中-重度变态反应性鼻炎的中药干预研究  

The role of combination of traditional Chinese and western medicine on severe allergicrhinitis

作　　者：范愈燕[1] 王向东[2] 锡琳[3] 支楠[1] 曹飞飞[2] 贺飞[3] 张罗[2,3] 

机构地区：[1]首都医科大学附属北京同仁医院传统医学科,100730 [2]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,100730 [3]北京市耳鼻咽喉科研究所耳鼻咽喉科重点实验室,100005

出　　处：《国际中医中药杂志》2013年第4期306-309,共4页International Journal of Traditional Chinese Medicine

基　　金：国家杰出青年科学基金（项目编号：81025007）;首都医科大学基础临床课题（项目编号：11JL39）

摘　　要：目的观察在开瑞坦及鼻喷剂辅舒良治疗无效的情况下，联合中药治疗变态反应性鼻炎（allergicrhinitis，AR）的临床疗效。方法选择2011年5月至2012年8月在北京同仁医院变态反应中心就诊的中一重度变态反应性鼻炎患者18例，在开瑞坦及辅舒良治疗一周后症状无明显改善的情况下，根据不同证型分别配合中药辛夷清肺汤或玉屏风散加味治疗，比较联合治疗后2周与非联合治疗前1周疗效，观察鼻部症状及其对日常生活质量影响、鼻功能及半年后电话随访的预后评估。结果鼻部喷嚏、鼻塞、鼻痒、流涕症状，在治疗后第3周[分别为（52．0±11．1）％、（69．1±5．3）％、（68．3±12．3）％、（55．5±10．0）％]与联合治疗前[分别为（10．9±2．4）％、（8．9±3．2）％、（12．5±4．3）％、（13．2±5．3）％]比较，差异有统计学意义（P〈0．05）。鼻功能中的鼻腔最小横截面积（MCA）、鼻气道阻力（R75和R150）和鼻腔容积（V5）在治疗后第3周[分别为（0．48±0．23）cm2、（0-31±0．33）Pa／cm3·S-1、（0-31±0．37）Pa／cm3·S-1、（2．24±1．03）cm2]与联合治疗前[分别为（0．58±0．12）cm2、（0．38±0．23）Pa／cm3·S-1、（0．44±0．32）paJcm3·S-1、（3．50±2．33）cm2]比较，差异有统计学意义（P均〈0．01）。半年后的随访发现患者鼻部症状明显好于预期。结论中西医联合治疗，可有效控制常年性伴季节性持续性中一重度变态反应性鼻炎患者的症状、生活质量及鼻功能反射。Objective To explore the effects of combination of traditional Chinese medicine （TCM） and western medicine on a variety of allergen induced severe perennial seasonal allergic rhinitis patients who were treated invalidly with antihistamines and intranasal flixonase for more than two years. Methods 16 patients with moderate to severe allergic rhinitis who were uncontrolled with antihistamines and intranasal flixonase for one week were treated by combination with TCM of Xin-Yi-Qing-fei San or Gyokuheifu-san mixed formula for two weeks. Nasal symptoms, its effects on the quality of daily life, and telephone follow-up half a year later were evaluated. Mini Rhinoconjunetivitis Quality of Life Questionnaire （Mini-RQLQ） and Nocturnal Rhinoconjunctivitis Quality of Life Questionnaire （NRQLQ） were used to evaluate the quality of life. Results After 2 weeks combination-treatment, the nasal symptoms of congestion, rhinorrhea, sneezing, nasal itching, and nasal obstruction were significantly improved compared with combination-before [ （52.0± 11.1） %, （69.1±5.3）%, （68.3±12.3）%, （55.5±10.0）% to （10.9±2.4）%, （8.9±3.2）%, （12.5±4.3）%, （13.2±5.3）%, respectively]. The before and after treatment of nasal function of nasal minimum cross-sectional area （MCA）, nasal cavity volume （V5） and nasal airway resistance （R75 and R150） respectively were （0.58±0.12）cm2, （0.38 ± 0.23） Pa/cm3 · s- 1, （0.44 ± 0.32） Pa/cm3 ·s- 1, （3.50± 2.33） cm2 to （0.48 ± 0.23） cm2, （0.31± 0.33） Pa/cm3 · s-1, （0.31 ±0.37） Pa/cm3 · s-1, （2.24± 1.03） cm2 （P〈0.01）. In addition, findings of patients with nasal symptoms by half year follow-up were significantly better than those of before. Conclusion The interventionof TCM can effectively control the perennial and seasonal severe symptoms of patients with AR, and improve the quality of life of patients.

关 键 词：中-重度变态反应性鼻炎 中西药联合治疗 鼻部症状 日常生活质量 鼻功能 

分 类 号：R276.1[医药卫生—中医五官科学]