大艾段温针灸治疗肺气虚寒型变应性鼻炎100例
Therapeutic Analysis of Da Aiduan Warm Needle Moxibustion on 100 Cases of Allergic Rhinitis with Cold of Deficiency Pattern in Lung Qi
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摘要: 目的 观察大艾段温针灸治疗肺气虚寒型变应性鼻炎(AR)的疗效并探索其作用机制。方法 将入选病例随机分为观察组、对照组各105例。观察组大艾段温针灸,每日1次,每周治疗4次,4周为1个疗程。对照组急性期丙酸氟替卡松鼻喷雾剂喷鼻,枸地氯雷他定片口服。病情稳定后,枸地氯雷他定片停药,丙酸氟替卡松鼻喷雾剂继续喷鼻。4周为1个疗程。观察2组治疗结束时及治疗后30 d的中医证候总积分、西医临床症状总积分、体征总积分、视觉模拟评分法(VAS评分)以及血清免疫球蛋白E(IgE)、白细胞介素-4(IL-4)、γ干扰素(IFN-γ)水平的变化。结果 治疗后2组中医证候总积分、临床症状总积分、体征总积分以及鼻部整体症状的严重程度VAS评分均明显低于同组治疗前(P<0.01),观察组明显低于对照组(P<0.05~0.01);血清3项指标,组内及组间差异均具有统计学意义(P<0.01)。治疗结束后30 d随访,观察组疗效优于对照组(P<0.05);2组中医证候总积分、临床症状总积分、体征总积分以及鼻部整体症状的严重程度VAS评分均明显低于同组治疗前(P<0.01);观察组明显低于对照组(P<0.05~0.01);血清3项指标,IFN-γ含量,对照组治疗结束后30 d与治疗前比,差异无统计学意义(P>0.05),其余各组内、组间3项指标比较,差异有统计学意义(P<0.01)。结论 大艾段温针灸法治疗肺气虚寒型变应性鼻炎的疗效较好,可显著改善患者的中医证候、临床症状、体征、VAS评分,在调节血清IgE、IL-4、IFN-γ含量方面优于对照组,作用机制可能也与降低血清IgE、IL-4含量,升高IFN-γ含量相关。Abstract: OBJECTIVE To observe the therapeutic effect of Da Aiduan warm needle moxibustion on allergic rhinitis with cold of deficiency pattern in lung qi and explore its mechanism. METHODS The selected cases were randomly divided into the observation group (105 cases) and the control group (105 cases). The observation group was treated with Da Aiduan warm needle moxibustion once a day, four times a week, four weeks as a course. In the control group, patients were given fluticasone propionate nasal spray and orally taken desloratadine citrate disodium tablets in acute phase, Fu Shu Liang alone when patients were in stable condition. The course was four weeks. At the end of treatment and 30 days after treatment, the changes of total syndrome scores, physical sign points, visual analogy score (VAS), serum immunoglobulin E (IgE), interleukin 4 (IL-4), γ interferon (IFN-γ) were observed. RESULTS The total symptom scores, physical sign points and VAS of nasal symptoms severity in the two groups were significantly lower than those before treatment (P<0.01), and the observation group was significantly lower than that in the control group (P<0.05, P<0.01). The three indexes of serum were statistically significant both within and between groups (P<0.01). Follow-up result (30 days after treatment) indicated that the curative effect of the observation group was better than that of the control group (P<0.05). The total symptom scores, physical sign points and VAS of nasal symptoms severity in the two groups were significantly lower than that before treatment (P<0.01) and the observation group was significantly lower than that in the control group (P<0.05,P<0.01). The given indexes of the two groups before treatment and 30 days after treatment were monitored. It showed that there was no significant difference in the changes of three indexes of serum and IFN-γ in the control group (P>0.05). When it came to the comparison of three indexes in the observation group and between the two groups, they had significant difference (P<0.01). CONCLUSION The Da Aiduan warm needle moxibustion has good therapeutic effect on allergic rhinitis patients with cold of deficiency pattern in lung qi. It can significantly improve the clinical symptoms, physical signs and VAS score of the patients, with better effect in regulating the content of serum IgE, IL-4 and IFN-γ than the control group. Its mechanism may be related to the decrease of serum IgE, IL4 and the increase of IFN-γ.
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[1] 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组,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(2015,天津)[J].中华耳鼻咽喉头颈外科杂志,2016,51(1):6-24. [2] 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组,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. [3] BOUSQUET J,KHALTAEV N,CRUZ AA,et al. Allergic rhinitis and its impact on asthma(ARIA) 2008 update (in collaboration with the World Health Organization,GA2LEN and AllerGen)[J].Allergy,2008,63(S86):8-160. [4] 刘蓬.中医耳鼻咽喉科学[M].北京: 中国中医药出版社,2016: 108-111. [5] 熊大经,严道南.中医耳鼻咽喉科学[M].上海: 上海科学技术出版社,2017: 105-108. [6] 王惠敏,黄美,严道南,等.循经刮痧配合氯雷他定治疗持续性变应性鼻炎的临床研究[J].南京中医药大学学报,2017,33(6):583-586. [7] 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,2002:324-327. [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] 黄帝内经灵枢[M].天津:天津科学技术出版社,1999:1431. [10] 巢元方.诸病源候论[M].北京:中国医药科技出版社,2011:159. [11] 王焘.外台秘要[M].北京:华夏出版社,1993:415. [12] 王怀隐.太平圣惠方[M].郑州:河南科学技术出版社,2015:266. [13] 沈金鳌. 杂病源流犀烛[M].北京:人民卫生出版社,2006:748. [14] 朱秀平,陈宝维,钟慈琼,等.温针灸颈夹脊穴联合穴位贴敷治疗过敏性鼻炎临床研究[J].陕西中医,2017,38(1):107-108. [15] 曹凤娇,叶永铭,田楠,等.隔姜温针灸大椎穴治疗过敏性鼻炎的临床随访观察[J].针灸临床杂志,2015,31(7):3-6. [16] 吴焕淦,严洁,余曙光,等.灸法研究的现状与发展趋势[J].上海针灸杂志,2009,28(1):1-6. [17] 胡蓉,唐森,刘怀,等.艾灸配合自血穴位注射治疗肺脾气虚型变应性鼻炎:随机对照研究[J].中国针灸,2016,36(8):815-819. [18] 吴焕淦.中国灸法学[M].上海:上海科学技术出版社,2006:91-93,99-105. [19] 韩云祥.变应性鼻炎的针灸治疗进展[J].光明中医,2015,30(1):202-206. [20] 傅昌吉.和中止鼽汤与温针灸治疗变应性鼻炎的疗效比较[J].四川中医,2017,35(10):135-137. [21] 肖丽,黎波,杜元灏,等.针灸治疗变应性鼻炎临床随机对照研试验的系统评价[J].中国针灸,2009,29(6):512-516. [22] 李白云.温针灸联合小青龙汤合苍耳子散加减治理变应性鼻炎50例[J].江西中医药大学学报,2018,30(4):62-64. [23] 梁繁荣,王华.针灸学[M].北京: 中国中医药出版社,2016:150-151.
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