穴位敷贴联合孟鲁司特治疗儿童肺虚感寒型变应性鼻炎临床观察  

Clinical observation of acupoint application combined with montelukast in the treatment of allergic rhinitis in children with syndrome of lung deficiency related cold

作　　者：李幼瑾[1] 丁丽凤[2] 芮晓清 马蓓颖[3] 秦丽萍[4] LI Youjin;DING Lifeng;RUI Xiaoqing;MA Beiyin;QIN Liping(Department of Otolaryngology,Shanghai Children＇s Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127,China;Department of Traditional Chinese Medicine,Shanghai Children＇ s Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China;Department of Molecular Diagnostics, Shanghai Children＇ s Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China;Department of Traditional Chinese Medicine,Xinhua Hospital Affiliated to Shanghai Jiao Tong University Sehool of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属上海儿童医学中心耳鼻咽喉科,上海200127 [2]上海交通大学医学院附属上海儿童医学中心中医科,上海200127 [3]上海交通大学医学院附属上海儿童医学中心分子诊断室,上海200127 [4]上海交通大学医学院附属新华医院中医科,上海200092

出　　处：《上海中医药大学学报》2018年第3期42-46,共5页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：上海市科委科研计划资助项目(15401933800)

摘　　要：目的:评价穴位敷贴联合孟鲁司特治疗儿童变应性鼻炎(AR)的疗效及初步机制探讨。方法:纳入180例肺虚感寒型AR患儿,随机分为中西医结合组、中医组和西医组,每组各60例。中西医结合组患儿给予穴位敷贴加孟鲁司特钠口服治疗,中医组患儿给予穴位敷贴治疗,西医组患儿给予孟鲁司特钠口服治疗。观察周期为3个月。评估三组的临床疗效,于治疗前及治疗1周、3个月时检测三组患儿的血IFN-γ、IL-4水平,并计算IFN-γ/IL-4比值。结果:治疗3个月时,中西医结合组、中医组、西医组的临床总有效率分别为75.44%、63.79%、54.39%,三组比较差异具有统计学意义(P=0.048),且中西医结合组与西医组比较,其差异亦有统计学意义(P=0.015)。治疗1周、3个月时,中西医结合组患儿的IFN-γ水平及IFN-γ/IL-4比值较治疗前明显升高(P<0.01),IL-4水平较治疗前明显降低(P<0.01);治疗1周时,中医组患儿的IFN-γ/IL-4比值较治疗前明显升高(P<0.01),IL-4水平较治疗前明显降低(P<0.01)。与中医组比较,治疗3个月时,中西医结合组患儿的IFN-γ/IL-4比值明显升高(P<0.05),IL-4水平明显降低(P<0.05)。与西医组比较,治疗1周、3个月时,中西医结合组患儿的IFN-γ/IL-4比值均明显升高(P<0.05);治疗3个月时,中西医结合组患儿的IL-4水平降低(P<0.05),中医组患儿的IL-4水平升高(P<0.05)。结论:穴位敷贴联合孟鲁司特治疗可有效缓解AR患儿的临床症状,其机制可能与Th1/Th2细胞因子IL-4、IFN-γ介导的非特异性炎症反应相关。Objective： To evaluate the efficacy of acupoint application combined with montelukast in the treatment of allergic rhinitis（ AR） in children and discuss its mechanism. Methods： 180 AR children patients with syndrome of lung deficiency related cold were randomly divided into the integrated Chinese and western medicine group,Chinese medicine group and western medicine group,60 cases in each group. The integrated Chinese and western medicine group was treated with acupoint application and montelukast,the Chinese medicine group was treated with acupoint application and the western medicine group was treated with montelukast,with a course of 3 months. The clinical efficacy was evaluated in the three groups. Before treatment and after treatment for one week and three months,the levels of IL-4 and IFN-γ were detected in each group,and the ratio of IFN-γ/IL-4 was calculated. Results： After treatment for 3 months,the clinical total effective rates were 75.44% in the integrated Chinese and western medicine group,63.79% in the Chinese medicine group and 54.39% in the western medicine group. There were statistically significant differences on the total effective rate among the three groups（ P = 0. 048）,and there was statistically significant difference on the total effective rate between the integrated Chinese and western medicine group and western medicine group（ P = 0.015）. After treatment for one week and three months,the IFN-γ level and the IFN-γ/IL-4 ratio were obviously increased in the integrated Chinese and western medicine group compared with treatment before（ P〈0.01）,and the IL-4 level was obviously decreased（ P〈0.01）. After treatment for one week,the IFN-γ/IL-4 ratio was obviously increased in the Chinese medicine group compared with treatment before（ P〈0.01）,and the IL-4 level was obviously decreased（ P〈0.01）. After treatment for 3 months,the IFN-γ/IL-4 ratio was obviously increased in the integrated Chinese and western medicine group compared with Chinese medicine

关 键 词：变应性鼻炎 肺虚感寒型 穴位敷贴 孟鲁司特 儿童 IL-4/IFN-γ 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]