针灸治疗脾虚型中重度持续性变应性鼻炎的临床效果探究

马新刚; 郭云良; 李志帅; 谢坤

doi:10.13898/j.cnki.issn.1000-2200.2021.04.020

针灸治疗脾虚型中重度持续性变应性鼻炎的临床效果探究

Clinical effects of acupuncture in the treatment of moderate and severe persistent allergic rhinitis of spleen deficiency type

摘要

摘要:
目的探究针灸结合地氯雷他定治疗脾虚型中重度持续性变应性鼻炎（AR）的疗效，以及对病人血清血小板活化因子（PAF）、转化生长因子-β（TGF-β）和辅助型T细胞1（Th1）/辅助性T细胞2（Th2）的影响。
方法将60例脾虚型中重度持续性AR病人按照随机数字表法分为2组，2组均进行健康教育，对照组30例给予地氯雷他定片治疗，观察组30例给予地氯雷他定片联合针灸治疗，2组疗程均为4周。比较2组疗效，观察比较2组病人治疗前后中医证候评分、视觉模拟量表（VAS）评分、鼻结膜炎病人生活质量问答卷（RQLQ）评分变化，并检测比较2组病人治疗前后血清PAF、TGF-β、干扰素-γ（IFN-γ）、白细胞介素-1（IL-1）、IL-4、IL-13、IL-35水平变化。
结果观察组有效率为93.33%明显高于对照组的70.00%（P < 0.05）。治疗后，2组中医证候各项评分及总分降低（P < 0.01），且观察组低于对照组（P < 0.01）；2组VAS评分和RQLQ评分均降低（P < 0.01），且观察组低于对照组（P < 0.01）；2组血清PAF、IL-4、IL-13、IL-35含量均降低（P < 0.01），且观察组低于对照组（P < 0.01）；2组血清TGF-β、IFN-γ、IL-1含量均升高（P < 0.01），且观察组高于对照组（P < 0.01）。
结论针灸联合氯雷他定治疗脾虚型中重度持续性AR，疗效显著，能够显著改善病人鼻部症状，提高生活质量，作用机制与调节PAF、TGF-β水平以及Th1/Th2平衡有关。

Abstract:
ObjectiveTo explore the effects of acupuncture combined with loratadine in the treatment of moderate and severe persistent allergic rhinitis(AR) of spleen deficiency type, and effects on the serum levels of platelet activating factor(PAF), transforming growth factor-β(TGF-β) and helper T cell 1(Th1)/helper T cell 2(Th2).
MethodsSixty patients with moderate or severe persistent AR of spleen deficiency type were divided into the control group and observation group according to the random number table method(30 cases in each group).Two groups were given health education, and the control group and observation group were treated with desloratadine and desloratadine combined with acupuncture for 4 weeks, respectively.The efficacy was compared between two groups.The changes of traditional Chinese medicine(TCM) syndrome scores, visual analogue scale(VAS) scores and RQLQ scores of rhinoconjunctivitis patients before and after treatment were observed and compared between two groups.The serum levels of PAF, TGF-β, interferon-γ(IFN-γ), interleukin-1(IL-1), IL-4, IL-13 and IL-35 in two groups were detected and compared between before and after treatment.
ResultsThe effective rates in the observation group and control group were 93.33% and 70.00%, respectively, and the difference of which was statistically significant between two groups(P < 0.05).After treatment, the each item score and total score of TCM syndrome in two groups were lower than those before treatment(P < 0.01), and the observation group was lower than the control group(P < 0.01).The VAS scores and RQLQ scores in two groups after treatment were lower than those before treatment(P < 0.01), and the observation group was lower than the control group(P < 0.01).After treatment, the serum PAF, IL-4, IL-B, and IL-35 levels of the two group decreased(P < 0.01);and the observation group was lower than the control group(P < 0.01);after treatment, the serum TGF-β, IFN-γ and IL-1 levels in the two groups increased(P < 0.01), and the observation group was higher than the control group(P < 0.01).
ConclusionsAcupuncture combined with loratadine in the treatment of moderate and severe persistent AR of spleen deficiency type has significant effects.It can significantly improve the nasal symptoms and quality of life of patients, and the mechanism of which is related to the regulation of PAF and TGF-β levels, and Th1/Th2 balance.

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