不同证型变应性鼻炎复合大鼠模型鼻腔黏膜神经源性炎症特点的对比分析

目的:探讨不同证型变应性鼻炎(AR)复合大鼠模型鼻腔黏膜神经源性炎症的特点。方法:动物随机分为模型组(肺气虚AR组、脾气虚AR组、单纯AR组)与空白对照组,以相应造模方法先后建立中医证型以及证型AR复合模型。并通过证型评估、大鼠变应性鼻炎行为学评分、镜下黏膜组织病理学观察、P物质(SP)与血管活性肠肽肽(VIP)免疫组化染色以及积分光密度值测定,对各组大鼠鼻黏膜神经源性炎症特点进行对比分析。结果:中医证型造模后,肺气虚模型组大鼠呼吸频率明显升高,脾气虚模型组大鼠提质量增幅明显降低。AR复合模型建立后,各模型组大鼠行为学评分明显升高;黏膜HE染显色示肺气虚AR组炎性细胞浸润、脾气虚AR组黏膜下腺体扩张较其它组更加明显;神经肽免疫组化显示肺气虚与脾气虚AR模型组分别在SP、VIP出现高水平表达,且差异具有统计学意义(P0.05)。结论:不同证型AR复合大鼠模型之间鼻腔黏膜神经源炎症检测指标具有一定的差异。     

鼻内针刺对变应性鼻炎兔神经源性炎性反应的影响

目的:观察鼻内针刺对变应性鼻炎(AR)新西兰兔鼻黏膜P物质(SP)、血管活性肠肽(VIP)、神经肽Y(NPY)蛋白表达及血清免疫球蛋白E(IgE)、白细胞介素4(IL-4)、干扰素-γ(IFN-γ)含量的影响,探讨鼻内针刺治疗AR的机制。方法:新西兰兔采用随机数字表法随机分为正常组、模型组、非经非穴组和鼻内针刺组,每组8只。采用卵蛋白腹腔注射及鼻黏膜刺激法建立AR新西兰兔模型。鼻内针刺组针刺两侧鼻腔"内迎香"穴(下鼻甲前端附着区距鼻阈1 cm处),非经非穴组浅刺面部两颊外缘处(非穴位浅刺),两组均留针20 min,隔日治疗1次,共7次。干预前后观察各组新西兰兔行为学变化,采用免疫组织化学法检测鼻黏膜SP、VIP、NPY的表达,采用酶联免疫吸附法检测血清IgE、IL-4、IFN-γ含量。结果:治疗前后,模型组症状积分均明显高于正常组(P<0.01);治疗后,与模型组及非经非穴组比较,鼻内针刺组症状积分明显下降(P<0.05)。模型组新西兰兔鼻黏膜SP、VIP表达明显高于正常组(P<0.01),NPY的表达明显低于正常组(P<0.05);鼻内针刺组鼻黏膜SP、VIP表达明显低于模型组及非经非穴组(P<0.01),NPY的表达明显高于模型组及非经非穴组(P<0.05)。模型组血清IgE、IL-4含量明显高于正常组(P<0.05),IFN-γ含量明显低于正常组(P<0.01);鼻内针刺组血清IgE、IL-4含量明显低于模型组及非经非穴组(P<0.05),IFN-γ含量显著高于模型组及非经非穴组(P<0.01)。鼻黏膜SP、VIP积分吸光度值与血清IgE、IL-4含量呈正相关(P<0.05),与血清IFN-γ含量呈负相关(P<0.05)。结论:鼻内针刺治疗可明显降低鼻黏膜感觉神经及副交感神经兴奋性,提升交感神经兴奋性,并以相应神经肽为介质,通过神经免疫系统调控免疫应答,进而改善神经源性炎性反应,缓解鼻部症状。     

