Efficacy of Thunder-Fire Moxibustion Combined with Sijunzi Decoction in the Treatment of Chronic Pharyngitis with Lung and Spleen Qi Deficiency and the Effect on the Level of Inflammatory Factors and Immune Factors
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摘要: 目的 观察雷火灸联合四君子汤治疗肺脾气虚型慢性咽炎的疗效及对炎性因子、免疫因子水平的影响。方法 选取60例肺脾气虚型慢性咽炎患者随机分为观察组和对照组, 每组30例, 观察组给予雷火灸联合四君子汤加减治疗, 对照组给予常规西药治疗, 每个疗程7 d, 共4个疗程。观察2组患者治疗前后白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、免疫球蛋白A(IgA)、免疫球蛋白E(IgE)及分泌型免疫球蛋白A(SIgA)水平、中医证候积分变化及临床疗效。结果 治疗后, 2组中医证候积分明显改善(P < 0.05, P < 0.01), 观察组优于对照组(P < 0.05, P < 0.01)。2组患者炎性因子IL-6、TNF-α及免疫因子IgE水平下降, 免疫因子IgA、SIgA水平上升(P < 0.01), 观察组优于对照组(P < 0.05, P < 0.01)。结论 雷火灸联合四君子汤加减治疗能明显改善肺脾气虚型慢性咽炎患者咽部症状, 其机制与降低体内炎症因子IL-6、TNF-α水平及免疫因子IgE水平, 提高免疫因子IgA、SIgA水平, 增强全身免疫力，改善局部环境有关。Abstract: OBJECTIVE To observe the efficacy of thunder-fire moxibustion combined with Sijunzi decoction in the treatment of chronic pharyngitis with lung and spleen qi deficiency and the effects on the levels of inflammatory factors and immune factors.METHODS A total of 60 patients with chronic pharyngitis of lung and spleen qi deficiency were randomly divided into observation group and control group, 30 patients in each group. The observation group was treated with thunder-fire moxibustion combined with modulated Sijunzi decoction, while the control group was given conventional western medical treatment. There were four courses of treatment, seven days per course. In addition, the levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), immunoglobulin A (IgA), immunoglobulin E (IgE), and secretory immunoglobulin A (SIgA), Chinese medicine syndrome scores and clinical efficacy were observed before and after treatment in the two groups.RESULTS After treatment, Chinese medicine syndrome scores of the two groups improved significantly (P < 0.05, P < 0.01), while the result in the observation group was better than that in the control group (P < 0.05, P < 0.01). The levels of inflammatory factor IL-6, TNF-α, and immune factor IgE decreased, while the levels of immune factor IgA and SIgA increased in the two groups (P < 0.01). However, the results in the observation group were better than those in the control group (P < 0.05, P < 0.01).CONCLUSION Thunder-fire moxibustion combined with modulated Sijunzi decoction treatment can significantly reduce the pharyngeal symptoms in patients with chronic pharyngitis with lung and spleen qi deficiency. The mechanism is related to reducing the levels of inflammatory factor IL-6, TNF-α, and immune factor IgE, increasing the levels of immune factor IgA and SIgA, enhancing systemic immunity, as well as improving the local environment.
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Key words:
- chronic pharyngitis /
- Lung spleen deficiency /
- thunder fire moxibustion /
- Immune factors
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表 1 慢性喉痹肺脾气虚证积分标准
分级记分 咽干 咳嗽 有痰 渴不欲饮 咽黏膜状态 0分 无 无(0~3) 无 无 无 1分 偶有感觉 偶有(3~5) 偶有 不明显 不明显 2分 咽干稍明显 阵发性咳嗽(5~9) 清嗓后减轻 稍有症状 较为明显 3分 咽干明显、舌燥 咳嗽难自控(≥9) 痰多、频频清嗓 虽渴难饮水 明显 
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表 2 2组患者治疗前后中医证候积分改善情况比较(x±s, n=30)
组别 时间 咽干 咳嗽 有痰 渴不欲饮 咽黏膜状态 观察组 治疗前 1.43±0.72 1.37±0.84 1.47±0.88 1.50±0.89 1.60±0.99 治疗后 0.67±0.65**# 0.63±0.66** 0.57±0.62**## 0.67±0.65**## 0.67±0.70**# 对照组 治疗前 1.47±0.72 1.40±0.75 1.36±0.83 1.47±0.96 1.47±0.96 治疗后 1.03±0.71* 0.93±0.63** 0.93±0.73* 1.00±0.68* 1.07±0.68* 注: 组内比较, **P < 0.01, *P < 0.05;组间比较, #P < 0.05, ##P < 0.01。
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表 3 2组患者治疗前后IL-6、TNF-α含量比较(x±s, ng·L-1, n=30)
组别 时间 IL-6 TNF-α 观察组 治疗前 183.77±12.53 181.10±23.74 治疗后 106.90±18.21**## 112.50±15.27**## 对照组 治疗前 196.43±16.26 189.86±25.44 治疗后 137.87±17.42** 151.20±13.79** 注: 组内比较, **P < 0.01;组间比较, ##P < 0.01。
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表 4 2组患者治疗前后IgA、IgE及SIgA含量比较(x±s, n=30)
组别 时间 IgA/(mg·L-1) IgE/(ng·L-1) SIgA/(mg·L-1) 观察组 治疗前 1.07±0.36 443.04±33.11 7.50±3.25 治疗后 1.75±0.50**## 170.24±53.15**## 17.14±2.19**# 对照组 治疗前 1.04±0.36 434.56±31.09 8.26±2.98 治疗后 1.38±0.25** 242.24±50.18** 12.09±2.69** 注: 组内比较, **P < 0.01;组间比较, #P < 0.05, ##P < 0.01。
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