加味补肺白石英散联合鼓膜内注射曲安奈德治疗变应性鼻炎合并渗出性中耳炎的临床疗效  

Curative Effect of Modified Bufei Baishiying San Combined with Intramedullary Triamcinolone Acetonide Injection on Allergic Rhinitis and Exudative Otitis Media

作　　者：陈璐璐 李静波[1] 王俊杰[1] 贺星华 Chen Lulu;Li Jingbo;Wang Junjie;He Xinghua(Henan province hospital of traditional Chinese medicine,Zhengzhou 450002)

机构地区：[1]河南省中医院,郑州450002

出　　处：《中药药理与临床》2021年第4期191-195,共5页Pharmacology and Clinics of Chinese Materia Medica

基　　金：河南省中医药科学研究专项课题(编号:2018ZY1010);河南省高等学校重点科研项目(编号:15A360005)。

摘　　要：目的:观察加味补肺白石英散联合鼓膜内注射曲安奈德治疗变应性鼻炎合并渗出性中耳炎肺气虚寒证的疗效及对血清、鼻分泌物、耳积液中特异性变应原IgE(IgE)、白三烯C4(LTC4)、转化生长因子-β1(TGF-β1)的影响。方法:120例患者随机分为对照组和观察组,各60例。在鼓膜内注射曲安奈德治疗基础上,对照组口服辛芩颗粒,观察组给予加味补肺白石英散内服和局部冲洗,疗程均为4 w。观察两组治疗前后及随访12个月患者生命质量评价量表(RQLQ),中医证状。检测治疗前后两组气骨听阈导差、血清、鼻分泌物、耳积液中IgE、LTC4、TGF-β1的含量。比较两组临床症状,安全性及随访12个月复发情况。结果:观察组总有效率96.6%(57/59),明显高于对照组的80.7%(46/57)(P<0.05)。随访12个月,观察组(治愈+显效+有效)患者的复发率为5.3%(3/57),低于对照组的30.4%(14/46)(P<0.05)。与本组治疗前比较,两组治疗后及随访3、6、12个月RQLQ评分明显降低(P<0.05),观察组治疗后及随访3、6、12个月中医证状评分明显降低(P<0.05)。与本组治疗前比较,两组治疗后血清、鼻分泌物及耳积液中IgE、LTC4、TGF-β1含量降低(P<0.05),气骨听阈导差升高(P<0.05)。与对照组治疗后及随访至少12个月比较,观察组同期RQLQ和中医证状评分降低(P<0.05)。与对照组治疗后比较,观察组气骨听阈导差升高(P<0.05),血清、鼻分泌物、耳积液中IgE、LTC4、TGF-β1含量降低(P<0.05)。治疗期间对照组出现1例轻微头痛头晕,1例轻微失眠;观察组出现1例轻微头晕。结论:加味补肺白石英散联合鼓膜内注射曲安奈德可明显改善变应性鼻炎合并渗出性中耳炎肺气虚寒证患者的临床症状,降低血清、鼻分泌物、耳积液中IgE、LTC4、TGF-β1的含量,复发率低。Objective:To observe the clinical efficacy of Flavored Bufei Baishiying San combined with intramedullary triamcinolone acetonide injection in the treatment of allergic rhinitis and exudative otitis media with Feiqixuhan syndrome and its effect on immunoglobulin E(IgE), leukotriene C_(4)(LTC_(4)) and transforming growth factor-β_(1)(TGF-β_(1)) in serum, nasal secretion and ear effusion. Methods: 120 patients were randomly divided into the control group and the observation group, 60 cases in each group. On the basic treatment of intramedullary triamcinolone acetonide injection, the control group was orally given Xinqin granule, and the observation group was given Flavored Bufei Baishiying San orally and local flushing, for 4 weeks separately. Before and after treatment and follow-up for 12 months, Rhinoconjunctivitis quality of life questionnaire(RQLQ) and TCM syndromes were observed between two groups. The difference of Qi-bone hearing threshold, the content levels of IgE, LTC4and TGF-β1in serum, nasal secretions and ear effusion were detected before and after treatment. The clinical symptoms, security and recurrence follow-up for 12 months were also compared between the two groups. Results: The total effective rate was 96.6%(57/59) in the observation group, which was higher than 80.7%(46/57) in the control group(P<0.05). Follow-up for 12 months, the recurrence rate in the observation group was 5.3%(3/57),which was lower than 30.4%(14/46) in the control group(P<0.05). Compared with before treatment, RQLQ in the two groups were decreased after treatment and follow-up for 3,6 and12 months(P<0.05), while TCM syndrome scores in the observation group were decreased after treatment and follow-up for 3, 6 and 12 months(P<0.05). Compared with before treatment, the contents of IgE, LTC4 and TGF-β_(1) in serum, nasal secretions and auricular effusion were decreased after treatment(P<0.05), and the difference of the auditory threshold in the two groups was increased(P<0.05). Compared with the control group after treatmen

关 键 词：加味补肺白石英散 鼓膜内注射曲安奈德 变应性鼻炎 渗出性中耳炎 肺气虚寒证 

分 类 号：R765.21[医药卫生—耳鼻咽喉科] R764.21[医药卫生—临床医学]