鼻内针刺治疗持续性中重度变应性鼻炎的临床研究

目的观察鼻内针刺治疗变应性鼻炎（AR）的疗效，并探究其作用机制。方法将161例中重度AR患者采用随机数字表法分为针刺组（81例）和对照组（80例）。针刺组采用鼻内针刺治疗（经鼻内镜针刺双侧鼻腔内迎香穴），留针20 min，隔天1次；对照组每日口服氯雷他定片联合布地奈德鼻喷剂喷鼻治疗，两组均治疗14天。观察两组患者治疗前后总体症状及鼻部症状视觉模拟量表（VAS）、鼻－结膜炎相关生活质量问卷（RQLQ）评分的变化；采用ELISA法检测治疗前后针刺组患者血清IgE含量及鼻腔分泌物P物质（SP）、血管活性肠肽（VIP）、神经肽Y（NPY）的含量。结果与本组治疗前比较，两组患者VAS和RQLQ总评分均明显下降（P<0.05），针刺组患者血清IgE及鼻腔分泌物SP、VIP含量均明显下降（P<0.05），鼻腔分泌物NPY含量差异无统计学意义（P>0.05）。治疗后两组有效率及VAS、RQLQ总评分差异无统计学意义（P>0.05）。多数患者认为鼻内针刺疼痛程度较轻，可以耐受；且患者出血量不多，易止，未见其他明显不良反应。结论鼻内针刺可明显改善持续性中重度AR患者的鼻部症状，并提高其生活质量，其作用机制可能为通过调控鼻黏膜神经功能，并以神经肽为介质，经神经—免疫网络通调节免疫应答，从而降低神经源性炎症程度以有效改善AR症状。     

针刺蝶腭神经治疗变应性鼻炎18例

笔者近1年来在临床中采用针刺蝶腭神经治疗变应性鼻炎18例,取得良好疗效,现报告如下. 1资料与方法 1.1诊断标准参照《变应性鼻炎的诊治原则和推荐方案(2004年,兰州)》[1]诊断标准.(1)病史:详细询问病史,分析症状发作的时间和诱发因素.具有鼻痒、喷嚏、鼻分泌物和鼻塞4项症状中至少3项,常年性者在有症状的日子里症状每日累计达0.5-1 h以上.(2)检查:鼻腔检查可见鼻黏膜苍白、水肿或充血、肿胀.花粉症患者往往有明显的结膜充血、水肿,严重者眼睑肿胀.发作期鼻分泌物涂片和(或)结膜刮片嗜酸粒细胞检查阳性.变应原皮肤试验呈阳性反应,至少1种为(++)或(++)以上.     

变应性鼻炎神经免疫机制及针灸治疗作用探讨

变应性鼻炎（AR）是一种临床常见的变态反应性疾病，机体内的各种免疫细胞、细胞因子、神经肽类等参与了AR的发病过程，针灸是治疗AR的一种有效手段。笔者将对AR的神经免疫机制和针灸的治疗机制进行初步探讨。     

灸法治疗变应性鼻炎近况

变应性鼻炎(AR),又称过敏性鼻炎,是耳鼻喉科的多发病、常见病.鼻粘膜高反应性是其主要特点,是因变应原作用于鼻粘膜所引起的一种变态反应性疾病,属于IgE介导的I型变态反应,并可引起各种并发症.     

变应性鼻炎针灸治法近况

变应性鼻炎似R）又称过敏性鼻炎，是发生在鼻黏膜的IgE介导Ⅰ型变态反应性疾病，临床症状以鼻塞、鼻痒、鼻流清涕、喷嚏为主，属中医学“鼻鼽”、“鼽嚏”等范畴。近年来，很多医生以针灸为主治疗该病取得了很好疗效。现概述如下。1毫针疗法何氏等针刺印堂透鼻根、四白透鼻根、迎香透鼻根、列缺、合谷、风池为主，临证以气虚、血虚、阳虚、风寒、风热、痰热分型配穴，治疗60例患者，痊愈41例，总有效率为85．00％。姜氏等以毫针直刺双侧翳风、风池、天柱、哑门，治疗30例患者，显效18例，总有效率为93．33％。饶氏等引采用毫针直刺风池、肺俞、脾俞、肾俞、合谷、足三里、迎香、印堂等穴，治疗47例患者，显效31例，总有效率为95．75％；并在停止治疗半年后继续观察其中42例患者的远期疗效，显效11例，总有效率为69．05％。     

针灸治疗变应性鼻炎19例

目的：观察针灸治疗变应性鼻炎的临床疗效。方法：19例变应性鼻炎患者采用针灸治疗,1次／d,10次为1个疗程。间隔3d行第2个疗程治疗,两个疗程结束后评价疗效。结果：治愈率为89．5％,总有效率为100．0％。结论：针灸治疗变应性鼻炎的效果明显。     

