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大艾段温针灸治疗肺气虚寒型变应性鼻炎100例
作者姓名:孙敦坡  马小闵  姜明孝  尚国超  王益松  高绪柱
作者单位:1.南京医科大学康达学院附属连云港中医院,江苏 连云港 222004
摘    要:目的 观察大艾段温针灸治疗肺气虚寒型变应性鼻炎(AR)的疗效并探索其作用机制。方法 将入选病例随机分为观察组、对照组各105例。观察组大艾段温针灸,每日1次,每周治疗4次,4周为1个疗程。对照组急性期丙酸氟替卡松鼻喷雾剂喷鼻,枸地氯雷他定片口服。病情稳定后,枸地氯雷他定片停药,丙酸氟替卡松鼻喷雾剂继续喷鼻。4周为1个疗程。观察2组治疗结束时及治疗后30 d的中医证候总积分、西医临床症状总积分、体征总积分、视觉模拟评分法(VAS评分)以及血清免疫球蛋白E(IgE)、白细胞介素-4(IL-4)、γ干扰素(IFN-γ)水平的变化。结果 治疗后2组中医证候总积分、临床症状总积分、体征总积分以及鼻部整体症状的严重程度VAS评分均明显低于同组治疗前(P<0.01),观察组明显低于对照组(P<0.05~0.01);血清3项指标,组内及组间差异均具有统计学意义(P<0.01)。治疗结束后30 d随访,观察组疗效优于对照组(P<0.05);2组中医证候总积分、临床症状总积分、体征总积分以及鼻部整体症状的严重程度VAS评分均明显低于同组治疗前(P<0.01);观察组明显低于对照组(P<0.05~0.01);血清3项指标,IFN-γ含量,对照组治疗结束后30 d与治疗前比,差异无统计学意义(P>0.05),其余各组内、组间3项指标比较,差异有统计学意义(P<0.01)。结论 大艾段温针灸法治疗肺气虚寒型变应性鼻炎的疗效较好,可显著改善患者的中医证候、临床症状、体征、VAS评分,在调节血清IgE、IL-4、IFN-γ含量方面优于对照组,作用机制可能也与降低血清IgE、IL-4含量,升高IFN-γ含量相关。 

关 键 词:温针灸    变应性鼻炎    鼻鼽    肺气虚寒    临床疗效    作用机制

Therapeutic Analysis of Da Aiduan Warm Needle Moxibustion on 100 Cases of Allergic Rhinitis with Cold of Deficiency Pattern in Lung Qi
Authors:SUN Dun-po  MA Xiao-min  JIANG Ming-xiao  SHANG Guo-chao  WANG Yi-song  GAO Xu-zhu
Institution:1.Lianyungang TCM Hospital, Kangda College, Nanjing Medical University, Lianyungang, 222004, China2.Central Laboratory, The Second People's Hospital of Lianyungang, Lianyungang, 222023, China
Abstract:OBJECTIVE To observe the therapeutic effect of Da Aiduan warm needle moxibustion on allergic rhinitis with cold of deficiency pattern in lung qi and explore its mechanism. METHODS The selected cases were randomly divided into the observation group (105 cases) and the control group (105 cases). The observation group was treated with Da Aiduan warm needle moxibustion once a day, four times a week, four weeks as a course. In the control group, patients were given fluticasone propionate nasal spray and orally taken desloratadine citrate disodium tablets in acute phase, Fu Shu Liang alone when patients were in stable condition. The course was four weeks. At the end of treatment and 30 days after treatment, the changes of total syndrome scores, physical sign points, visual analogy score (VAS), serum immunoglobulin E (IgE), interleukin 4 (IL-4), γ interferon (IFN-γ) were observed. RESULTS The total symptom scores, physical sign points and VAS of nasal symptoms severity in the two groups were significantly lower than those before treatment (P<0.01), and the observation group was significantly lower than that in the control group (P<0.05, P<0.01). The three indexes of serum were statistically significant both within and between groups (P<0.01). Follow-up result (30 days after treatment) indicated that the curative effect of the observation group was better than that of the control group (P<0.05). The total symptom scores, physical sign points and VAS of nasal symptoms severity in the two groups were significantly lower than that before treatment (P<0.01) and the observation group was significantly lower than that in the control group (P<0.05,P<0.01). The given indexes of the two groups before treatment and 30 days after treatment were monitored. It showed that there was no significant difference in the changes of three indexes of serum and IFN-γ in the control group (P>0.05). When it came to the comparison of three indexes in the observation group and between the two groups, they had significant difference (P<0.01). CONCLUSION The Da Aiduan warm needle moxibustion has good therapeutic effect on allergic rhinitis patients with cold of deficiency pattern in lung qi. It can significantly improve the clinical symptoms, physical signs and VAS score of the patients, with better effect in regulating the content of serum IgE, IL-4 and IFN-γ than the control group. Its mechanism may be related to the decrease of serum IgE, IL4 and the increase of IFN-γ. 
Keywords:warm needle moxibustion  allergic rhinitis  rhinorrhea  cold of deficiency pattern in lung qi  clinical effect  mechanism
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