桂屏通窍汤联合针刺治疗过敏性鼻炎疗效观察
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摘要
目的:观察桂屏通窍汤联合针刺对过敏性鼻炎患者症状改善及血清辅助性T细胞1/辅助性T细胞2(Th1/Th2)水平的影响。方法:将94例过敏性鼻炎患者按随机数字表法分为对照组和治疗组各47例。对照组给予常规西医治疗,治疗组在对照组治疗的基础上给予桂屏通窍汤联合针刺治疗。比较两组治疗前后中医证候积分、鼻部通气功能指标[最大呼气流速(peak expiratory flow,PEF)、PEF昼夜变异率]、免疫功能指标[免疫球蛋白E(immunoglobulin,Ig E)、Th1/Th2]、炎性细胞因子[白细胞介素-4(interleukin-4,IL-4)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-ɑ(tumor necrosis factor,TNF-ɑ)]。结果:两组过敏性鼻炎患者治疗后中医证候积分较治疗前明显下降(P <0. 05),且治疗组较对照组更低(P <0. 05);对照组有效率为80. 85%,治疗组有效率为95. 74%,两组有效率比较,差异有统计学意义(P <0. 05);两组过敏性鼻炎患者治疗后PEF升高,PEF昼夜变异率下降,与治疗前比较差异均有统计学意义(P <0. 05),且治疗组治疗后PEF较对照组高,PEF昼夜变异率较对照组低,组间比较差异有统计学意义(P <0. 05);两组过敏性鼻炎患者治疗后Ig E、Th1/Th2与治疗前比较均明显降低,差异有统计学意义(P <0. 05),且治疗组治疗后Ig E、Th1/Th2低于对照组,差异有统计学意义(P <0. 05);两组过敏性鼻炎患者治疗后血清IL-4、IL-6、TNF-ɑ水平均明显降低,与治疗前比较差异有统计学意义(P <0. 05),且治疗组治疗后血清IL-4、IL-6、TNF-ɑ均低于对照组,差异有统计学意义(P <0. 05)。结论:桂屏通窍汤联合针刺治疗可以明显改善过敏性鼻炎患者临床症状,促进鼻部通气功能恢复,降低血清炎性细胞因子、Ig E、Th1/Th2水平。
Objective: To observe the effect of Guiping Tongqiao Decoction(GPTQD) combined with acupuncture on the improvement of symptoms and the level of serum helper T cell 1/helper T cell 2(Th1/Th2) in patients with allergic rhinitis. Methods:A total of 94 patients with allergic rhinitis were randomly divided into the control group and the treatment group,with 47 cases each. The control group was treated with conventional Western medicine,while the treatment group was treated with acupuncture combined with Chinese Medicinal on the basis of the control group. The scores of TCM syndromes,nasal ventilation function indexes including peak expiratory flow(PEF) and diurnal variation rate of PEF,immune function indicators including mmunoglobulin E(Ig E) and Th1/Th2,inflammatory cytokines including interleukin-4(IL-4),interleukin-6(IL-6) and tumor necrosis factor(TNF-ɑ) before and after the treatment were compared between the two groups. Results: The scores of TCM syndromes of allergic rhinitis patients in the two groups decreased significantly after treatment(P < 0. 05),and the decrease in the treatment group was more obvious than that in the control group(P < 0. 05). The effective rate was 80. 85% in the control group and95. 74% in the treatment group. There was a significant difference between the two groups(P < 0. 05). After the treatment,PEF increased and PEF diurnal variation rate decreased in allergic rhinitis patients of the two groups,and all the differences were statistically significant(P < 0. 05). PEF in the treatment group was higher than that in the control group,and PEF diurnal variation rate was lower than that in the control group,and all the differences were statistically significant(P < 0. 05). After the treatment,Ig E and Th1/Th2 of allergic rhinitis patients in the two groups were significantly lower than those before the treatment,and all the differences were statistically significant(P < 0. 05),and the Ig E and Th1/Th2 in the treatment group were lower than those in the control group,and all the differences were statistically significant(P < 0. 05). The serum levels of IL-4,IL-6 and TNF-ɑ in the two groups were significantly decreased after the treatment,and all the differences were statistically significant(P <0. 05),and the serum levels of IL-4,IL-6 and TNF-ɑ in the treatment group were lower than those in the control group,and all the differences were statistically significant(P < 0. 05). Conclusion: GPTQD) combined with acupuncture can significantly improve the clinical symptoms of allergic rhinitis patients,promote the recovery of nasal ventilation function,and reduce the levels of inflammatory cytokines,Ig E and Th1/Th2 in serum.