中西医治疗变应性鼻炎近况

变应性鼻炎 (ＡＲ)是发生在鼻粘膜的变态反应性疾病 ,以突然和反复发作的鼻痒、阵发性喷嚏、大量水样涕和鼻塞为主要特征。属于祖国医学“鼻鼽”之范畴 ,中西医对其治疗方法颇多 ,现将笔者搜集的治疗近况报道如下。1　中西药结合陈兵[1] 以息斯敏 0 18,冰片 10 ｇ ,共研为细末     

变应性鼻炎针灸治疗概况

参考近10年来有关文献,从毫针、灸疗、穴位贴敷、穴位注射、耳针疗法、刺血疗法等方面对针灸治疗变应性鼻炎概况进行综述,提出必须加强针灸治疗本病的机理研究,提高研究的科学性和实用性,更好的指导针灸临床治疗.     

Observation on clinical effect of acupuncture for allergic rhinitis

Objective： To observe the clinical effect of acupuncture plus acupoint injection and laser radiation on the nasal cavity for allergic rhinitis. Methods： Ninety patients with allergic rhinitis were randomly divided into a treatment group and a control group, 45 cases in each group. The treatment group was treated by acupuncture, acupoint injection method and He-Ne laser radiation on the nasal cavity. The control group was treated by Triamcinolone Acetonide nasal spray. The clinical effects were assessed after two courses of treatment. Results： The clinical curative rate was 88.9% and the total effective rate was 100.0% in the treatment group, versus 57.8% and 80.0% in the control group. The clinical curative rate and total effective rate were remarkably higher in the treatment group than those in the control group （P〈0.05）. In comparison of the therapeutic effects in the different courses between the two groups, the curative rates in the one course and two courses were higher in the treatment group than those in the control group （P〈0.05）. In the follow-up visit of the cured patients of the two groups for half a year, the recurrence rate was 2.5% in the treatment group versus 34.6% in the control group, with a statistical difference between the two groups （P〈0.01）. Conclusion： Acupuncture plus acupoint injection and laser radiation on the nasal cavity for allergic rhinitis has better clinical effect and long-term effect, and can obviously shorten the course, enhance the clinical effect and reduce the recurrence rate.     

针灸疗法治疗过敏性鼻炎的疗效观察

目的:观察过敏性鼻炎采用针灸疗法治疗的效果.方法:选取2018年7月-2019年2月收治的过敏性鼻炎患者74例,随机分为观察组和对照组各37例,对照组采取常规西药治疗,观察组实施针灸疗法,对比效果.结果:观察组治疗总有效率、各炎症因子水平、生活质量各维度评分均优于对照组(P<0.05).结论:针灸疗法治疗过敏性鼻炎效果...     

针刺治疗变应性鼻炎疗效观察及对血清免疫学的影响

目的：对比观察针刺及耳穴贴压对常年变应性鼻炎的疗效。方法：将150例患者随机分为针刺组、耳压组、药物组各50例。针刺组每日针1次，连针6天后休息1天；耳压组每周更换2次；药物组口服西药赛特赞，每日1次，每次10mg。3组均7天为一疗程，共治疗4个疗程。比较3组治疗后的近远期疗效及对血清免疫学的影响。结果：针刺组和耳压组近期显效率及症状体征积分的改善优于药物组（P〈0．01，P〈0．05），但两组之间差异无显著性意义（P〉0．05）；远期总有效率及症状体征积分的改善优于药物组（P〈0．01）；3种疗法均可降低患者血清IgE、白介素-4含量，但对干扰素γ水平影响不明显。结论：针刺组及耳压组对症状体征的改善优于药物组，作用机理可能是通过抑制Th细胞向Th2方向分化，调节体内失衡的Th1／Th2细胞，从而减少IgE的合成来抑制变态反应的发生。     

针刺治疗过敏性鼻炎研究概述

综述近五年针刺治疗过敏性鼻炎(Allergic Rhinitis,AR)的文献,发现针刺治疗包括单纯针刺法;局部取穴、局部+远端取穴、透刺;针刺配合药物;针刺蝶腭神经节。通过临床研究发现针刺治疗过敏鼻炎可以提高过敏性鼻炎患者近期及远期生活质量。对于针刺治疗过敏鼻炎的机制有待进一步研究。     

