针刺蝶腭神经节联合氯雷他定治疗变应性鼻炎的效果

doi:10.3760/cma.j.issn.1007-1245.2022.22.022

摘要/Abstract

摘要： 目的　探析氯雷他定复合针刺蝶腭神经节治疗变应性鼻炎（AR）的效果。方法　选择2020年5月至2022年1月天津医科大学第二医院收治的AR患者71例进行前瞻性研究，其中男性37例，女性34例，年龄（37.99±19.51）岁。按治疗方法将其分成A组（39例）和B组（32例），A组给予氯雷他定治疗，B组则在A组的基础上联合针刺蝶腭神经节治疗，观察两组临床疗效及相关细胞因子变化情况，并使用SPSS 20.0统计软件分析数据，采用χ²检验、独立样本t检验。结果　治疗后B组中医总症候积分为（4.86±0.89）分，低于A组的（7.32±1.06）分（t=10.447，P<0.001）；B组治疗总有效率为84.38%（27/32），高于A组的58.97%（23/39）（χ²=4.991，P=0.027）；B组生活质量总得分为（9.15±2.12）分，低于A组的（14.75±1.93）分（t=11.637，P<0.001）；B组治疗后白细胞介素（IL）-4、IL-10、干扰素（INF）-γ、Th1/Th2水平分别为（10.27±0.51）ng/L、（7.55±0.67）ng/L、（18.22±0.23）ng/L、（13.14±0.46）%，A组分别为（12.11±0.31）ng/L、（9.85±0.53）ng/L、（20.92±0.14）ng/L、（15.78±0.22）%，B组各项细胞因子水平均低于A组（均P<0.05）。结论　在针对AR患者的治疗中，与常规单一西药治疗相比，针刺蝶腭神经节联合氯雷他定临床应用效果良好，有利于调节相关细胞因子水平，提高患者日常生活质量。

关键词: 针刺疗法, 蝶腭神经节, 氯雷他定, 变应性鼻炎, 辅助性T细胞, 干扰素γ

Abstract: Objective　To explore the effect of loratadine combined with sphenopalatine ganglion acupuncture on allergic rhinitis (AR). Methods　Seventy-one AR patients admitted to Second Hospital of Tianjin Medical University from May 2020 to January 2022 were selected for the prospective study, including 37 males and 34 females, with an age of (37.99±19.51) years old. The patients were divided into group A (39 cases) and group B (32 cases) according to the therapeutic methods. Group A was treated with loratadine, and group B was treated with sphenopalatine ganglion acupuncture on the basis of group A. The clinical efficacy and changes of related cytokines in the two groups were observed, the data were analyzed with SPSS 20.0 statistical software, and χ² test and independent sample t test were used. Results　After treatment, the total syndrome score of TCM in group B was (4.86±0.89), which was lower than that in group A (7.32±1.06) (t=10.447, P<0.001). The total effective rate in group B was 84.38% (27/32), which was higher than 58.97% (23/39) in group A (χ²=4.991, P=0.027). The overall score of quality of life in group B was (9.15±2.12), which was lower than that in group A (14.75±1.93) (t=11.637, P<0.001). The levels of interleukin (IL)-4, IL-10, interferon (INF)-γ, and Th1/Th2 in group B after treatment were (10.27±0.51) ng/L, (7.55±0.67) ng/L, (18.22±0.23) ng/L, and (13.14±0.46)%, those in group A were (12.11±0.31) ng/L, (9.85±0.53) ng/L, (20.92±0.14) ng/L, and (15.78±0.22)%, and the levels of all cytokines in group B were lower than those in group A (all P<0.05). Conclusion　In the treatment of AR patients, compared with conventional single western medicine, sphenopalatine ganglia acupuncture combined with loratadine has a good clinical effect, which is beneficial to regulate the levels of related cytokines and improve the quality of daily life.

Key words: Acupuncture therapy, Sphenopalatine ganglia, Loratadine, Allergic rhinitis, Helper T cells, Interferon gamma

于云青. 针刺蝶腭神经节联合氯雷他定治疗变应性鼻炎的效果[J]. 国际医药卫生导报, 2022, 28(22): 3208-3211.

