培元疗嚏方治疗元气不足型变应性鼻炎的临床研究

Clinical Study on the Efficacy of Peiyuan Liaoti Formula in Treating Allergic Rhinitis of Primordial Qi Deficiency Type

  • 摘要:
    目的 研究培元疗嚏方治疗元气不足型变应性鼻炎患者的临床疗效。
    方法 纳入河南省中医院80例元气不足型变应性鼻炎患者,随机分为对照组、观察组各40例,最终2组均纳入38例分析。对照组采取变应性鼻炎常规西医治疗方案(西替利嗪片+糠酸莫米松鼻喷雾剂),观察组予培元疗嚏方口服治疗,2组疗程均为4周。治疗前及治疗2周、4周后观察2组患者的中医证候积分、视觉模拟量表(VAS)评分、鼻结膜炎生活质量调查问卷(RQLQ)评分并评估临床疗效,采用前鼻测量法测量患者鼻阻力水平;糖精试验观察患者鼻黏液纤毛传输速度及速率;ELISA法检测患者血清中干扰素-γ(IFN-γ)、白介素(IL)-2、IL-4、IL-5、IL-10、IL-13、转化生长因子-β(TGF-β)、总免疫球蛋白E(tIgE)水平;流式细胞术检测患者外周血单个核细胞(PBMC)中CD4+/CD8+细胞比值。治疗期间监测2组患者不良反应发生情况。
    结果 治疗2周、4周,2组患者中医证候积分、VAS及RQLQ评分、多数鼻阻力指标均下降(P<0.05,P<0.01),治疗2周,对照组患者鼻鼽主症积分优于观察组(P<0.01),治疗4周,观察组患者中医证候总积分、VAS评分优于对照组(P<0.05)。治疗4周,2组患者纤毛传输速率及清除速度均升高(P<0.05,P<0.01),对照组优于观察组(P<0.01);2组患者血清tIgE、IL-4、IL-5、IL-13水平下降,IFN-γ、IL-2、IL-10、TGF-β水平及PBMC中CD4+/CD8+比值上升(P<0.05,P<0.01),观察组患者IFN-γ、IL-2、IL-10、TGF-β水平及CD4+/CD8+高于对照组(P<0.01),IL-4、IL-13水平低于对照组(P<0.01)。2组患者的不良反应发生情况未见明显差异(P>0.05)。
    结论 培元疗嚏方可调节患者免疫功能,有效改善元气不足型变应性鼻炎患者的临床症状,具有较高安全性。

     

    Abstract:
    OBJECTIVE To investigate the clinical efficacy of Peiyuan Liaoti Formula (PYLTF) in treating patients with allergic rhinitis (AR) of primordial qi deficiency type.
    METHODS A total of 80 patients with AR of primordial qi deficiency type from Henan Province Hospital of Traditional Chinese Medicine were enrolled and randomly assigned to a control group and an observation group (40 cases each). Finally, 38 cases were included in each group for statistical analysis. The control group received standard Western medical therapy for AR (cetirizine tablets plus mometasone furoate nasal spray), while the observation group was administered PYLTF; both groups were treated for 4 weeks. Before treatment and 2 and 4 weeks after treatment, the TCM syndrome scores, Visual Analogue Scale (VAS) scores, and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) scores of the two groups of patients were observed to assess clinical efficacy. Nasal resistance levels were measured using the anterior nasal measurement method, and the mucociliary transport velocity and rate of nasal mucus were observed using the saccharin test. Serum levels of IFN-γ, IL-2, IL-4, IL-5, IL-10, IL-13, TGF-β, and tIgE were detected using ELISA. The CD4+/CD8+ cell ratio in peripheral blood mononuclear cells (PBMCs) was detected by flow cytometry. Adverse reactions were monitored in both groups during treatment.
    RESULTS After 2 and 4 weeks of treatment, the TCM syndrome scores, VAS and RQLQ scores, and most nasal resistance indices of both groups decreased (P<0.05, P<0.01). After 2 weeks of treatment, the main nasal syndrome score of the control group was better than that of the observation group (P<0.01). After 4 weeks of treatment, the total TCM syndrome score and VAS score of the observation group were better than those of the control group (P<0.05). After 4 weeks of treatment, both groups showed increased ciliary transport rate and clearance speed (P<0.05, P<0.01), with the control group showing better results than the observation group (P<0.01). Serum levels of tIgE, IL-4, IL-5, and IL-13 decreased in both groups, while levels of IFN-γ, IL-2, IL-10, and TGF-β, and the CD4+/CD8+ ratio in PBMCs increased (P<0.05, P<0.01). The observation group had higher levels of IFN-γ, IL-2, IL-10, and TGF-β, and a higher CD4+/CD8+ ratio than the control group (P<0.01), while IL-4 and IL-13 levels were lower in the observation group (P<0.01). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).
    CONCLUSION PYLTF can regulate the immune function of patients, effectively improve the clinical symptoms of patients with AR due to primordial qi deficiency, and has good safety.

     

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