摘要
目的:观察扶阳固本针灸法治疗常年性变应性鼻炎(PAR)的远期疗效与安全性,并探讨其作用机制。方法:PAR患者随机分为针药组30例、西药组30例。西药组予以丙酸氟替卡松鼻喷雾剂喷鼻治疗,每次每侧鼻腔各1喷,每日1次,共治疗6周;针药组在西药组的基础上,配合扶阳固本针灸法治疗,针刺上星、印堂及双侧迎香、上迎香、四白、合谷、尺泽,大椎采用温针灸,每次治疗30min,前4周每周治疗3次,后两周每周治疗2次,共治疗6周。比较治疗前、治疗后及随访第10、18、30周两组患者回顾性鼻症状总分(rTNSS)、鼻伴随症状总分(TNNSS)、眼周症状评分(TOSS)、鼻结膜炎生活质量量表(RQLQ)评分。ELISA法检测患者治疗前、治疗6周后血清总免疫球蛋白E(IgE)、白细胞介素-4(IL-4)含量。结果:治疗后,两组患者rTNSS、TNNSS、TOSS、RQLQ评分均较治疗前降低(P<0.05);随访第10、18、30周两组患者rTNSS、TNNSS、TOSS、RQLQ评分均较治疗前降低(P<0.05),针药组明显低于西药组(P<0.05)。治疗后,针药组患者血清总IgE、IL-4含量较治疗前明显减少(P<0.05),针药组血清总IgE、IL-4含量低于西药组(P<0.05)。结论:在丙酸氟替卡松鼻喷雾剂基础上,加用扶阳固本针灸法治疗PAR安全有效,远期疗效明显,其机制可能与下调患者血清总IgE、IL-4有关。
Objective To investigate the long-term clinical efficacy and safety of“Fuyang Guben”(supporting yang and consolidating root)acupuncture-moxibustion therapy on perennial allergic rhinitis(PAR),and to explore its functioning mechanism.Methods The patients with PAR were randomly divided into acupuncture+western medicine group(n=30)and western medicine group(n=30).In the western medicine group,fluticasone propionate nasal spray was administered,one spray in each nostril in one treatment,once a day,for 6 weeks.On the basis of the western medicine group,fuyangguben acupuncture-moxibustion therapy was supplemented.Acupuncture was applied to Shangxing(GV23),Yintang(GV24+),and bilateral Yingxiang(LI20),Shangyingxiang(EX-HN8),Sibai(ST2),Hegu(LI4)and Chize(LU5);warm needling was applied at Dazhui(GV14).The patients of this group received 30 min of acupuncture-moxibustion therapy 3 times weekly during the first 4 weeks and twice a week in the last 2 weeks,totally for 6 weeks.Before treatment,after treatment,in week 10,18 and 30 of follow-up visits,the reflective total nasal symptom score(rTNSS),the total non-nasal symptom score(TNNSS),the total ophthalmic symptom score(TOSS),and the score of the rhinitis quality of life(RQLQ)scale were compared in the patients of the two groups separately.Using ELISA,the serum concentrations of total immunoglobulin E(IgE)and interleukin-4(IL-4)were detected before and after treatment.Results After treatment,the rTNSS,TNNSS,TOSS,as well as RQLQ score were lower in comparison with those before treatment in each group(P<0.05).The rTNSS,TNNSS,TOSS and the score of RQLQ in the week 10,18 and 30 of follow-up visits were reduced when compared with those before treatment in each group(P<0.05),and these scores in the acupuncture+western medicine group were remarkably lower than those of the western medicine group(P<0.05).After treatment,the serum contents of total IgE and IL-4 were significantly decreased when compared with those before treatment in the acupuncture+western medicine group(P<0.05),and these indicators in the acupuncture+western medicine group were lower than those of the western medicine group(P<0.05).Conclusion On the base of treatment with fluticasone propionate nasal spray,“Fuyang Guben”acupuncture-moxibustion therapy is safe and effective on PAR,presenting a remarkably long-term efficacy.The functioning mechanism may be related to the down-regulation of total IgE and IL-4 in serum.
作者
吴飞虎
查必祥
张婷婷
陈卓泓
赵宏
刘钢
WU Fei-hu;ZHA Bi-xiang;ZHANG Ting-ting;CHEN Zhuo-hong;ZHAO Hong;LIU Gang(Department of Otolaryn-gology,The First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230031,China;Department of Acupuncture and Moxibustion,The First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230031,China;Acupuncture and Moxibustion Hospital,China Academy of Chinese Medical Sciences,Beiing 100700)
出处
《针刺研究》
CAS
CSCD
北大核心
2023年第6期600-605,共6页
Acupuncture Research
基金
国家中医药管理局中医药循证能力建设项目(No.2019xzzx-zj001)。
关键词
常年性变应性鼻炎
扶阳固本针灸法
远期疗效
免疫球蛋白E
白细胞介素-4
Perennial allergic rhinitis
“Fuyang Guben”acupuncture-moxibustion therapy
Long-term efficacy
Immunoglobulin E
Interleukin-4