Objective: To observe the effect of Guiping Tongqiao Decoction(GPTQD) combined with acupuncture on the improvement of symptoms and the level of serum helper T cell 1/helper T cell 2(Th1/Th2) in patients with allergic rhinitis. Methods:A total of 94 patients with allergic rhinitis were randomly divided into the control group and the treatment group,with 47 cases each. The control group was treated with conventional Western medicine,while the treatment group was treated with acupuncture combined with Chinese Medicinal on the basis of the control group. The scores of TCM syndromes,nasal ventilation function indexes including peak expiratory flow(PEF) and diurnal variation rate of PEF,immune function indicators including mmunoglobulin E(Ig E) and Th1/Th2,inflammatory cytokines including interleukin-4(IL-4),interleukin-6(IL-6) and tumor necrosis factor(TNF-ɑ) before and after the treatment were compared between the two groups. Results: The scores of TCM syndromes of allergic rhinitis patients in the two groups decreased significantly after treatment(P < 0. 05),and the decrease in the treatment group was more obvious than that in the control group(P < 0. 05). The effective rate was 80. 85% in the control group and95. 74% in the treatment group. There was a significant difference between the two groups(P < 0. 05). After the treatment,PEF increased and PEF diurnal variation rate decreased in allergic rhinitis patients of the two groups,and all the differences were statistically significant(P < 0. 05). PEF in the treatment group was higher than that in the control group,and PEF diurnal variation rate was lower than that in the control group,and all the differences were statistically significant(P < 0. 05). After the treatment,Ig E and Th1/Th2 of allergic rhinitis patients in the two groups were significantly lower than those before the treatment,and all the differences were statistically significant(P < 0. 05),and the Ig E and Th1/Th2 in the treatment group were lower than those in the control group,and all the differences were statistically significant(P < 0. 05). The serum levels of IL-4,IL-6 and TNF-ɑ in the two groups were significantly decreased after the treatment,and all the differences were statistically significant(P <0. 05),and the serum levels of IL-4,IL-6 and TNF-ɑ in the treatment group were lower than those in the control group,and all the differences were statistically significant(P < 0. 05). Conclusion: GPTQD) combined with acupuncture can significantly improve the clinical symptoms of allergic rhinitis patients,promote the recovery of nasal ventilation function,and reduce the levels of inflammatory cytokines,Ig E and Th1/Th2 in serum.
引文
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[15]陈建斌.中西医结合治疗过敏性鼻炎临床研究[J].河南中医,2015,35(9):2245-2246.
[16]王玲.针刺治疗过敏性鼻炎的系统评价与选穴配伍规律的研究[D].济南:山东中医药大学,2016.
[17]张治成,杨晓,杨晓刚.自拟醒窍益气汤联合针刺治疗过敏性鼻炎的疗效探讨[J].中国现代医学杂志,2016,26(3):137-140.
[18]叶浩昕,卢伟筠,冯志文,等.醒窍益气汤联合针刺对过敏性鼻炎鼻部通气功能及炎症反应的影响[J].内蒙古中医药,2017,36(9):34-35.
[19]田颖,李霞.玉屏风颗粒联合氯雷他定片治疗过敏性鼻炎[J].吉林中医药,2016,36(8):799-801.
