针刺联合艾灸治疗过敏性鼻炎的临床疗效及安全性评价  

Clinical efficacy and safety evaluation of acupuncture combined with moxibustion in treatment of allergic rhinitis

作　　者：马伟 翟春涛 尚慧梅 徐小珊 郑通 田岳凤 MA Wei;ZHAI Chun-Tao;SHANG Hui-Mei;XU Xiao-Shan;ZHENG Tong;TIAN Yue-Feng(College of Acupunc-ture-Moxibustion and Tuina*Hunan University of Chinese Medicine,Changsha 410208,China;Preventive Treatment Center,Yulin Hospital of Chinese Medicine,Yulin 719000,Shaanxi Province;The Third Clinical College,Shanxi University of Chinese Medicine,Taiyuan 030024)

机构地区：[1]湖南中医药大学针灸推拿学院,长沙410208 [2]榆林市中医医院治未病中心,陕西榆林719000 [3]山西中医药大学第三临床学院,太原030024

出　　处：《针刺研究》2022年第4期336-342,共7页Acupuncture Research

基　　金：山西省高等学校人文社会科学重点研究基地项目(No.20190127)。

摘　　要：目的:评价针刺联合艾灸治疗过敏性鼻炎(AR)的临床疗效及安全性。方法:选取AR患者80例,采用随机数字表法分为药物组与针刺联合艾灸组,每组40例。药物组给予氯雷他定片口服,每日1片,10 d为1个疗程,治疗3个疗程;针刺联合艾灸组以迎香(双)、印堂、合谷(双)、肾俞(双)为主穴进行针刺和艾灸,并随证加减穴位,每日治疗1次,每次30 min, 10次为1个疗程,治疗3个疗程。治疗前后分别评定临床症状评分、临床体征评分及鼻-结膜相关生活量表评分;刮取部分下鼻甲黏膜组织表面的分泌物,采用HE染色法及Sheldeny评价法进行嗜酸性粒细胞(EOS)分布程度评分;采用酶联免疫吸附法测定血清免疫球蛋白E(IgE)、维甲酸孤儿受体γt(RORγt)、叉头盒蛋白P3(Foxp3)、白细胞介素-17(IL-17)、IL-27、IL-33含量。评价两组AR患者的临床疗效,并记录治疗期间出现的所有不良反应。结果:两组患者临床症状评分、临床体征评分及鼻-结膜相关生活量表评分、EOS分布评分及血清IgE、RORγt、IL-17、IL-33含量均较本组治疗前降低(P<0.05),血清Foxp3、IL-27含量较本组治疗前升高(P<0.05)。治疗后针刺联合艾灸组临床症状评分、临床体征评分及鼻-结膜相关生活量表评分及血清IgE、RORγt、IL-33含量低于药物组(P<0.05),血清Foxp3、IL-27含量高于药物组(P<0.05)。针刺联合艾灸组总有效率为100.0%(40/40),显著高于药物组的82.5%(33/40,P<0.05)。治疗期间及治疗后,两组患者均未出现明显不良反应。结论:针刺联合艾灸治疗AR疗效显著,安全性好,其治疗机制可能与调控幼稚CD4;T细胞介导的辅助性T细胞(Th)1/Th2、Th17/调节性T细胞平衡有关。Objective To evaluate the clinical efficacy and safety of acupuncture combined with moxibustion on allergic rhinitis. Methods Using the random number table, 80 patients with allergic rhinitis were divided into a medication group and an acupuncture combined with moxibustion(acu-mox) group, 40 cases in each one. In the medication group, ioratadine tables were prescribed for oral administration, one tablet daily for 10 days as 1 session, 3 sessions of treatment were required. In the acupuncture combined with moxibustion group, bilateral Yingxiang(LI20), Yintang(EX-HN3), bilateral Hegu(LI4) and bilateral Shenshu(BL23) were selected as the main points and stimulated with acupuncture and moxibustion;and the acupoint prescription was modified according to symptoms. This combined treatment was given once every day, stimulating for 30 min each time, and 10 treatments made 1 course, for 3 courses of treatment totally. Before and after treatment, the scores for symptoms and physical signs, as well as the score of rhino-conjunctivitis related quality of life scale(R-QOL) were evaluated separately. The sample of the inferior turbinate mucosa tissue was collected and the distribution of eosinophil(EOS) was scored using HE staining and Sheldeny evaluation. Using enzyme-linked immunosorbent assay(ELISA), the contents of serum immunoglobulin E(IgE), retinoic-acid-receptor-related orphan nuclear receptor γt(RORγt), forkhead box protein P3(Foxp3), interleukin-17(IL-17), IL-27 and IL-33 were determined. The clinical efficacy was evaluated in the patients with allergic rhinitis of two groups and all the adverse reactions were recorded during treatment. Results The scores of symptoms and physical signs as well as the score of R-QOL, and EOS distribution score and the contents of serum IgE, RORγt, IL-17 and IL-33 were all reduced as compared with those before treatment in each group(P<0.05), and the contents of serum Foxp3 and IL-27 were increased as compared with those before treatment in each group(P<0.05). After treatment, the sc

关 键 词：针刺联合艾灸 过敏性鼻炎 临床疗效 安全性评价 

分 类 号：R246.6[医药卫生—针灸推拿学]