从中医“正气”理论探讨变应性鼻炎的治疗

中医"正气"理论强调了正气在疾病的发生发展中具有决定性作用,变应性鼻炎的发生主要责之于正气亏虚、免疫功能低下、机体抗病能力弱,无以抵抗外邪的侵袭。脏腑亏虚、功能失调、体质异常皆为正气不足的表现。治疗上应使患者"正气存内",既要在发病之时及时控制炎症反应,补益正气,扶正祛邪;又要注重未病防护,自我调养。     

从湿论治过敏性鼻炎探賾

过敏性鼻炎属于临床常见的过敏性疾病之一,其病因病机复杂难辨.湿邪伤人多从口鼻而入,不仅影响鼻的生理功能,又内伤五脏六腑,易致过敏性鼻炎发作.文章从湿邪与过敏性鼻炎的相关性进行探讨,认为无论外湿或内湿皆可引发过敏性鼻炎.其旨在充实中医湿邪致病理论的同时,亦为临床防治过敏性鼻炎提供一定的研究方向.     

113例荨麻疹兼见过敏性鼻炎临床调查

目的通过临床典型病例调查探索"肺主皮毛"理论内涵及其对荨麻疹和过敏性鼻炎辨证论治的指导意义。方法通过对2014年3月至2015年2月期间在新疆医科大学附属中医医院及第五附属医院皮肤科门诊及病房就诊的荨麻疹患者113例作典型病例临床调查,分析总结荨麻疹兼见过敏性鼻炎的发病情况。结果 (1)113例荨麻疹患者中有51例兼见过敏性鼻炎(占45.13%),急、慢性荨麻疹兼见过敏性鼻炎的比较,χ~2=5.271,P0.05;(2)51例荨麻疹中有43例先发有过敏性鼻炎(比例为84.31%),40例慢性荨麻疹中有32例先发过敏性鼻炎(比例为80%)。结论荨麻疹与过敏性鼻炎基本病机皆与"肺"相关,肺失宣发与肃降或肺气虚弱可能是荨麻疹兼见过敏性鼻炎发作的主要原因。     

内外结合治疗过敏性鼻炎临床观察

内外结合治疗过敏性鼻炎临床观察吉林省人民医院耳鼻喉科（１３００２１）赵丹妮【关键词】中药内服法，激光穴位照射法，过敏性鼻炎过敏性鼻炎是一种变态反应性疾病，又称变态反应性鼻炎。以发作性鼻痒、鼻塞、喷嚏、流清水样涕为主要症状，我们在实践中发现：采用内治、...     

陈竹医师辨证治疗儿童过敏性鼻炎临证经验

陈竹副主任医师认为过敏性鼻炎主因是感受风邪,正气不足所致,在治疗上以疏风散邪、通鼻窍、补肺固表扶正为主,同时强调结合中医外治法综合治疗,从而缩短病程,减少复发率。总结陈竹副主任医师灵活辨治小儿过敏性鼻炎的临证经验,分析陈老师治疗小儿过敏性鼻炎的用药经验和学术思想。     

僵蚕治疗过敏性鼻炎疗效确切

我科用白僵蚕加味治疗过敏性鼻炎疗效显著.过敏性鼻炎可分常年性和季节性两种,尤其在内蒙古地区发病率较高,典型症状是阵发性发作,鼻内发痒,连续喷嚏,大量清水样鼻涕,具有鼻塞和嗅觉减退等,季节性者症状比常年性者严重,多在花开季节发作,症状呈持续性,除鼻部症状外,尚有眼痒、流泪、喉痛、气管发痒、咳嗽哮喘等.中医认为,肺开窍于鼻,肺气平和,卫气固密,则鼻窍灵敏,若卫阳不固,肺气不宣,则导致鼻窍失灵.<内经>云:"正气存内,邪不可干","邪之所凑,其气必虚."     

浅谈肖相如教授治疗过敏性鼻炎的经验

肖相如教授系北京中医药大学附属国医堂中医门诊部主任医师,博士研究生导师,工作30余载,对中医药防治过敏性鼻炎颇多领悟,在“顾护正气”理论的前提下擅于应用益气养阴护肾的中药方治疗过敏性鼻炎,常获效验.兹将其治疗过敏性鼻炎的经验介绍如下.     

