不同强度穴位贴敷治疗中重度持续性变应性鼻炎:随机对照研究  

Moderate and severe persistent allergic rhinitis treated with acupoint application therapy of the different intensity: a randomized controlled trial

作　　者：胡奇妙 谷鹏鹏 姜霞[1] 姜方琦 庄进飞[1] 郑海松 杨观虎 蒋松鹤[1,2] 

机构地区：[1]温州医科大学附属第二医院育英儿童医院,浙江温州325027 [2]温州医科大学中美针灸康复研究所整合优化医学研究中心,浙江温州325000

出　　处：《中国针灸》2017年第11期1177-1182,共6页Chinese Acupuncture & Moxibustion

基　　金：浙江省中医药适宜技术培育项目:2014 ZP 005

摘　　要：目的:评价三伏天不同强度穴位贴敷对中重度持续性变应性鼻炎的临床疗效差异及安全性。方法:将160例中重度持续性变应性鼻炎患者随机分为治疗1组、治疗2组、治疗3组和安慰剂组,每组40例。4组取穴均为大椎、定喘、肺俞、脾俞、命门、膏肓、肾俞、气海。3个治疗组统一采用复方白芥子处方(白芥子、白芷、细辛、延胡索)共研细末。治疗1组以姜汁调和上述中药粉末(即姜调贴敷)制成药饼贴敷,治疗2组、治疗3组用蜂蜜调和中药粉末(即蜜调贴敷)制成药饼贴敷,安慰剂组用小米粉和蒸馏水制成外观相同的假药饼贴敷。其中治疗1组、治疗2组贴敷2 h,治疗3组、安慰剂组贴敷6 h,于三伏天期间每周贴敷1次,连续贴敷5周。观察4组患者治疗前、治疗5周后的鼻症状总分(TNSS)、鼻结膜炎生命质量调查问卷(RQLQ)评分、血液中嗜酸性粒细胞(EOS)计数,并比较4组的临床疗效,观察治疗各组皮肤不良反应发生率。结果:治疗后3个治疗组TNSS、RQLQ评分均较治疗前降低(P<0.05,P<0.01),其中治疗3组的改善程度优于治疗1组、治疗2组(均P<0.05);治疗后3个治疗组EOS计数较治疗前均有所下降(均P<0.05),各治疗组组间差异无统计学意义(均P>0.05);治疗3组总有效率为85.0%(34/40),优于治疗1组的76.3%(29/38)、治疗2组的71.8%(28/39)及安慰剂组的5.0%(2/40,P<0.05,P<0.01);治疗2组、3组的皮肤不良反应发生率低于治疗1组(均P<0.01)。结论:不同强度穴位贴敷均能改善中重度持续性变应性鼻炎患者的症状和生活质量。姜调贴敷刺激强度大,2 h贴敷后即可致皮肤出现水泡;蜜调贴敷较温和,未出现水泡,6 h蜜调贴敷疗效最佳。Objective To evaluate the clinical therapeutic effects and safety on moderate and severe persistent allergic rhinitis treated with acupoint application therapy of the different intensity during the dog days. Methods One hundred and sixty patients of moderate and severe persistent allergic rhinitis were randomized into a No.1 treatment group, a No.2 treatment group, a No.3 treatment group and a placebo group, 40 cases in each one. The same acupoints were used in the four groups, named Dazhui（GV 14）, Dingchuan（EX-B1）, Feishu（BL 13）, Pishu（BL 20）, Mingmen（GV 4）,Gaohuang（BL 43）, Shenshu（BL 23） and Qihai（CV 6）. In the three treatment groups, the fine powder of the ingredients（semen brassicae, radix angeliceae, asarum sieboldii, rhizome corydalis） of compound baijiezi formula was used. In the No.1 treatment group, the herbal paste（ginger-prepared paste） was prepared with ginger juice and the above herbal powder. In the No.2 and No.3 treatment groups, the herbal paste（honey-prepared paste） was prepared with honey with the above herbal powder. In the placebo group, the pseudo-herbal paste of the same appearance was prepared with millet powder and distilled water. The acupoint application was given for 2 h in the No.1 and No.2 groups and was for 6 h in theNo.3 treatment group and the placebo group. The acupoint application therapy was given once every week during the dogdays, continuously for 5 weeks. The total nasal symptom score（TNSS）, the score of the rhinoconjunctivitis quality of life questionnaire（RQLQ） and the count of blood eosinophils（EOS） were observed in the patients of the 4 groups before and after treatment. The clinical therapeutic effects were compared among the 4 groups. The incidences of the skin adverse reactions were observed in each treatment group. Results After treatment, the scores of TNSS and RQLQ were all reduced as compared with those before treatment in the three treatment groups（P0.05, P0.01）, in which, the improvements in the No.3 tre

关 键 词：变应性鼻炎 持续性 穴位贴敷 随机对照试验 

分 类 号：R246.8[医药卫生—针灸推拿学]