The effect of acupuncture on allergic rhinitis: a randomized controlled clinical trial

Allergic rhinitis is a common health problem usually treated with drug therapy. Some patients experience side effects of drug therapy while others fear the use of drugs. Acupuncture is an interesting alternative to traditional treatment. The few studies evaluating acupuncture indicate a possible clinical effect on allergic rhinitis. This study compared active versus sham acupuncture in 40 consecutive patients with a history of allergic rhinitis and a positive skin test. Patients were randomized and assessed prior to treatment and then reassessed after 12 months. Improvements in symptoms using visual analogue scales, reduction in skin test reactions and levels of specific immunoglobin E (IgE) were used to compare the effect of treatment. For one allergen, mugwort, a greater reduction in levels of specific IgE (p = 0.019, 0.039) and skin test reaction (p = 0.004) was seen in the group receiving active acupuncture compared to the group receiving sham acupuncture. However, this finding might be an artifact. No differences in clinical symptoms were seen between active versus sham acupuncture, thus the conclusion being that the effect of acupuncture on allergic rhinitis should be further evaluated in larger randomized studies.     

针刺治疗过敏性鼻炎疗效观察

目的:探求过敏性鼻炎的有效针灸治法。方法:将135例过敏性鼻炎患者随机分为观察组、对照Ⅰ组、对照Ⅱ组,每组45例。观察组穴取迎香、上迎香、印堂、合谷,配风池、大椎、肺俞针刺治疗;对照Ⅰ组单纯针刺迎香、上迎香、印堂、合谷治疗;对照Ⅱ组予以口服鼻炎康片,每次4片,每日3次。3组均每日治疗1次,10次为一疗程,治疗2个疗程并随访半年后进行疗效比较。结果:观察组总有效率91.1%,对照Ⅰ组总有效率71.1%,对照Ⅱ组总有效率46.7%,3组疗效比较差异有显著性意义(P<0.05,P<0.01);3组痊愈病例1年后复发率比较,差异有显著性意义(P<0.05,P<0.01)。结论:针刺治疗过敏性鼻炎疗效肯定,前后配穴法针刺效果更好。     

Therapeutic efficacy observation on acupuncture for persistent allergic rhinitis

Objective

To observe the clinical effect of acupuncture for persistent allergic rhinitis (PAR).

Methods

A total of 154 PAR patients were randomized into a treatment group and a control group, 78 cases in the treatment group received acupuncture at meridian points, while 76 cases in the control group received acupuncture at non-meridian points. The treatment was done every other day, 3 times a week for a total 4 weeks. The total nasal symptom score (TNSS), the total non-nasal symptom score (TNNSS) and the rhinoconjunctivitis quality of life questionnaire (RQLQ) were measured before the treatment and after 2 weeks and 4 weeks of treatment, as well as 1 month and 3 months after the treatment to compare the clinical effect between the two groups.

Results

After 4 weeks of treatment, the total effective rate in the treatment group was 92.3%, versus 76.3% in the control group, showing a statistically significant difference (P<0.05). Intra-group comparisons of TNSS, TNNSS and RQLQ scores after 4 weeks of treatment showed statistically significant differences (all P<0.05). Between-group comparisons of TNSS, TNNSS and RQLQ score after 4 weeks of treatment and in follow-up visits showed statistically significant differences (all P<0.05).

Conclusion

Acupuncture is effective for PAR, and acupuncture at meridian points can produce a better effect than acupuncture at non-meridian points.

     

针刺运动疗法治疗过敏性鼻炎疗效观察

目的：探讨针刺运动疗法治疗过敏性鼻炎的临床效果;方法：将40例过敏性鼻炎患者运用针刺运动疗法进行治疗,1次／天,治疗10天为一个疗程,每个疗程休息2天,3个疗程后结果：显效30例,占75％,好转10例,占25％,无效0例,总有效率100％。结论：运用针刺运动疗法治疗过敏性鼻炎疗程短,见效快,经济实惠,无副作用,值得临床推广。