益气温阳方对变应性鼻炎患者气道功能和炎性反应递质的影响
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摘要
目的:探讨益气温阳方对变应性鼻炎患者气道功能和炎性反应递质的影响。方法:选取2017年1—12月三亚市中医院收治的变应性鼻炎患者88例作为研究对象,按入院顺序随机分为对照组和观察组,每组44例,对照组患者给予孟鲁司特钠咀嚼片、布地奈德喷剂治疗,观察组在对照组的基础上联合益气温阳方治疗,2组均连续治疗3周后进行疗效评估并定期随访6个月。治疗后统计2组患者临床疗效,检测并比较2组治疗前后主要症状体征改善情况、气道功能指标及血清炎性反应递质变化,随访期间记录并比较2组患者复发情况及不良反应发生情况。结果:治疗后观察组临床总有效率为93. 18%,较对照组的77. 27%显著升高,差异有统计学意义(P <0. 05);与治疗前比较,治疗后2组患者鼻痒、鼻塞、流涕、喷嚏、鼻甲肿大积分及血清IL-6、IL-8水平降低,且观察组显著低于对照组,差异有统计学意义(P <0. 05);治疗后2组患者用力肺活量(FVC),第1秒钟用力呼气容积(FEV1)、最高呼气流速(PEF)、血清IL-10水平及观察组FEV1均升高,差异有统计学意义(P <0. 05),观察组显著高于对照组,差异有统计学意义(P <0. 05);治疗后3个月2组复发率差异无统计学意义(P> 0. 05),而治疗后6个月观察组复发率较对照组显著降低,差异有统计学意义(P <0. 05);随访期间2组均未见严重不良反应。结论:益气温阳方可显著改善变应性鼻炎患者临床症状,抑制机体炎性反应并提升其气道功能,有效防止复发且全性良好,临床疗效更明显。
Objective: To explore the effects of Yiqi Wenyang Prescription on the airway function and inflammatory factor level of patients with allergic rhinitis. Methods: A total of 88 cases patients with allergic rhinitis admitted in Sanya Hospital of Chinese Medicine from January to December 2017 were selected and randomly divided into a control group( n = 44) and an observation group( n = 44) according to order of admission. Patients in the control group were treated with menglusite sodium chewing tablets,bryderonide spray,while patients in the observation group were treated with Yiqi Wenyang Prescription on the basis of the control group. The efficacy in the 2 groups was evaluated after treating continuously for 3 weeks and regularly followed-up for 6 months. The clinical efficacy in the 2 groups was evaluated after treatment. The main symptoms and signs improvement,airway function indexes and serum inflammatory factors levels before and after treatment were detected and compared. The recurrence and the occurrence of adverse reactions in the 2 groups during followed-up period were recorded and compared. Results: The clinical total effective rate in the observation group after treatment was 93. 18%,which was higher than 77. 27% in control group( P < 0. 05); Compared with before treatment,the scores of nasal itching,nasal congestion,runny nose,sneezing,turbinate enlargement and serum IL-6,IL-8 levels in the 2 groups after treatment decreased,and the observation group was lower than that of the control group( P < 0. 01); The FCV,FEV1/FVC,PEF and serum IL-10 levels in the 2 groups and the FEV1 in the observation group after treatment increased( P< 0. 01),and the observation group was higher than that of the control group( P < 0. 01); There was no significant difference in the recurrence rate 3 months after treatment between the 2 groups( P > 0. 05),while the recurrence rate 6 months after treatment in the observation group was lower than that in control group significantly( P < 0. 05). No serious adverse reaction occurred in the 2 groups during the followed-up period. Conclusion: Yiqi Wenyang Prescription can improve the clinical symptoms of patients with allergic rhinitis effectively,inhibit the body's inflammatory response and enhance the airway function,prevent the recurrence of patients with good security. The clinical efficacy is better than conventional western medicine treatment significantly.
Objective: To explore the effects of Yiqi Wenyang Prescription on the airway function and inflammatory factor level of patients with allergic rhinitis. Methods: A total of 88 cases patients with allergic rhinitis admitted in Sanya Hospital of Chinese Medicine from January to December 2017 were selected and randomly divided into a control group( n = 44) and an observation group( n = 44) according to order of admission. Patients in the control group were treated with menglusite sodium chewing tablets,bryderonide spray,while patients in the observation group were treated with Yiqi Wenyang Prescription on the basis of the control group. The efficacy in the 2 groups was evaluated after treating continuously for 3 weeks and regularly followed-up for 6 months. The clinical efficacy in the 2 groups was evaluated after treatment. The main symptoms and signs improvement,airway function indexes and serum inflammatory factors levels before and after treatment were detected and compared. The recurrence and the occurrence of adverse reactions in the 2 groups during followed-up period were recorded and compared. Results: The clinical total effective rate in the observation group after treatment was 93. 18%,which was higher than 77. 27% in control group( P < 0. 05); Compared with before treatment,the scores of nasal itching,nasal congestion,runny nose,sneezing,turbinate enlargement and serum IL-6,IL-8 levels in the 2 groups after treatment decreased,and the observation group was lower than that of the control group( P < 0. 01); The FCV,FEV1/FVC,PEF and serum IL-10 levels in the 2 groups and the FEV1 in the observation group after treatment increased( P< 0. 01),and the observation group was higher than that of the control group( P < 0. 01); There was no significant difference in the recurrence rate 3 months after treatment between the 2 groups( P > 0. 05),while the recurrence rate 6 months after treatment in the observation group was lower than that in control group significantly( P < 0. 05). No serious adverse reaction occurred in the 2 groups during the followed-up period. Conclusion: Yiqi Wenyang Prescription can improve the clinical symptoms of patients with allergic rhinitis effectively,inhibit the body's inflammatory response and enhance the airway function,prevent the recurrence of patients with good security. The clinical efficacy is better than conventional western medicine treatment significantly.
