玉屏风颗粒联合西替利嗪治疗过敏性鼻炎疗效观察及对患者血清炎性因子水平的影响  

Efficacy of Yupingfeng granule combined with cetirizine in the treatment of allergic rhinitis and its effects on serum inflammatory factor level

作　　者：张爱春[1] 方玉婷 靳阳子[1] 张辰 Zhang Aichun;Fang Yuting;Jin Yangzi;Zhang Chen(Department of Otolaryngology,Zhejiang Provincial Hospital of Chinese Medicine,Hangzhou 310000,Zhejiang Province,China)

机构地区：[1]浙江省中医院耳鼻喉科,杭州310000

出　　处：《中国基层医药》2023年第4期523-527,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省中医药科技计划(2016ZB044)。

摘　　要：目的探讨玉屏风颗粒联合西替利嗪治疗过敏性鼻炎的疗效观察及对患者血清炎性因子水平的影响。方法选取浙江省中医院2021年1月至2022年3月诊治的过敏性鼻炎患者162例,采用前瞻性对照研究方法,按照随机数字表法分为两组,各81例。对照组给予西替利嗪治疗,观察组给予玉屏风颗粒联合西替利嗪治疗,两组疗程4周。观察比较两组治疗4周后临床疗效;比较两组治疗前与治疗后4周主要症状积分,鼻功能指标[总鼻气道阻力(NAR)、鼻腔最小横断面积(NMCA)和0~5 cm鼻腔容积(0~5 cmNCV)],炎性因子[白细胞介素4(IL-4)、白细胞介素6(IL-6)和白细胞介素10(IL-10)]水平,及鼻结膜炎生活质量调查问卷(RQLQ)评分变化。结果观察组治疗总有效率[92.59%(75/81)]高于对照组[79.01%(64/81)](χ^(2)=6.13,P<0.05)。治疗后4周,观察组鼻塞(0.63±0.20)分、鼻痒(0.70±0.21)分和喷嚏(0.54±0.17)分,均低于对照组的(1.07±0.23)分、(1.08±0.24)分和(0.89±0.22)分(t=12.99、10.72、11.33,均P<0.05)。治疗后4周,观察组总NAR(0.17±0.05)kPa·s^(-1)·L^(-1),低于对照组的(0.26±0.06)kPa·s^(-1)·L^(-1),而NMCA[(0.94±0.17)cm2]和0~5 cmNCV[(9.74±0.89)cm3]均高于对照组的(0.76±0.10)cm2和(8.43±0.78)cm3,差异均有统计学意义(t=10.37、8.21、9.96,均P<0.05)。治疗后4周,观察组血清IL-4(67.79±9.94)ng/L和IL-6(6.74±1.42)ng/L,均低于对照组的(104.31±14.45)ng/L和(10.29±2.56)ng/L,而IL-10(17.97±2.54)ng/L,高于对照组的(12.48±2.46)ng/L,差异均有统计学意义(t=18.74、10.91、13.97,P<0.05)。治疗后4周,观察组RQLQ评分(27.43±8.82)分,低于对照组的(38.95±7.76)分(t=8.82,P<0.05)。结论玉屏风颗粒联合西替利嗪对过敏性鼻炎患者疗效显著,可减轻患者主要症状,改善患者鼻功能,减轻患者炎性反应,提高患者生活质量。Objective To investigate the efficacy of Yupingfeng granule combined with cetirizine in the treatment of allergic rhinitis and its effects on serum inflammatory factor level.Methods A total of 162 patients with allergic rhinitis admitted to Zhejiang Provincial Hospital of Chinese Medicine from January 2021 to March 2022 were included in this prospective controlled study.They were randomly divided into a control group and an observation group(n=81/group).The control group was treated with cetirizine and the observation group was treated with Yupingfeng granule combined with cetirizine.All patients were treated for 4 weeks.Clinical efficacy was compared between the two groups after 4 weeks of treatment.Main symptom score,nasal function indexes(total nasal airway resistance,nasal minimal cross-sectional area,and 0-5 cm nasal cavity volume),levels of inflammatory factors(interleukin-4,interleukin-6,and interleukin^(-1)0),and Rhinoconjunctivitis Quality of Life Questionnaire scores were compared between the two groups before and after 4 weeks of treatment.Results Total response rate in the observation group was significantly higher than that in the control group[92.59%(75/81)vs.79.01%(64/81),χ^(2)=6.13,P<0.05].After 4 weeks of treatment,the scores of nasal congestion,nasal itching,and sneezing in the observation group were(0.63±0.20)points,(0.70±0.21)points,and(0.54±0.17)points,which were significantly lower than(1.07±0.23)points,(1.08±0.24)points,and(0.89±0.22)points in the control group(t=12.99,10.72,11.33,all P<0.05).After 4 weeks of treatment,total nasal airway resistance in the observation group was significantly lower than that in the control group[(0.17±0.05)kPa·s^(-1)·L^(-1)vs.(0.26±0.06)kPa·s^(-1)·L^(-1),t=10.37,P<0.05].Nasal minimal cross-sectional area and 0-5 cm nasal cavity volume in the observation group were(0.94±0.17)cm2 and(9.74±0.89)cm3,respectively,which were significantly higher than(0.76±0.10)cm2 and(8.43±0.78)cm3 in the control group(t=8.21,9.96,both P<0.05).After 4 weeks of trea

关 键 词：鼻炎 过敏 气道阻力 鼻腔 白细胞介素4 白细胞介素6 白细胞介素10 玉屏风颗粒 西替利嗪 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]