近10年针灸治疗过敏性鼻炎研究进展

过敏性鼻炎已经成为现代临床常见的疾病之一,其发病率逐年增长。近几年研究发现,传统中医药在治疗及预防过敏性鼻炎中起到至关重要的作用,其中最为推崇及突出的为针灸疗法,故笔者对近10年有关针灸治疗过敏性鼻炎的相关文献进行梳理。笔者发现,针灸治疗过敏性鼻炎方法丰富多样,疗效显著,具体治疗方法可分为:单纯普通针刺治疗、针刺配合火罐治疗、针刺配合中药治疗、针刺配合隔物灸治疗、针刺结合自血疗法治疗、针刺配合穴位注射疗法、针刺配合耳针疗法、针刺配合穴位贴敷疗法、针刺配合中药雾化及其他方法等方案,都能够明显改善过敏性鼻炎引起的症状,操作简便,经济实用,效果显著。但笔者同时发现许多文献在实验设计、评价标准、基础研究、作用机制、结合方式等方面也存在一些不足。     

王丽平针灸治疗过敏性鼻炎经验探析

王丽平教授对治疗过敏性鼻炎有独到见解,常以多种针灸方法联合应用。她根据过敏性鼻炎的病机特点,立扶正固卫之法,应用腹部腧穴扶助正气,配以灸法、拔罐法固护卫气。附验案2则以佐证。     

彭顺林教授应用止嗽散加减治疗过敏性咽炎体会

彭顺林教授巧用止嗽散加减治疗过敏性咽炎以控制、消除症状,同时注重通过饮食、生活调摄达到"阴平阳秘""正气存内,邪不可干",从而防止该病复发的目的,具有良好的临床疗效。     

Patientin mit allergischer Rhinitis: Female Patient Suffering from Allergic Rhinitis

Background

Any allergic problem is a functional disease and therefore accessible to functional therapies such as acupuncture. This case report of a 25 year-old female patient who in her childhood suffered from eczema and rhinitis due to cat-hair allergy and who over the recent years has developed a mite allergy causing persistent pain in the sinuses demonstrates how allergic problems can be treated using acupuncture and related techniques. In addition to well-established acupuncture points, three experts will show further methods to alleviate allergic symptoms.

Objective

The aim of treating patients with allergic disposition is to reduce symptoms as well as the use of anti-histaminic drugs. Treatment should also prevent an aggravation of symptoms, for instance from allergic rhinitis to allergic asthma.

Methods

One acupuncture session per week over the course of 10 weeks.

Results

The patient's symptoms in the present case could be reduced by about 50 %. This result remained stable throughout the following 6 months. There was no follow-up.

Discussion

Acupuncture can alleviate allergic symptoms but should always be combined with the appropriate diet as well as physical exercise. Clinical studies have brought inhomogenous results. However, long-term observations collected at the Kaiserin Elisabeth-Hospital in Vienna suggest that acupuncture administered as a therapy against allergic rhinitis should be initialized pre-seasonally and be administered annually over the course of 10 weeks.     

疏肝清肝法治疗变应性鼻炎

研究表明,古今医家治疗变应性鼻炎,多从肺脾肾论治。临床中作者发现,部分患者的病机与肝有关,属于肝气郁结或肝经风热,作者从肝论治,治以疏肝解郁,益气固表,或清肝泻火,疏风止痒,疗效满意。文章分析了肝病引发变应性鼻炎的病机,探讨了相应的治疗方法和用药特点,为变应性鼻炎的治疗拓宽了思路。     

变应性鼻炎从脾论治辨析

脾脏与变应性鼻炎关系密切。本文从病因病机、经脉络属、生理、病理功能等方面探讨脾与变应性鼻炎的关系,阐述脾虚为变应性鼻炎发病的根本病机,提示变应性鼻炎临床遣方用药当重视"益气健脾,升阳通窍"之法,并从现代病理、药理学及临床案例证实益气健脾的重要性,为临床从脾论治变应性鼻炎提供思路。     

“脾主四时”与鼻鼽发病相关性的理论发微

鼻鼽发病受外界环境影响显著。脾土为肺金之母，脾与鼻窍关系亦密切，脾不独主一时，作为后天之本，在各个季节对常年性变应性鼻炎的发病皆有影响，从“脾主四时”角度探讨鼻鼽的病因、病机、治法方药，明确脾在该病中的地位，以及与其他脏腑在该病发生发展中的相互影响与联系，进而充实“脾主四时”的科学内涵，也为临床防治鼻鼽提供一定的理论依据。     

推拿结合中药治疗小儿过敏性鼻炎28例

目的：探讨推拿结合中药治疗小儿过敏性鼻炎的临床疗效。方法：将28例小儿过敏性鼻炎患者采用小儿推拿结合玉屏风散并桂枝汤煎剂口服,治疗6次后观察临床疗效。结果：推拿结合中药治疗小儿过敏性鼻炎的总有效率为85.71%。结论：小儿推拿结合玉屏风散并桂枝汤治疗过敏性鼻炎疗效肯定,值得临床上推广应用。     

