鼻内针刺联合中药序贯疗法治疗中-重度变应性鼻炎的疗效及对细胞因子、嗅觉功能的影响  

Efficacy of Intranasal Acupuncture Combined with TCM Sequential Therapy in the Treatment of Moderate-to-severe Allergic Rhinitis and the Effects on Cytokines and Olfactory Function

作　　者：李丙泉 董博洋 李岩[2] LI Bingquan;DONG Boyang;LI Yan(Graduate School of Heilongjiang University of Chinese Medicine,Harbin 150040,China;First Affiliated Hospital,Heilongjiang University of Chinese Medicine,Harbin 150040,China)

机构地区：[1]黑龙江中医药大学研究生院,黑龙江哈尔滨150040 [2]黑龙江中医药大学附属第一医院,黑龙江哈尔滨150040

出　　处：《中国中医药信息杂志》2024年第5期145-150,共6页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：教育部春晖计划(HLJ2019036);国家自然科学基金(81874495);黑龙江省自然科学基金(LH2019H054);黑龙江省中医药科研项目(ZHY19-033)。

摘　　要：目的观察鼻内针刺联合中药序贯疗法治疗中-重度变应性鼻炎的临床疗效,及对细胞因子、嗅觉功能的影响。方法采用随机数字表法将180例患者按1∶1∶1∶1比例分为西药组、鼻内针刺组、中药序贯疗法组和联合组各45例。西药组予糖酸莫米松鼻喷雾剂,鼻内针刺组针刺双侧内迎香、鼻丘,中药序贯疗法组予中药熏蒸鼻部,联合组采用鼻内针刺联合中药熏蒸鼻部,4组均连续治疗2周。分别观察4组治疗前后鼻部症状积分(TNSS)、鼻伴随症状积分(TNNSS)、嗅觉功能评分、嗜酸性粒细胞计数(EOS)、IgE及血清细胞因子白细胞介素-4、γ干扰素。监测4组患者治疗期间可能出现的不良反应。结果联合组总有效率(88.89%)高于西药组(71.11%)、鼻内针刺组(75.56%)、中药序贯疗法组(73.3%),4组比较差异有统计学意义(P<0.05)。4组患者治疗后TNSS、TNNSS、嗅觉功能评分及EOS、IgE均下降(P<0.05),且联合组明显低于其他3组(P<0.05)。4组患者治疗后γ干扰素含量较治疗前升高、白细胞介素-4含量较治疗前降低,且联合组治疗后改善情况优于其他3组(P<0.05)。试验期间,西药组出现头疼2例、鼻出血2例、鼻部不适4例;鼻内针刺组出现鼻出血1例、针刺痛感1例;联合组出现鼻出血1例,均继续参与试验。结论鼻内针刺联合中药序贯疗法可改善变应性鼻炎患者临床症状,调节细胞因子水平,促进嗅觉功能恢复。Objective To observe the clinical efficacy of intranasal acupuncture combined with TCM sequential therapy in the treatment of moderate-to-severe allergic rhinitis and the effects on cytokines and olfactory function.Methods Using a random number table method,180 patients were divided into Western medicine group,intra nasal acupuncture group,TCM sequential therapy group,and combination group in a ratio of 1∶1∶1∶1,with 45 cases in each group.The Western medicine group was treated with dexamethasone gluconate nasal spray,the intra nasal acupuncture group was treated with acupuncture on bilateral Neiyingxiang and Biqiu,the TCM sequential therapy group was treated with TCM fumigation of the nose,and the combined group was treated with intra nasal acupuncture combined with TCM fumigation of the nose.All four groups were treated continuously for 2 weeks.Total nasal symptom score(TNSS),total non-nasal symptom score(TNNSS),olfactory function scores,EOS,IgE and serum cytokines of IL-4 and IFN-γ,before and after treatment were observed in each group respectively.Adverse reactions in the four groups were observed.Results The total effective rate of the combination group(88.89%)was higher than that of the Western medicine group(71.11%),the intranasal acupuncture group(75.56%),and the TCM sequential therapy group(73.3%).There was statistical significance among the four groups(P<0.05).TNSS,TNNSS,olfactory function score,and EOS,IgE of the patients in the four groups decreased after treatment(P<0.05),and the combination group was significantly lower than the other three groups(P<0.05).After treatment,the content of IFN-γin the four groups was higher than before treatment,the content of interleukin-4 decreased compared with before treatment,and the improvement in the combination group was better than the other three groups(P<0.05).During the trial period,two cases of headache,two cases of nasal bleeding,and four cases of nasal discomfort occurred in the patients of the Western medicine group;one case of nasal bleeding and

关 键 词：鼻内针刺 中药序贯疗法 变应性鼻炎 疗效观察 

分 类 号：R276.521[医药卫生—中医五官科学]