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1.成都中医药大学 附属医院,成都 610075
2.成都中医药大学 临床医学院,成都 610075
洪冬冬,在读博士,从事中医药防治变应性鼻炎的基础与临床研究,E-mail:hddjeff@163.com
彭顺林,博士,主任医师,从事中医药防治耳鼻咽喉疾病的基础与临床研究,Tel:028-87766132,E-mail:psl6@163.com
纸质出版日期:2021-01-20,
网络出版日期:2020-09-17,
收稿日期:2020-05-21,
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洪冬冬,彭顺林,苏俊桦等.摄涕止鼽汤联合揿针治疗肺气虚寒型变应性鼻炎的临床观察[J].中国实验方剂学杂志,2021,27(02):80-86.
HONG Dong-dong,PENG Shun-lin,SU Jun-hua,et al.Clinical Efficacy of Sheti Zhiqiu Decoction Combined with Intradermal Needling in Treatment of Allergic Rhinitis with Deficient Cold of Lung Qi Syndrome[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(02):80-86.
洪冬冬,彭顺林,苏俊桦等.摄涕止鼽汤联合揿针治疗肺气虚寒型变应性鼻炎的临床观察[J].中国实验方剂学杂志,2021,27(02):80-86. DOI: 10.13422/j.cnki.syfjx.20202321.
HONG Dong-dong,PENG Shun-lin,SU Jun-hua,et al.Clinical Efficacy of Sheti Zhiqiu Decoction Combined with Intradermal Needling in Treatment of Allergic Rhinitis with Deficient Cold of Lung Qi Syndrome[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(02):80-86. DOI: 10.13422/j.cnki.syfjx.20202321.
目的
2
观察摄涕止鼽汤联合揿针治疗肺气虚寒型变应性鼻炎(allergic rhinitis,AR)的临床疗效及对辅助性T细胞17(helper T cell 17,Th17)和调节性T细胞(regulatory T cell,Treg)相关细胞因子的影响。
方法
2
将105例肺气虚寒型AR患者随机分为中药组、联合组和西药组各35例。中药组予摄涕止鼽汤,1剂/d;联合组在中药组基础上联合揿针治疗,穴取印堂、双侧迎香、风池、肺俞、足三里,每留针3 d后更换;西药组予糠酸莫米松鼻喷雾剂,每次每侧鼻腔100 μg,1次/d;枸地氯雷他定片,8.8 mg/次,1次/d。3组疗程均为4周,随访3个月。观察3组患者治疗前后鼻眼症状评分和鼻结膜炎生活质量调查问卷(rhinoconjunctivitis quality of life questionnaire,RQLQ)评分,检测治疗前后血清白细胞介素-17(interleukin-17,IL-17),白细胞介素-10(interleukin-10,IL-10)和转化生长因子-
β
1
(transforming growth factor-
β
1
,TGF-
β
1
)水平,评价临床疗效及安全性,并随访观察疾病复发率。
结果
2
与本组治疗前比较,治疗后3组患者各项鼻眼症状评分和总分,RQLQ各维度评分和总分均显著降低(
P
<
0.01);治疗后与中药组和西药组比较,联合组除眼痒/异物感/眼红评分外的其余项鼻眼症状评分和总分,RQLQ各维度评分和总分均降低(
P
<
0.05,
P
<
0.01)。与本组治疗前比较,治疗后3组患者血清IL-17水平显著降低(
P
<
0.01),IL-10,TGF-
β
1
水平显著升高(
P
<
0.01);治疗后与中药组和西药组比较,联合组血清IL-17水平降低(
P
<
0.05),IL-10,TGF-
β
1
水平升高(
P
<
0.05,
P
<
0.01)。联合组临床疗效优于中药组和西药组(Z=-2.207,Z=-2.185,
P
<
0.05)。联合组和中药组复发率比较差异无统计学意义,且联合组与中药组复发率均低于西药组(
χ
2
=5.020,
χ
2
=4.835,
P
<
0.05)。3组患者治疗期间均未发生明显不良反应。
结论
2
摄涕止鼽汤联合揿针治疗肺气虚寒型AR患者疗效确切,能明显缓解患者症状,提高患者生活质量,减少疾病复发,其作用机制可能是通过调节机体Th17/Treg的免疫平衡,改善其免疫功能而发挥作用。
Objective
2
To observe the clinical efficacy of Sheti Zhiqiu decoction combined with intradermal needling in treatment of allergic rhinitis (AR) of deficient cold of lung Qi syndrome and its effect on cytokines of helper T cell 17 (Th17) and regulatory T cells (Treg).
Method
2
A total of 105 patients with AR of deficient cold of lung Qi syndrome were randomly divided into traditional Chinese medicine (TCM) group, combination group and western medicine group, with 35 cases in each group. The TCM group was treated with Sheti Zhiqiu decoction, 1 dose a day. The combination group was treated with intradermal needling in addition to the therapy of the TCM group. The selected acupoints were Yintang, bilateral Yingxiang, Fengchi, Feishu and Zusanli. The needles were retained for 3 days before being replaced. The western medicine group was treated with mometasone furoate nasal spray, 100 μg/time at each side of the nasal cavity,
qd
, and desloratadine citrate tablet, 8.8 mg/time,
qd
. Three groups were treated for 4 weeks and followed up for 3 months. Nasal and ocular symptom scores and rhinoconjunctivitis quality of life questionnaire (RQLQ) scores of patients in three groups were observed before and after treatment. Levels of serum interleukin-17 (IL-17), interleukin-10 (IL-10) and transforming growth factor-
β
1
(TGF-
β
1
) were measured before and after treatment. The clinical efficacy and safety were evaluated, and the disease recurrence rate was observed during the follow-up period.
Result
2
Compared with before treatment, nasal and ocular symptom scores and total score, and RQLQ scores and total score of patients in three groups were significantly decreased after treatment (
P
<
0.01). Compared with the TCM group and the western medicine group after treatment, except for eyes itching/foreign body sensation/red eyes score, nasal and ocular symptom scores and total score, and RQLQ scores and total score of the combination group were lower(
P
<
0.05,
P
<
0.01). Compared with before treatment, level of serum IL-17 of patients in three groups was significantly decreased (
P
<
0.01), while levels of IL-10 and TGF-
β
1
were significantly increased after treatment (
P
<
0.01). Compared with the TCM group and the western medicine group after treatment, level of serum IL-17 was lower, whereas levels of IL-10 and TGF-
β
1
were higher in the combination group (
P
<
0.05,
P
<
0.01). The clinical efficacy of the combination group was better than that of the TCM medicine group and the western medicine group (Z=-2.207,Z=-2.185,
P
<
0.05). There was no significant difference in recurrence rate between combination group and the TCM group, and the recurrence rate of both groups was lower than that of the western medicine group(
χ
2
=5.020,
χ
2
=4.835,
P
<
0.05). There was no significant adverse reaction during the treatment period in three groups.
Conclusion
2
Sheti Zhiqiu decoction combined with intradermal needling is effective in treatment of patients with AR of deficient cold of lung Qi syndrome. It can significantly relieve patients' symptoms, improve patients' quality of life and reduce disease recurrence. It may play a role by regulating immune balance of Th17/Treg of patients and improving their immune function.
变应性鼻炎肺气虚寒证摄涕止鼽汤揿针辅助性T细胞17调节性T细胞细胞因子
allergic rhinitisdeficient cold of lung Qi syndromeSheti Zhiqiu decoctionintradermal needlinghelper T cell 17regulatory T cellcytokine
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