鼻炎1号方联合沙美特罗替卡松粉吸入剂治疗过敏性鼻炎合并哮喘的疗效观察  

Observation on the efficacy of Rhinitis Formula No.1 combined with Seretide on the treatment of allergic rhinitis complicated with asthma

作　　者：张晋韬 陈鸿杰[2] 柯千山[2] 肖阁敏[2] 杨宏志 黄雪琨[3,4] 杨钦泰[3,4] 戴敏[2,3] ZHANG Jintao;CHEN Hongjie;KE Qianshan;XIAO Gemin;YANG Hongzhi;HUANG Xuekun;YANG Qintai;DAI Min(Department of Traditional Chinese Medicine,Zhaoqing Hospital,the Third Affiliated Hospital of Sun Yat-sen University,Zhaoqing 526040,China;Department of Traditional Chinese Medicine,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China;Department of Allergy,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China;Department of Otorhinolaryngology,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院肇庆医院中医科,广东肇庆526040 [2]中山大学附属第三医院中医科,广东广州510630 [3]中山大学附属第三医院过敏科,广东广州510630 [4]中山大学附属第三医院耳鼻咽喉科,广东广州510630

出　　处：《新医学》2024年第11期928-935,共8页Journal of New Medicine

基　　金：国家自然科学基金(U20A20399);广东省中医药重点学科建设项目(20220104);全国名老中医药专家传承工作室建设项目(140000020162)。

摘　　要：目的探讨鼻炎1号方联合沙美特罗替卡松粉吸入剂(舒利迭)治疗过敏性鼻炎合并支气管哮喘(哮喘)的效果,为岭南中药在鼻肺异病同治中的应用提供新的临床依据。方法将140例符合过敏性鼻炎及哮喘诊断的患者随机分为中西医结合组和西药组各70例。西药组予舒利迭常规治疗,中西医结合组在西药组基础上加用鼻炎1号方(党参15 g、甘草6 g、柯子10 g、桔梗10 g、细辛3 g、荆芥10 g、熟地15 g、茯苓10 g、桂枝3 g、陈皮6 g、巴戟天6 g、乌梅10 g),每日1剂,分2次服用。2组均连续观察2周。比较2组治疗前后的自制中医证候量表评分、哮喘控制测试评分(ACT)、鼻炎症状评分(TNSS)、鼻炎伴随症状评分(TNNSS)、免疫功能指标、炎症指标以及不良反应。结果中西医结合组脱落5例,西药组脱落7例,脱落患者纳入安全性分析,但不纳入疗效统计学分析。2组患者治疗前中医量表评分、ACT、TNSS、鼻炎伴随症状评分、免疫功能指标、炎症指标具可比性(P均>0.05)。中西医结合组治疗后中医证候量表评分、TNSS、TNNSS均低于西药组,中西医结合组治疗后ACT高于西药组(P均<0.05)。中西医结合组中医证候量表评分、TNSS、TNNSS、ACT改善程度均优于西药组(P均<0.05)。治疗后,2组IgA、IgG水平均高于治疗前,IgE水平均低于治疗前;中西医结合组的IgA、IgG水平均高于西药组,IgE低于西药组(P均<0.05)。治疗后,2组IL-10水平均高于治疗前,IL-6及IL-17水平均低于治疗前,且中西医结合组患者的IL-10水平高于西药组,IL-6及IL-17水平均低于西药组(P均<0.05)。2组不良反应发生率比较差异无统计学意义(P=0.753)。结论与单用舒利迭相比,鼻炎1号方联合舒利迭治疗过敏性鼻炎合并哮喘的疗效更佳。Objective To explore the effect of Rhinitis Formula No.1 combined with Seretide on the treatment of allergic rhinitis complicated with asthma,aiming to provide a new clinical basis for the application of Lingnan Traditional Chinese Medicine in the integrated treatment of nasal and lung diseases.Methods One hundred and forty patients who met the combined diagnosis of allergic rhinitis and asthma were randomly divided into the Western Medicine group and the Traditional Chinese medicine(TCM)combined with Western Medicine group,with 70 cases in each group.The Western Medicine group received routine treatment with Seretide.The TCM and Western Medicine group,in addition to Seretide,was administered Rhinitis Formula No.1(consisting of 15 g Codonopsis pilosula,6 g Glycyrrhiza uralensis Fisch,10 g Terminalia chebula Retz,10 g Platycodon grandiflorus,3 g Asarum sieboldii,10 g Schizonepeta tenuifolia,15 g Radix Rehmanniae Praeparata,10 g Poria cocos,3 g Ramulus Cinnamomi,6 g dried tangerine peel,6 g Morinda officinalis,and 10 g smoked plum)once daily,divided into two doses.Both groups were continuously observed for two weeks.The two groups were compared based on the self-developed TCM Symptom Scale Score,Total Nasal Symptom Score(TNSS),Total Nasal and Non-Nasal Symptom Score(TNNSS),Asthma Control Test Scores(ACT),indicators of immune function and inflammation,and adverse reactions before and after treatment.Results In the Western Medicine group,7 patients dropped out,and in the TCM combined with Western Medicine group,5 patients dropped out.The patients who dropped out were included in the safety analysis but were not included in the statistical analysis of efficacy.The general data of the two groups was comparable,and there were no significant differences in the TCM Symptom Scale Scores,TNSS,TNNSS and ACT before treatment between the two groups(all P>0.05).After treatment,the TCM Symptom Scale Scores(P<0.001),TNSS(P<0.001),and TNNSS(P=0.001)in the TCM combined with Western Medicine group were lower than those in the Wester

关 键 词：过敏性鼻炎 哮喘 中西医结合 岭南中医方药 鼻炎1号方 

分 类 号：R765.21[医药卫生—耳鼻咽喉科] R562.25[医药卫生—临床医学]