatment, the subjective scale score of the treatment group was better than that of the control group (P < 0.05). After the treatment, the Lund-Kennedy and Lund-Mackay scores of both groups decreased (P < 0.05). After treatment, the objective scale score of the treatment group was lower than that of the control group (P < 0.05). After treatment, the levels of NLR and serum IL-17, ECP, and HMGB1 in both groups decreased significantly (P < 0.05), and those in the treatment group were lower than those in the control group (P < 0.05). Conclusion The application of Qianbai Biyan Tablets combined with roxithromycin has a relatively good therapeutic effect in treatment of chronic sinusitis, and can further regulate the immune inflammatory reaction of patients, reduce the severity of lesions and olfactory dysfunction, which is conducive to the improvement of the overall curative effect and physical and mental health.

R976

西藏自治区自然科学基金组团式援藏医学项目[XZ2024ZR-ZY026(Z)]