健脾止鼽汤治疗变应性鼻炎脾气虚弱证临床研究
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摘要
目的:探讨健脾止鼽汤治疗变应性鼻炎脾气虚弱证的疗效及对血清CC型趋化因子CCL17和CCL22水平的影响。方法:将88例变应性鼻炎患者随机分为观察组和对照组,各44例。对照组采取布地奈德鼻喷雾剂,初始剂量为每个鼻孔各1喷,早晚喷2次;症状缓解后每日每鼻喷1次,每次1喷。地氯雷他定片,口服,每天1次,每次5 mg。观察组在对照组基础上采用健脾止鼽汤治疗,每天1剂,分早晚2次口服。两组连续治疗3周。比较两组症状、生活质量评分及临床疗效。检测患者血清CC型趋化因子CCL17和CCL22水平。结果:治疗后,观察组患者活动、睡眠及鼻部症状评分显著少于对照组(P<0.01)。观察组有效率为79.55%,明显高于对照组38.64%,差异有统计学意义(P<0.01)。观察组血清CC型趋化因子CCL17和CCL22显著低于对照组(P<0.01)。结论:健脾止鼽汤治疗变应性鼻炎脾气虚弱证疗效明显,降低患者血清CC型趋化因子CCL17和CCL22可能是其作用机制之一。
Objective: To observe efficacy of Jianpi Zhiqiu decoction in treatment of allergic rhinitis with syndrome of deficiency of spleen Qi,and the role on serum levels of Chemokine CCL17( CCL17) and CCL22. Methods: 88 cases with allergic rhinitis were randomly divided into the observation group( 44 cases) and the control group( 44 cases). The control group was given budesonide nasal spray,1 sprinkle every nose and bid for initial dosage,and 1 sprinkle every nose and qd post symptomatic relief,and desloratadine tablets with qd and 5mg per time. Based on control group,the observation group was treatedwith Jianpi Zhiqiu decoction,1 dose each time and bid. 3 weeks were used to observe efficacy in both groups. Scores of symptom and life quality and efficacy were compared in both groups. Serum levels of CCL17 and CCL22 were detected in both groups. Results: After treatment,scores of symptoms and activity,sleep,and sniffle were obviously lower than those of control group( P < 0. 01). Total effective rate of observation group was 79. 55%,which was evidently higher than that of control group 38. 64%( P < 0. 01). Serum levels of CCL17 and CCL22 of observation group were remarkably lower than those of control grouip after treatment( P < 0. 01). Conclusion: Efficacy of Jianpi Zhiqiu decoction treatment of allergic rhinitis with syndrome of deficiency of spleen Qi is significant,and down-regualtion of serum levles of CCL17 and CCL22 may be one of mechanisms.
Objective: To observe efficacy of Jianpi Zhiqiu decoction in treatment of allergic rhinitis with syndrome of deficiency of spleen Qi,and the role on serum levels of Chemokine CCL17( CCL17) and CCL22. Methods: 88 cases with allergic rhinitis were randomly divided into the observation group( 44 cases) and the control group( 44 cases). The control group was given budesonide nasal spray,1 sprinkle every nose and bid for initial dosage,and 1 sprinkle every nose and qd post symptomatic relief,and desloratadine tablets with qd and 5mg per time. Based on control group,the observation group was treatedwith Jianpi Zhiqiu decoction,1 dose each time and bid. 3 weeks were used to observe efficacy in both groups. Scores of symptom and life quality and efficacy were compared in both groups. Serum levels of CCL17 and CCL22 were detected in both groups. Results: After treatment,scores of symptoms and activity,sleep,and sniffle were obviously lower than those of control group( P < 0. 01). Total effective rate of observation group was 79. 55%,which was evidently higher than that of control group 38. 64%( P < 0. 01). Serum levels of CCL17 and CCL22 of observation group were remarkably lower than those of control grouip after treatment( P < 0. 01). Conclusion: Efficacy of Jianpi Zhiqiu decoction treatment of allergic rhinitis with syndrome of deficiency of spleen Qi is significant,and down-regualtion of serum levles of CCL17 and CCL22 may be one of mechanisms.
