摘要
目的:观察隔药灸联合布地奈德鼻喷雾剂(雷诺考特)对肾阳虚型中重度持续性变应性鼻炎(AR的治疗作用,探讨鼻部温度与变应性鼻炎症情的相关性。方法:将70例中重度持续性AR患者随机分为观察组(35例)和对照组(35例,脱落3例)。两组均采用雷诺考特治疗,每次每侧鼻孔1喷(每喷约64μg),早晚各1次,连续治疗4周。观察组在此基础上,选用肾俞、肺俞、至阳、大椎隔药灸治疗,每穴灸3壮,单次治疗持续约30 min,隔日治疗1次,每周治疗3次,连续治疗4周。观察两组治疗前后及治疗后3个月随访时AR症状视觉模拟量表(VAS)评分的变化,采用红外热成像诊断系统检测两组患者治疗前后鼻、肺、大肠、肾体表投影区域热值(温度、极差)的变化情况,并对治疗前后的VAS评分与鼻温度进行相关性分析,根据VAS评分评价两组患者的临床疗效。结果:治疗后观察组总有效率为85.7%(30/35),高于对照组的71.9%(23/32,P<0.05)。治疗后及随访时两组患者VAS评分均较治疗前降低(P<0.05),且随访时观察组VAS评分低于对照组(P<0.05)。治疗后,观察组患者鼻温度、肺极差、大肠极差、肾极差均较治疗前降低(P<0.05),对照组患者鼻温度、鼻极差较治疗前降低(P<0.05),且观察组鼻温度、鼻极差、肾极差降低幅度大于对照组(P<0.05)。治疗前后,VAS评分均与鼻部温度存在相关性(P<0.05)。结论:隔药灸联合西药改善中重度持续性AR症状的疗效及远期疗效均优于单纯西药,且可以改善患者鼻、肺、大肠、肾体表投影区域的热值。此外,鼻部温度可反映中重度持续性AR患者症情的严重程度,或可作为评价AR症情的次要指标。
Objective To observe the therapeutic effect of herb-separated moxibustion combined with budesonide nasal spray(rhinocort)on moderate to severe persistent allergic rhinitis(AR)of kidney-yang deficiency type,and to explore the correlation between nasal temperature and condition of allergic rhinitis.Methods A total of 70 patients with moderate to severe persistent AR were randomized into an observation group(35 cases)and a control group(35 cases,3 cases dropped off).Both groups were treated with rhinocort,one spray on each side of the nostril(approximately 64μg each spray),once in the morning and once in the evening,for 4 weeks.On the basis of the above treatment,the observation group was treated with herb-separated moxibustion at Shenshu(BL 23),Feishu(BL 13),Zhiyang(GV 9),Dazhui(GV 14),3 moxibustions per acupoint,a single treatment lasting about 30 min.This treatment was given once every other day,3 times every week,and totally continuous 4 weeks.The changes of AR symptom visual analogue scale(VAS)scores were observed before and after treatment and at 3 months follow-up after treatment.The heat variation(temperature,range)on projection areas of the nose,lungs,large intestine and kidneys of the two groups’patients before and after treatment were detected by the infrared thermal imaging diagnostic system,and the correlation between the VAS scores and nasal temperature before and after treatment was analyzed.The clinical effects of both groups were evaluated according to the VAS score.Results The total effective rate in the observation group after treatment was 85.7%(30/35),which was higher than 71.9%in the control group(23/32,P<0.05).After treatment and at follow-up,the VAS scores of both groups were lower than those before treatment(P<0.05),and the VAS score of the observation group was lower than that of the control group at follow-up(P<0.05).After treatment,the nasal temperature,pulmonary range,large intestinal range and renal range of the observation group were all lower than those before treatment(P<0.05),the nasal temperature and nasal range of the control group were lower than before treatment(P<0.05),and the reduction of nasal temperature,nasal range and renal range in the observation group was greater than that of the control group(P<0.05).Before and after treatment,there was a correlation between VAS score and nasal temperature(P<0.05).Conclusion The herb-separated moxibustion combining western medication has a better effect and long-term effect than western medication alone for moderate to severe persistent AR,which can improve heat variation on projected areas of the nose,lung,large intestine and kidney of patients.In addition,nasal temperature can reflect the severity of the symptoms of patients with moderate to severe persistent AR,or it can be used as a secondary indicator to evaluate condition of AR.
作者
贾一凡
赵吉平
温志宏
谢琦
陈晟
JIA Yi-fan;ZHAO Ji-ping;WEN Zhi-hong;XIE Qi;CHEN Sheng(Department of TCM,Peking Union Medical College Hospital,Beijng 100010,China;Department of Acupuncture and Moxibustion,Dongzhimen Hospital,Beijng University of CM,Beijing 100700)
出处
《中国针灸》
CAS
CSCD
北大核心
2020年第7期721-725,共5页
Chinese Acupuncture & Moxibustion
基金
北京市自然科学基金项目:7164272
北京中医药科技发展基金项目:JJ 2015-62。
关键词
变应性鼻炎
红外热成像
症状评价
隔药灸
雷诺考特
allergic rhinitis(AR)
infrared thermal imaging
symptom evaluation
herb-separated moxibustion
rhinocort