[20]胡思茂.黄芪桂枝五物汤合苍耳子散治疗过敏性鼻炎临床疗效及对免疫功能的影响[D].福州:福建中医药大学,2018.
[21]黄员福,薛梅,欧锦添.氯雷他定联合布地奈德鼻喷剂治疗过敏性鼻炎的效果观察[J].中国当代医药,2015,22(35):148-150.
[2]SARKISSIAN L,SARKISSIAN L,E STEWART T,et al.Incidence of allergic rhinitis in children with residual snoring and sleep symptoms after adenotonsillectomy[J].Aust J Gen Pract,2018,47(9):632-637.
[3]SHAHA A,MIZUGUCHI H,KITAMURA Y,et al.Effect of Royal Jelly and Brazilian Green Propolis on the Signaling for Histamine H1 Receptor and Interleukin-9 Gene Expressions Responsible for the Pathogenesis of the Allergic Rhinitis[J].Biol Pharm Bull,2018,41(9):1440-1447.
[4]许婵娟,王旭东,缪易.中西医结合治疗过敏性鼻炎的疗效研究[J].中国民康医学,2017,29(23):85-86.
[5]罗冰萍.中西医结合治疗过敏性鼻炎49例[J].河南中医,2015,35(10):2501-2502.
[6]陈弘,胡丽萍,施晓兰.过敏性鼻炎针刺治疗及选穴特点分析[J].亚太传统医药,2015,11(19):59-61.
[7]黄攀峰,黄秋节.益气固表通窍法治疗过敏性鼻炎的疗效观察[J].中国中医急症,2017,26(5):869-871.
[8]王福玲.世界医学会《赫尔辛基宣言》---涉及人类受试者的医学研究的伦理原则[J].中国医学伦理学,2016,29(3):544-546.
[9]中华耳鼻咽喉头颈外科杂志编委会,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[J].中国临床医生,2010,38(6):67-68.
[10]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.
[11]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:58-60.
[12]RESTIMULIA L,PAWARTI D R,EKORINI H M.The Relationship between Serum Vitamin D Levels with Allergic Rhinitis Incidence and Total Nasal Symptom Score in Allergic Rhinitis Patients[J].Open Access Maced J Med Sci,2018,6(8):1405-1409.
[13]JORDAKIEVA G,JENSEN-JAROLIM E.The impact of allergen exposure and specific immunotherapy on circulating blood cells in allergic rhinitis[J].World Allergy Organ J,2018,11(1):19.
[14]易兴亮.中西医结合与传统西药治疗支气管哮喘合并过敏性鼻炎的临床研究[J].西部医学,2015,27(1):47-49.
[15]陈建斌.中西医结合治疗过敏性鼻炎临床研究[J].河南中医,2015,35(9):2245-2246.
[16]王玲.针刺治疗过敏性鼻炎的系统评价与选穴配伍规律的研究[D].济南:山东中医药大学,2016.
[17]张治成,杨晓,杨晓刚.自拟醒窍益气汤联合针刺治疗过敏性鼻炎的疗效探讨[J].中国现代医学杂志,2016,26(3):137-140.
[18]叶浩昕,卢伟筠,冯志文,等.醒窍益气汤联合针刺对过敏性鼻炎鼻部通气功能及炎症反应的影响[J].内蒙古中医药,2017,36(9):34-35.
[19]田颖,李霞.玉屏风颗粒联合氯雷他定片治疗过敏性鼻炎[J].吉林中医药,2016,36(8):799-801.
[20]胡思茂.黄芪桂枝五物汤合苍耳子散治疗过敏性鼻炎临床疗效及对免疫功能的影响[D].福州:福建中医药大学,2018.
[21]黄员福,薛梅,欧锦添.氯雷他定联合布地奈德鼻喷剂治疗过敏性鼻炎的效果观察[J].中国当代医药,2015,22(35):148-150.