“鼻三针”结合超短波治疗过敏性鼻炎的疗效观察

目的:观察"鼻三针"为主配合超短波治疗过敏性鼻炎的疗效。方法:以针刺"鼻三针"为主配合超短波治疗过敏性鼻炎,1次/d,3次为1个疗程,治疗2个疗程后评定疗效。结果:总有效率为80.8%。结论:针刺"鼻三针"配合超短波治疗过敏性鼻炎疗效显著。     

联合穴位脱敏治疗变态反应性鼻炎伴发哮喘419例疗效分析

目的：探讨联合穴位脱敏新疗法的效果。方法：用阳性变应原浸液，在头部穴位和背上部穴位联合脱敏治疗４１９例变态反应性鼻炎伴发哮喘患者。结果：治疗３个疗程后，再用相应的阳性变应原重复皮试，其红晕、肿胀范围比治疗前缩小（Ｐ〈０．０１）。联合穴位脱敏组＾３Ｈ－ＴｄＲ掺入洒巴细胞转化率与Ａ（穴位水针组）或Ｂ（上臂皮下脱敏组）两对照组相比较，差异显著（Ｐ〈０．０１）；嗜酸性细胞直接计数、ＩｇＡ、ＩｇＧ、Ｅ－玫瑰     

针刺配合中药治疗过敏性鼻炎40例疗效观察

目的　观察针刺配合中药治疗过敏性鼻炎的临床疗效。方法　 70例过敏性鼻炎随机分为 2组。治疗组 4 0例采用针刺配合中药玉屏风散加减治疗 ,对照组 30例服用酮替芬治疗。 2组均 6周为 1个疗程。结果　治疗组总有效率 92 .5 % ,对照组总有效率 73.3% ,2组比较有显著性差异 (P <0 .0 5 )。结论　针刺配合中药治疗过敏性鼻炎疗效确切     

鼻鼽汤治疗儿童变应性鼻炎临床研究

目的:研究用三维组方方法自拟鼻鼽汤治疗儿童变应性鼻炎的临床疗效。方法:将204例符合变应性鼻炎诊断标准的患儿按随机数字表法分为三组,每组68例,三组分别为自拟中药鼻鼽汤组(中药组),西药丙酸氟替卡松气雾剂组(西药组)和中西药联合组(联合组)。中药组采用单纯中药鼻鼽汤治疗,西药组用单纯西药丙酸氟替卡松治疗,联合组采用联合治疗,经过为期1个月的治疗观察疗效。结果:中药组总有效率为88.23%,西药组为55.88%,联合组为95.58%,差异具有统计学意义(P<0.05)。三组患儿症状评分均低于治疗前(喷嚏、清水样涕、鼻氧、鼻塞等),联合组低于单纯中药组(P<0.05),单纯中药组低于西药组(P<0.05),联合组低于单纯西药组(P<0.05)。 三组血清免疫球蛋白 E(IgE)和白细胞介素-17(IL-17)水平都明显下降,三组白细胞介素-10(IL-10)与治疗前比较都升高,差异具有统计学意义( P<0.05),且三组上述指标的改善情况为联合组免疫球蛋白 E(IgE)和白细胞介素-17(IL-17)水平均下降最为明显,单纯西药组指标下降低于单纯中药组(P<0.05)。结论:鼻鼽汤治疗儿童变应性鼻炎效果优于单纯丙酸氟替卡松气雾剂,自拟鼻鼽汤联合丙酸氟替卡松治疗变应性鼻炎效果优于单纯中药治疗。中西药配合使用治疗儿童变应性鼻炎效果更加明显。     

Treatment of perennial allergic rhinitis using Shi-Bi-Lin,a Chinese herbal formula

Aim of the study

Shi-Bi-Lin (SBL) is modified from the classic formula Cang-Er-Zi-San which has been used to treat chronic rhinitis, paranasal sinusitis and allergic rhinitis by herbal practitioners. The present study aimed at patients with moderate to severe perennial allergic rhinitis. SBL which has been shown effective in treating a guinea-pig model of allergic rhinitis, was evaluated for its efficacy and safety.

Materials and methods

126 allergic rhinitis patients were recruited in a double-blind randomized control trial. Half of the patients received SBL capsules and the others half received placebo for 4 weeks. Symptoms scores, physician's evaluation, nose examination, quality of life, adverse effects, serum cytokines were evaluated before and after treatment.

Results

SBL was found to be safe and effective in relieving some symptoms of perennial allergic rhinitis, improving the nose condition, and enhancing some domains of quality of life when compare to placebo, (p < 0.05). In the 2 weeks follow up after treatment completion, the SBL enjoyed a prolongation of symptom control (p = 0.05).

Conclusion

SBL relieved symptoms of nose blockage among patients with perennial allergic rhinitis, and some aspects of the quality of life were also improved. The improvement was sustained for at least 2 weeks after treatment. No serious adverse events were encountered.