Yu Yunqing. Effect of acupuncture on sphenopalatine ganglia combined with loratadine in the treatment of allergic rhinitis[J]. International Medicine and Health Guidance News, 2022, 28(22): 3208-3211.

参考文献

[1] 程雷,周文成,陆美萍.中国变应性鼻炎和哮喘舌下免疫治疗指南英文版精要解读[J].临床耳鼻咽喉头颈外科杂志,2020,34(4):292-295. DOI:10.13201/j.issn.2096-7993. 2020.04.002.
[2] 陈广道,吴子谕,刘运可,等.广州地区哮喘及变应性鼻炎和湿疹儿童血清特异性过敏原IgE的对比分析[J].国际医药卫生导报,2020,26(14):2104-2107. DOI:10.3760/cma.j.issn.1007-1245.2020.14.031.
[3] Zhu L, Wu Y, Lin C, et al. Dynamic microbial shifts and signatures of long-term remission in allergic rhinitis after an herbal formula treatment[J]. Front Immunol, 2021, 12:774966. DOI: 10.3389/fimmu.2021.774966.
[4] 刘建党,郑念祖,靳琦,等.针刺治疗变应性鼻炎的远期疗效观察[J].中华中医药杂志,2020,35(3):1590-1592.
[5] 陈雪松,王雪松,付伟伟.枸地氯雷他定联合布地奈德治疗鼻窦炎患者的效果[J].国际医药卫生导报,2021,27(14):2170-2173. DOI:10.3760/cma.j.issn.1007-1245.2021. 14.032.
[6] 韩鹏,胡晓阳,付强,等.揿针联合针刺蝶腭神经节治疗变应性鼻炎临床研究[J].针灸临床杂志,2021,37(3):35-39. DOI:10.19917/j.cnki.1005-0779.021052.
[7] 林文森.变态反应性鼻炎中西医结合诊疗标准(草案)[J].中西医结合杂志,1989(2):124.
[8] 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组,中华医学会耳鼻咽喉头颈外科学分会鼻科学组.变应性鼻炎诊断和治疗指南(2015年,天津)[J].中华耳鼻咽喉头颈外科杂志,2016,51(1):6-24. DOI:10.3760/cma.j.issn.1673-0860. 2016.01.004.
[9] 国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994.
[10] Nascimento Silva M, Naspitz C, Solé D. Evaluation of quality of life in children and teenagers with allergic rhinitis: adaptation and validation of the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ)[J]. Allergol Immunopathol (Madr), 2001, 29(4):111-118. DOI: 10.1016/s0301-0546(01)79042-8.
[11] 薛建荣,马敬,邱昌余,等.362例变应性鼻炎患者屋尘螨皮下免疫治疗全身不良反应的观察分析[J].中华耳鼻咽喉头颈外科杂志,2020,55(5):445-451. DOI:10.3760/cma.j.cn115330-20200426-00333.
[12] Li YH, Yu CJ, Qian XY, et al. The correlation between FeNO and nNO in allergic rhinitis and bronchial asthma[J]. Medicine (Baltimore), 2021, 100(39):e27314. DOI: 10.1097/MD.0000000000027314.
[13] Rha MS, Cho HJ, Yoon JH, et al. Association between the use of electronic cigarettes and the prevalence of chronic rhinosinusitis and allergic rhinitis: a nationwide cross-sectional study[J]. Rhinology, 2022, 60(1):20-28. DOI: 10.4193/Rhin21.287.
