桂枝加黄芪汤对肺气虚寒型变应性鼻炎的疗效及部分机制分析
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摘要
目的:观察桂枝加黄芪汤对肺气虚寒型变应性鼻炎的临床疗效,并探讨其部分作用机制。方法:选取2012年1月至2014年6月我院收治的134例肺经寒型变应性鼻炎患者纳入研究,随机分为对照组和观察组,每组67例。其中对照组患者接受常规曲安奈德鼻喷剂法,1次/d,患者接受与对照组相同的常规治疗方法,同时加服桂枝加黄芪汤加减,1剂/d,分2次,100 m L/次,温服,所有患者均治疗3个疗程,每个疗程为20 d,比较治疗前后患者鼻部症状评分、外周血T淋巴细胞亚群水平变化。结果:1)经过治疗后其中观察组临床总有效率为90.79%,与对照组的73.68%比较,差异有统计学意义(P<0.05)。观察组优于对照组。针对临床症状评分方面,2组治疗后临床症状平均均有所下降,其中观察组下降的趋势更为明显;2)对照组治疗后CD4~+、CD4~+/CD8~+升高,但与治疗前比较差异无统计学意义(P>0.05),治疗组治疗后CD4~+、CD4~+/CD8~+升高,且与治疗前比较,差异有统计学意义(P<0.05);治疗后2组的CD8~+均相比之前下降(均P<0.05);治疗后治疗组和对照组的CD4~+、CD8~+、CD4~+/CD8~+组间比较差异有统计学意义(P<0.05),治疗组改善优于对照组。3)与治疗前比较,2组治疗后患者的Ig A、Ig G、Ig M表达水平均明显降低(P<0.05);2组患者治疗后相比,观察组的Ig A、Ig G、Ig M表达水平明显低于对照组(P<0.05)。结论:黄芪加桂枝汤对肺气虚寒型变应性鼻炎性反应状有明显改善症状,与其作用机制可能与改善患者免疫力有关。
Objective: To observe the curative effect of Huangqi Decoction added with Guizhi on allergic rhinitis of lung qi weak and cold pattern and to discuss its certain mechanism. Methods: A hundred and thirty-four patients with allergic rhinitis of lung qi weak and cold pattern in the hospital from January 2012 to June 2014 were included into the study and randomly divided into the control group and the observation group with 67 cases in each group. The patients of the control group received conventional triamcinolone acetonide nasal spray method once a day,while the patients in the observation group received the same conventional treatment methods as the control group and additionally took modified Huangqi Decoction added with Guizhi twice a day with 100 m L warm solution. All the patients received three courses of treatment,with 20 days for each course of treatment. Nasal symptom scores and T lymphocyte subsets level changes in peripheral blood of patients before and after the treatment were compared. Results: 1) The clinical total effective rate in the control group after treatment was73. 68% and 90. 79% in the observation group and the comparison of the two groups showed statistically significant differences( P < 0. 05). The observation group was better than the control group. The clinical symptom scores and clinical symptoms in both the two groups decreased after treatment and the downward trend in the observation group was more obvious. 2) CD4~+,CD4~+/ CD8~+increased in the control group after treatment,but there were no statistically significant differences compared with that before the treatment( P > 0. 05). CD4~+,CD4~+/ CD8~+increased in the treatment group after treatment,showing obvious statistically significant differences compared with that before the treatment( P < 0. 05); CD8~+in the two groups after treatment decreased compared with those before the treatment( P < 0. 05).The comparison between the treatment group and control group in CD4~+,CD8~+,CD4~+/ CD8~+after treatment showed statistic differences( P < 0. 05) and the improvement of the treatment group were better than that of the control group. 3) The expressions of Ig A,Ig G and Ig M of the patients in the two groups after treatment were significantly reduced( P < 0. 05) and the expression level of Ig A,Ig G,Ig M in the observation group were lower than that in the control group( P < 0. 05). Conclusion: Huangqi Decoction added with Guizhi may improve allergic rhinitis symptoms significantly in lung qi weak and cold type and its mechanism may related to the improvement of patients' immunity.
