曲安奈德足三里穴位注射治疗非过敏性鼻炎的临床观察  

Clinical observation on the therapeutic effect of acupoint injection into Zusanli with triamcinolone acetonide on patients with non-allergic rhinitis

作　　者：李庆 刘业海[1,2,3] 马燕 吴飞虎[4] 张燕影[3] 沈雪琴[1,2,3] 袁星月[1,2,3] LI Qing;LIU Yehai;MA Yan;WU Feihu;ZHANG Yanying;SHEN Xueqin;YUAN Xingyue(Graduate School of Anhui University of Traditional Chinese Medicine,Anhui,China)

机构地区：[1]安徽中医药大学研究生院,合肥230031 [2]安徽医科大学中西医结合学系,合肥 [3]安徽医科大学第一附属医院耳鼻咽喉头颈外科,合肥 [4]安徽中医药大学第一附属医院耳鼻喉科,合肥

出　　处：《中国中西医结合耳鼻咽喉科杂志》2024年第4期249-254,302,共7页Chinese Journal of Otorhinolaryngology in Integrative Medicine

基　　金：安徽省卫生健康委项目,AHWJ2021b160;安徽医科大学第一附属医院首批“登峰计划”学科建设项目,(院科〔2019〕22号);2020年安徽省卫生健康软科学研究,重点项目(2020WR02014);2021年高等学校省级质量工程项目(项目编号2021jyxm0726)。

摘　　要：目的观察曲安奈德注射液足三里穴位注射治疗非过敏性鼻炎的临床疗效并探讨其作用机制。方法随机选取非过敏性鼻炎(non-allergic rhinitis,NAR)与过敏性鼻炎(allergic rhinitis,AR)门诊患者各50例,均予以双侧足三里穴位注射曲安奈德注射液治疗,每周1次,连续注射4周。治疗前后检测患者Th1、Th2相关因子水平;观察两组治疗4周时、3月后以及1年后随访期间的鼻部症状总评分(TNSS)变化,比较分析两组近期疗效和远期疗效。结果NAR组与AR组在治疗4周结束时、疗后3月及1年随访期间的TNSS均比治疗前明显下降(P<0.05)。NAR组与AR组患者治疗4周后的血清白介素-2(IL-2)、干扰素-γ(INF-γ)、肿瘤坏死因子(TNF)水平均比治疗前上升(P<0.05),白介素-4(IL-4)则较治疗前显著下降(P<0.05)。治疗4周后NAR组有效率84.0%,AR组有效率92.0%。随访期间,疗后3月NAR组有效率72.0%,AR组有效率64.0%,两组疗效差异无统计学意义(P>0.05);1年后,NAR组总有效率54.0%,AR组总有效率30.0%,NAR组总有效率显著高于AR组(P<0.05)。结论足三里穴位注射治疗NAR远期疗效更佳,对脾气虚弱和肺气虚寒型的治疗有效率更高。其机制可能与提升Th1细胞因子的分泌并抑制IL-4的产生,从而调节Th1/Th2的稳定状态相关。Objective To investigate the therapeutic effect of acupoint injection into Zusanli(ST36)with triamcinolone acetonide on patients with non-allergic rhinitis(NAR)and its effect mechanism.Methods A total of 100 cases with NAR or AR were randomly selected from outpatient cases,with 50 in each group.Triamcinolone acetonide injection was injected into acupoint Zusanli(ST36)on both sides of all cases in both groups,once a week and lasted for 4 weeks.The levels of Th1 and Th2 cytokines were determined before and after treatment among them respectively.At the same time,the total score of nasal symptoms(TNSS)was recorded at these time points as by the ends of the 4th week during the therapeutic course,the 3rd months after the treatment and 1 year during the following up period to evaluate their differences in the short-term and long-term efficacies between the two groups in a comparative way.Results There were significant improvement in TNSS among cases in both groups following the treatment lasted for 4 weeks,by the ends of the 3rd month and 1 year after treatment(P<0.05),significantly decreased when compared with that measured before treatment.The serum levels of interleukin-2(IL-2),interferon-γ(INF-γ)and tumor necrosis factor(TNF)were significantly increased in 2 groups following treatment(P<0.05),while that of interleukin-4(IL-4)was significantly decreased after treatment,when compared with that determined before treatment(P<0.05).By the end of the 4th week of therapeutic course,the effective rate evaluated was 84.0%in the NAR group and 92.0%in the AR group,while it was 72.0%in NAR group and 64.0%in AR group respectively during the follow-up period by of 54.0%in NAR group was significantly higher than that of 30.0%in AR group,with a statistically significant difference between them(P<0.05)by the end of the following up period lasted for one year.Conclusion Zusanli acupoint injection holds better long-term efficacy in the treatment of NAR,especially for those cases with the patterns of Spleen Qi weakness or Lung Qi de

关 键 词：非过敏性鼻炎 过敏性鼻炎 足三里 穴位注射 疗效 比较观察 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]