清肺健脾法治疗湿热证持续性变应性鼻炎疗效观察  

Observation on the curative effect of clearing lung and invigorating spleen in the treatment of persistent allergic rhinitis with damp-heat syndrome

作　　者：屈静[1] 王向东[1] 刘畅[1] 廉海红[1] 马小丽[1] QU Jing;WANG Xiangdong;LIU Chang;LIAN Haihong;MA Xiaoli(Beijing Tongren Hospital Affiliated to Capital Medical University/Beijing Otolaryngology Institute of Integrated Traditional Chinese and Western Medicine,Beijing 100730)

机构地区：[1]首都医科大学附属北京同仁医院/北京市中西医结合耳鼻咽喉科研究所,北京100730

出　　处：《现代中西医结合杂志》2022年第3期320-324,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：首都卫生发展科研专项项目(2014-2-2051)。

摘　　要：目的观察清肺健脾法治疗湿热证持续性变应性鼻炎的即刻和远期疗效及对免疫炎性因子的影响。方法将2016年11月—2018年5月在首都医科大学附属北京同仁医院治疗的80例湿热证持续性变应性鼻炎患者随机分为2组,治疗组给予清肺健脾治法中药颗粒剂口服,对照组给予氯雷他定片口服,2组均治疗4周。观察2组治疗前、治疗4周后、治疗结束后16周症状积分、鼻结膜炎生活质量调查问卷(RQLQ)评分及血清免疫球蛋白E(IgE)、白细胞介素-4(IL-4)、白细胞介素-5(IL-5)、干扰素-γ(IFN-γ)水平变化,比较2组治疗4周后即刻疗效和治疗结束后16周远期疗效,评估2组治疗安全性。结果治疗组39例、对照组38例完成研究。治疗4周后,2组症状积分、生活质量RQLQ评分及血清IgE、IL-5水平均明显低于治疗前(P均<0.05),治疗组血清IFN-γ水平明显高于治疗前(P<0.05),但2组间各指标比较差异均无统计学意义(P均>0.05)。治疗结束后16周,对照组症状积分、生活质量RQLQ评分及血清IgE、IL-4、IL-5、IFN-γ水平与治疗前比较差异均无统计学意义(P均>0.05);治疗组症状积分、生活质量RQLQ评分均明显低于治疗前及同期对照组(P均<0.05),血清IFN-γ水平均明显高于治疗前及同期对照组(P均<0.05),血清IgE、IL-4、IL-5水平与治疗前及同期对照组比较差异均无统计学意义(P均>0.05)。治疗4周后,治疗组总有效率为87.2%(34/39),对照组总有效率为76.3%(29/38),2组比较差异无统计学意义(P>0.05)。治疗结束后16周,治疗组总有效率为76.9%(30/38),对照组总有效率为44.7%(17/38),2组比较差异有统计学意义(P<0.05)。2组均无不良反应发生。结论清肺健脾法治疗持续性变应性鼻炎有效安全,尤其是在随访期表现出了优于西药的效果,有持续稳定症状、改善生活质量的作用,可能与降低IgE、纠正Th1/Th2细胞失衡有关。Objective It is to observe the immediate and long-term efficacy of Qingfei Jianpi method in the treatment of persistent allergic rhinitis with damp-heat syndrome and its effect on immune inflammatory factors. Methods Eighty patients with persistent allergic rhinitis with damp-heat syndrome treated in Beijing Tongren Hospital Affiliated to Capital Medical University from November 2016 to May 2018 were randomly divided into two groups. The treatment group was given Chinese medicine granules for clearing lung and invigorating spleen orally, the control group was given loratadine tablets orally, both groups were treated for 4 weeks. The changes in the symptom score, Rhinoconjunctivitis Quality of Life Questionnaire(RQLQ) scores, and the levels of serum immunoglobulin E(IgE), interleukin-4(IL-4), interleukin-5(IL-5) and interferon-γ(IFN-γ) were observed before treatment, after 4 weeks of treatment, and 16 weeks after treatment in the two groups. The immediate efficacy after 4 weeks of treatment and the long-term efficacy in 16 weeks after treatment were compared between the two groups, and the safety of the two groups was evaluated. Results 39 cases in the treatment group and 38 cases in the control group completed the study. After 4 weeks of treatment, the symptom scores, RQLQ scores, and the levels of serum IgE and IL-5 in both groups were significantly lower than those before treatment(P all<0.05), and the level of serum IFN-γ in the treatment group was significantly higher than that before treatment(P<0.05), but there was no significant difference in each index between the two groups(all P>0.05). In 16 weeks after the end of treatment, there were no significant differences in symptom scores, RQLQ scores and serum levels of IgE, IL-4, IL-5 and IFN-γ in the control group compared with those before treatment(all P>0.05);the symptom scores and RQLQ score in the treatment group were significantly lower while serum IFN-γ levels were significantly higher than those before treatment and in the control group at the sa

关 键 词：持续性变应性鼻炎 清肺健脾法 湿热证 IGE TH1/TH2细胞失衡 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]