引文
[1]程雷.变应性鼻炎的诊断和治疗[J].山东大学耳鼻喉眼学报,2013,27(2):1-4.
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[4]谢强,付文洋.变应性鼻炎中医治疗研究现状[J].西部中医药,2015,28(3):140-142.
[5]吴拥军,严道南,杨祁.益气温阳方治疗儿童变应性鼻炎肺气虚寒证临床观察[J].南京中医药大学学报,2014,30(3):229-231.
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[7]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.
[8]阮岩.中医耳鼻咽喉科学[M].北京:人民卫生出版社,2012:168-168.
[9]李凡成,徐绍勒.中西医结合耳鼻咽喉科学[M].北京:人民卫生出版社,2001:308-312.
[10]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:154-154.
[11]Demoly P,Chiriac AM,Berge B,et al.Reasons for prescribing second generation antihistamines to treat allergic rhinitis in real-life conditions and patient response[J].Allergy Asthma Clin Immunol,2014,10(1):29.
[12]谢强,付文洋.变应性鼻炎中医治疗研究现状[J].西部中医药,2015,28(3):140-142.
[13]罗恬,吴秦川,王乃平.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[J].世界中医药,2016,11(12):2584-2587.
[14]肖伊,刘真,李洵.疏肝清肝法治疗变应性鼻炎[J].世界中医药,2016,11(6):1052-1055.
[15]单采霞,高丽.变应性鼻炎的发病机制及中医药治疗的研究现状[J].新疆中医药,2017,35(5):133-136.
[16]史军,刘玉,严士海,等.益气温阳方对变应性鼻炎Treg细胞调控的研究[J].中华中医药杂志,2014,29(6):2037-2039.
[17]杨祁,吴拥军,严道南.益气温阳方治疗儿童变应性鼻炎的临床疗效观察[J].中华中医药杂志,2015,30(4):1337-1339.
[18]杨祁.益气温阳方治疗儿童变应性鼻炎的临床疗效观察[D].南京:南京中医药大学,2012.
[19]Mendes ES,Rebolledo P,Campos M,et al.Immediate antiinflammatory effects of inhaled budesonide in patients with asthma[J].Ann Am Thorac Soc,2014,11(5):706-711.
[20]唐雪春,樊佳.运用益气温阳、平喘通窍法治疗成人过敏性鼻炎-哮喘综合征[J].中医杂志,2016,57(7):615-617.
[2]Rondón C,Campo P,Zambonino MA,et al.Follow-up study in local allergic rhinitis shows a consistent entity not evolving to systemic allergic rhinitis[J].J Allergy Clin Immunol,2014,133(4):1026-1031.
[3]蔡粤川,任全伟.变应性鼻炎的中医外治法研究进展[J].中国中西医结合耳鼻咽喉科杂志,2015,23(2):159-160,143.
[4]谢强,付文洋.变应性鼻炎中医治疗研究现状[J].西部中医药,2015,28(3):140-142.
[5]吴拥军,严道南,杨祁.益气温阳方治疗儿童变应性鼻炎肺气虚寒证临床观察[J].南京中医药大学学报,2014,30(3):229-231.
[6]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.(上接第1501页)
[7]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.
[8]阮岩.中医耳鼻咽喉科学[M].北京:人民卫生出版社,2012:168-168.
[9]李凡成,徐绍勒.中西医结合耳鼻咽喉科学[M].北京:人民卫生出版社,2001:308-312.
[10]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:154-154.
[11]Demoly P,Chiriac AM,Berge B,et al.Reasons for prescribing second generation antihistamines to treat allergic rhinitis in real-life conditions and patient response[J].Allergy Asthma Clin Immunol,2014,10(1):29.
[12]谢强,付文洋.变应性鼻炎中医治疗研究现状[J].西部中医药,2015,28(3):140-142.
[13]罗恬,吴秦川,王乃平.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[J].世界中医药,2016,11(12):2584-2587.
[14]肖伊,刘真,李洵.疏肝清肝法治疗变应性鼻炎[J].世界中医药,2016,11(6):1052-1055.
[15]单采霞,高丽.变应性鼻炎的发病机制及中医药治疗的研究现状[J].新疆中医药,2017,35(5):133-136.
[16]史军,刘玉,严士海,等.益气温阳方对变应性鼻炎Treg细胞调控的研究[J].中华中医药杂志,2014,29(6):2037-2039.
[17]杨祁,吴拥军,严道南.益气温阳方治疗儿童变应性鼻炎的临床疗效观察[J].中华中医药杂志,2015,30(4):1337-1339.
[18]杨祁.益气温阳方治疗儿童变应性鼻炎的临床疗效观察[D].南京:南京中医药大学,2012.
[19]Mendes ES,Rebolledo P,Campos M,et al.Immediate antiinflammatory effects of inhaled budesonide in patients with asthma[J].Ann Am Thorac Soc,2014,11(5):706-711.
[20]唐雪春,樊佳.运用益气温阳、平喘通窍法治疗成人过敏性鼻炎-哮喘综合征[J].中医杂志,2016,57(7):615-617.