改良无痛麦粒化脓灸治疗肺虚感寒型变应性鼻炎:随机对照试验  

Modified painless wheat-grain blistering moxibustion for allergic rhinitis of lung deficiency and cold attacking:a randomized controlled trial

作　　者：张扬 任峥瑜 刘迪 邵智愚 郭金依 刘润峰 刘晓峰 苏秀贞[4] ZHANG Yang;REN Zhengyu;LIU Di;SHAO Zhiyu;GUO Jinyi;LIU Runfeng;LIU Xiaofeng;SU Xiuzhen(College of TCM,Weifang Medical University,Weifang 261000,Shandong Province,China;Department of TCM,Weifang People's Hospital;College of Acupuncture-Moxibustion and Tuina,Shandong University of TCM;Department of Acupuncture-Moxibustion,Weifang Hospital of TCM,Weifang 261000,Shandong Province)

机构地区：[1]潍坊医学院中医学院,山东潍坊261000 [2]潍坊市人民医院中医科 [3]山东中医药大学针灸推拿学院 [4]潍坊市中医院针灸科,山东潍坊261000

出　　处：《中国针灸》2024年第9期989-994,共6页Chinese Acupuncture & Moxibustion

基　　金：山东省中医药管理局齐鲁医派中医药特色技术推广项目:鲁卫涵[2020]132号;潍坊市卫生健康委员会科研项目:WFZYY2022-4-015。

摘　　要：目的:观察改良无痛麦粒化脓灸治疗肺虚感寒型变应性鼻炎(AR)的临床疗效及对患者血清免疫球蛋白E(IgE)、白细胞介素-10(IL-10)的影响。方法:将98例常年性肺虚感寒型AR患者随机分为观察组(49例,脱落2例)和对照组(49例,脱落2例)。对照组予糠酸莫米松鼻喷雾剂喷鼻治疗;观察组在对照组治疗基础上,于双侧肺俞、膏肓、足三里及身柱穴采用改良无痛麦粒化脓灸治疗,身柱隔天灸1次,每次灸3壮,施灸约1周后形成灸疮,此后每隔2d灸治1次;肺俞、膏肓、足三里左右侧分开施灸,先连续灸一侧穴位,隔天灸1次,每穴灸3壮,直至灸疮形成,再灸对侧穴位,如此两侧交替施灸。两组均治疗4周。观察两组治疗前后及治疗结束后4、12周随访时鼻部症状评分(TNSS)、鼻部症状视觉模拟量表(VAS)评分、鼻结膜炎相关生活质量问卷(RQLQ)评分,检测两组治疗前后血清Ig E以及IL-10含量,并观察两组疗效及随访复发率。结果:治疗后及随访时,两组患者TNSS、VAS、RQLQ评分均低于治疗前(P<0.05),观察组以上各项评分均低于对照组(P<0.05);除对照组随访时各时点及观察组随访4周TNSS评分外,两组患者以上各项评分均高于治疗后(P<0.05)。治疗后,两组患者血清Ig E含量较治疗前降低(P<0.05),血清IL-10含量较治疗前升高(P<0.05);观察组患者血清Ig E含量低于对照组(P<0.05),血清IL-10含量高于对照组(P<0.05)。观察组总有效率为93.6%(44/47),高于对照组的74.5%(35/47,P<0.05);观察组随访4、12周时复发率均低于对照组[4.5%(2/44)vs 22.9%(8/35),9.1%(4/44)vs 40.0%(14/35),P<0.05]。结论:在糠酸莫米松鼻喷雾剂治疗基础上加用改良无痛麦粒化脓灸可以明显改善肺虚感寒型AR患者临床症状,且远期疗效更巩固,其机制可能与调节血清Ig E、IL-10水平有关。Objective To observe the clinical efficacy of modified painless wheat-grain blistering moxibustion for allergic rhinitis(AR)of lung deficiency and cold attacking,and to explore its effects on serum immunoglobulin E(IgE)and interleukin-10(IL-10).Methods Ninety-eight patients of perennial AR with lung deficiency and cold attacking were randomly divided into an observation group(49 cases,2 dropped out)and a control group(49 cases,2 dropped out).The control group received mometasone furoate nasal spray treatment.The observation group received modified painless wheat-grain blistering moxibustion at bilateral Feishu(BL 13),Gaohuang(BL 43),Zusanli(ST 36),and Shenzhu(GV 12)in addition to the control group's treatment.Moxibustion at Shenzhu(GV 12)was applied once every other day,3 grains each time,forming moxibustion sores after about one week.After sores formed,moxibustion was applied once every other 2 days.For Feishu(BL 13),Gaohuang(BL 43),and Zusanli(ST 36),moxibustion was applied on one side first,every other day,3 grains each time,until sores formed,then on the other side,alternating sides in a cycle.Both groups were treated for 4 weeks.The total nasal symptoms score(TNSS),nasal symptom visual analogue scale(VAS),and rhinoconjunctivitis quality of life questionnaire(RQLQ)scores were observed before and after treatment,and after 4 and 12 weeks of treatment completion(follow-ups).Serum IgE and IL-10 levels were measured before and after treatment,and treatment efficacy and recurrence rates at follow-ups were recorded.Results Compared before treatment,TNSS,VAS,and RQLQ scores in both groups were reduced after treatment and at follow-ups(P<0.05),and these scores in the observation group were lower than those in the control group(P<0.05).Except for TNSS scores in the control group at the follow-ups,and in the observation group at the 4-week follow-up,all scores at follow-ups in both groups were higher than those after treatment(P<0.05).Compared before treatment,serum IgE levels in both groups were decreased(P<0.05),and s

关 键 词：变应性鼻炎 肺虚感寒型 改良无痛麦粒化脓灸 远期疗效 免疫球蛋白E 白细胞介素-10 

分 类 号：R246.81[医药卫生—针灸推拿学]