Objective: To observe the curative effect of Huangqi Decoction added with Guizhi on allergic rhinitis of lung qi weak and cold pattern and to discuss its certain mechanism. Methods: A hundred and thirty-four patients with allergic rhinitis of lung qi weak and cold pattern in the hospital from January 2012 to June 2014 were included into the study and randomly divided into the control group and the observation group with 67 cases in each group. The patients of the control group received conventional triamcinolone acetonide nasal spray method once a day,while the patients in the observation group received the same conventional treatment methods as the control group and additionally took modified Huangqi Decoction added with Guizhi twice a day with 100 m L warm solution. All the patients received three courses of treatment,with 20 days for each course of treatment. Nasal symptom scores and T lymphocyte subsets level changes in peripheral blood of patients before and after the treatment were compared. Results: 1) The clinical total effective rate in the control group after treatment was73. 68% and 90. 79% in the observation group and the comparison of the two groups showed statistically significant differences( P < 0. 05). The observation group was better than the control group. The clinical symptom scores and clinical symptoms in both the two groups decreased after treatment and the downward trend in the observation group was more obvious. 2) CD4~+,CD4~+/ CD8~+increased in the control group after treatment,but there were no statistically significant differences compared with that before the treatment( P > 0. 05). CD4~+,CD4~+/ CD8~+increased in the treatment group after treatment,showing obvious statistically significant differences compared with that before the treatment( P < 0. 05); CD8~+in the two groups after treatment decreased compared with those before the treatment( P < 0. 05).The comparison between the treatment group and control group in CD4~+,CD8~+,CD4~+/ CD8~+after treatment showed statistic differences( P < 0. 05) and the improvement of the treatment group were better than that of the control group. 3) The expressions of Ig A,Ig G and Ig M of the patients in the two groups after treatment were significantly reduced( P < 0. 05) and the expression level of Ig A,Ig G,Ig M in the observation group were lower than that in the control group( P < 0. 05). Conclusion: Huangqi Decoction added with Guizhi may improve allergic rhinitis symptoms significantly in lung qi weak and cold type and its mechanism may related to the improvement of patients' immunity.
引文
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[13]张军,张敏,崔勤.中西药联合治疗变应性鼻炎200例[J].现代中西医结合杂志,2011,20(21):2675-2676.
[14]汪国恩,赵凯维,王乐,等.中医药治疗过敏性鼻炎的现状与展望[J].亚太传统医药,2014,10(1):32-34.
[2]李鸣婧,张晓阳.T淋巴细胞及细胞因子与变应性鼻炎发病机制的关系[J].医学研究杂志,2012,41(4):175-177.
[3]Huang SK,Ho YL,Chang YS.Prescriptions of traditional Chinese medicine,western medicine,and integrated Chinese-Western medicine for allergic rhinitis under the National Health Insurance in Taiwan[J].J Ethnopharmacol,2015,173:212-6.
[4]赵翠青.中西医结合治疗肺气虚寒型常年性变应性鼻炎疗效观察[J].中国中西医结合耳鼻咽喉科杂志,2013,21(4):297-298.
[5]李鸣婧.200例变应性鼻炎的中医临床证型调查[D].哈尔滨:黑龙江中医药大学,2011.
[6]李深良.中西医结合治疗变应性鼻炎30例临床观察[J].中医药导报,2008,14(3):50-50,53.
[7]张雪梅,李海,胡云峰.中西医结合治疗变应性鼻炎103例[J].山东中医药大学学报,2004,28(4):290-290.
[8]Wang Y,Chen S,Wang P,et al.Comparison of clinical effectiveness of acupuncture and a Western drug on allergic rhinitis:study protocol for a randomized controlled trial[J].J Tradit Chin Med,2014,34(3):254-260.
[9]Kim BY,Park HR,Jeong HG,et al.Berberine reduce allergic inflammation in a house dust mite allergic rhinitis mouse model[J].Rhinology,2015,53(4):353-358.
[10]Liu Y,Shi J,Chen X.Identification of novel targets for seasonal allergic rhinitis during and outside the pollen season by microarray analysis[J].Acta Otolaryngol,2015,135(12):1330-1336.
[11]He S,Li Y,Chen J.Integrated traditional Chinese and Western medicine clinical research for the treatment of allergic rhinitis in children[J].Journal of Clinical Otorhinolaryngology Head And Neck Surgery,2014,28(23):1888-1890.
[12]Li X,Zhang Q,Jiang L,et al.Clinical effect of catgut implantation at acupoints for allergic rhinitis:study protocol for a randomized controlled trial[J].Trials,2013,14:12.
[13]张军,张敏,崔勤.中西药联合治疗变应性鼻炎200例[J].现代中西医结合杂志,2011,20(21):2675-2676.
[14]汪国恩,赵凯维,王乐,等.中医药治疗过敏性鼻炎的现状与展望[J].亚太传统医药,2014,10(1):32-34.