[14] 李昕蓉,曹文灿,蒋明君,等.中医体质综合干预变应性鼻炎的实效性随机对照试验[J].中华中医药杂志,2021,36(8):5079-5083.
[15] 肖阁敏,郭文海,戴敏,等.小青龙汤合小柴胡汤治疗肺气虚寒型变应性鼻炎患者疗效与调节Treg细胞相关因子的研究[J].实用医学杂志,2021,37(17):2287-2291. DOI:10.3969/j.issn.1006-5725.2021.17.024.
[16] 朱烨.天灸结合耳穴疗法治疗变应性鼻炎的疗效观察[J].国际医药卫生导报,2018,24(18):2751-2753. DOI:10.3760/cma.j.issn.1007-1245.2018.18.007.
[17] 廖雪丽,朱灿阳,麦碧薇,等.氯雷他定联合左西替利嗪治疗儿童慢性难治性荨麻疹疗效及对血清IgE IFN-γ水平的影响[J].河北医学,2021,27(8):1383-1389. DOI:10.3969/j.issn.1006-6233.2021.08.032.
[18] 张帅,薛建亭.辛芩颗粒辅助氯雷他定对变应性鼻炎患者临床疗效与炎症因子水平及生活质量的影响[J].国际医药卫生导报,2019,25(7):1114-1117. DOI:10.3760/cma.j.issn.1007-1245.2019.07.032.
[19] 谢蔓芳,胡玲,黎小年,等.糠酸莫米松鼻喷雾剂联合氯雷他定片治疗变应性鼻炎儿童患者的临床研究[J].中国临床药理学杂志,2020,36(19):2989-2992. DOI:10.13699/j.cnki.1001-6821.2020.19.008.
[20] 王月美.火针联合地氯雷他定治疗神经性皮炎疗效及对肥大细胞功能的影响[J].现代中西医结合杂志,2021,30(6):616-620. DOI:10.3969/j.issn.1008-8849.2021.06.010.
[21] 胡燕,蒋惠珍,罗洁.升阳益肾汤联合氯雷他定治疗哮喘合并变应性鼻炎患儿的效果[J].中国医药导报,2020,17(11):80-83,97.
[22] Khurana S, Bhardwaj N, Kumar S, et al. Crosstalk between T helper cell subsets and their roles in immunopathogenesis and outcome of polytrauma patients[J]. Indian J Crit Care Med, 2020, 24(11):1037-1044. DOI: 10.5005/jp-journals-10071-23577.
[23] 侯盼盼,雷大宇,王贝贝.匹多莫德联合氯雷他定治疗对小儿过敏性鼻炎症状评分、炎性因子及T细胞亚群的影响[J].实用医院临床杂志,2021,18(5):71-74. DOI:10.3969/j.issn.1672-6170.2021.05.019.
[24] 何玮,胡敏,梁兴明,等.外周血辅助性T细胞9细胞因子与过敏性鼻炎患者疾病严重程度的相关性[J].广西医学,2021,43(14):1691-1694.
[25] 王雅琦,赵蔚波,严云,等.246例变应性鼻炎患者的中医体质分布规律调查研究[J].天津中医药,2021,38(5):572-576. DOI:10.11656/j.issn.1672-1519.2021.05.06.
[26] 练欣欣.中医辨证治疗变应性鼻炎的临床疗效[J].深圳中西医结合杂志,2021,31(6):79-81. DOI:10.16458/j.cnki.1007-0893.2021.06.034.
[27] 沈莉,吴继勇,殷敏.针刺蝶腭神经节治疗肺气虚寒型持续性中重度变应性鼻炎的疗效观察[J].中国中西医结合耳鼻咽喉科杂志,2021,29(3):200-204. DOI:10.16542/j.cnki.issn.1007-4856.2021.03.010.
[28] 李洪裕,唐树春.CT引导下蝶腭神经节联合选择性颈神经阻滞治疗蝶腭神经痛临床观察[J].海南医学,2020,31(21):2768-2771. DOI:10.3969/j.issn.1003-6350.2020.21.014.
[29] 闫新宇,王俊阁.通窍汤联合针刺蝶腭神经节治疗慢性鼻窦炎合并变应性鼻炎疗效观察[J].北京中医药,2021,40(7):695-698. DOI:10.16025/j.1674-1307.2021.07.003.
[30] 赵新雨,李靖,张鹏翔,等.针刺蝶腭神经节联合氯雷他定治疗变应性鼻炎的临床观察[J].中国中西医结合耳鼻咽喉科杂志,2020,28(4):247-250,286. DOI:10.16542/j.cnki.issn.1007-4856.2020.04.002.