引文
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[10]田丽,牛蔚露,许尤佳.基于数据挖掘的1979-2016年期刊文献儿童变应性鼻炎中医用药规律分析[J].中国实验方剂学杂志,2017,23(15):195-200.
[11]尹雪,任秀敏,王建星,等.IL-12细胞因子家族在变应性鼻炎中的研究进展[J].2017,临床耳鼻咽喉头颈外科杂志,31(3):237-241.
[12]冯国飞,尤慧华,王珊,等.血清趋化因子、细胞间黏附分子、嗜酸细胞阳离子蛋白及相应细胞因子在变应性鼻炎患者中的表达水平分析[J].中国卫生检验杂志,2017,27(8):1128-1130.
[13]Horak F,Puri KD,Steiner BH,et al.Randomized phase 1 study of the phosphatidylinositol 3-kinaseδinhibitor idelalisib in patients with allergic rhinitis[J].J Allergy Clin Immunol,2016,137(6):1733-1741.
[14]Yanai M,Sato K,Aoki N,et al.The role of CCL22/macrophage-derived chemokine in allergic rhinitis[J].Clin Immunol,2007,125(3):291-298.
[15]Hosoya K,Satoh T,Yamamoto Y,et al.Gene silencing of STAT6with siRNA ameliorates contact hypersensitivity and allergic rhinitis[J].Allergy,2011,66(1):124-131.
[2]王波,刘海涛.麻黄连翘赤小豆汤结合针灸治疗变应性鼻炎61例临床观察[J].中国实验方剂学杂志,2015,21(6):175-178.
[3]胡海慈,任璐璐,孙麦青.温肺健脾益气法治疗变应性鼻炎临床研究[J].中医学报,2016,31(2):279-281.
[4]徐春英,刘静,李蕾,等.中医辨证治疗变应性鼻炎的临床疗效观察[J].中国中西医结合杂志,2013,33(6):852-853.
[5]张军华,田浩,谢飞,等.针药结合治疗肺脾虚寒型变应性鼻炎临床研究[J].河南中医,2016,36(12):2208-2210.
[6]中华耳鼻咽喉头颈外科杂志编委会鼻科组,中华医学会耳鼻咽喉头颈外科学分会鼻科学组.变应性鼻炎诊断和治疗指南(2009年,武夷山)[J].中华耳鼻咽喉头颈外科杂志,2009,44(12):977-978.
[7]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:107-108.
[8]中华耳鼻咽喉头颈外科杂志编辑委员会,中华医学会耳鼻咽喉科分会.变应性鼻炎的诊治原则和推荐方案(2004年,兰州)[J].中华耳鼻咽喉头颈外科杂志,2005,40(3):166-167.
[9]罗恬,王乃平.苓桂术甘汤治疗变应性鼻炎临床研究[J].中医学报,2016,31(8):1206-1208.
[10]田丽,牛蔚露,许尤佳.基于数据挖掘的1979-2016年期刊文献儿童变应性鼻炎中医用药规律分析[J].中国实验方剂学杂志,2017,23(15):195-200.
[11]尹雪,任秀敏,王建星,等.IL-12细胞因子家族在变应性鼻炎中的研究进展[J].2017,临床耳鼻咽喉头颈外科杂志,31(3):237-241.
[12]冯国飞,尤慧华,王珊,等.血清趋化因子、细胞间黏附分子、嗜酸细胞阳离子蛋白及相应细胞因子在变应性鼻炎患者中的表达水平分析[J].中国卫生检验杂志,2017,27(8):1128-1130.
[13]Horak F,Puri KD,Steiner BH,et al.Randomized phase 1 study of the phosphatidylinositol 3-kinaseδinhibitor idelalisib in patients with allergic rhinitis[J].J Allergy Clin Immunol,2016,137(6):1733-1741.
[14]Yanai M,Sato K,Aoki N,et al.The role of CCL22/macrophage-derived chemokine in allergic rhinitis[J].Clin Immunol,2007,125(3):291-298.
[15]Hosoya K,Satoh T,Yamamoto Y,et al.Gene silencing of STAT6with siRNA ameliorates contact hypersensitivity and allergic rhinitis[J].Allergy,2011,66(1):124-131.