针刺蝶腭神经节对变应性鼻炎患者生活质量的改善:随机对照研究

Improvement of life quality of patients with allergic rhinitis treated with acupuncture on sphenopalatine ganglion:a randomized controlled trial

目的:比较针刺蝶腭神经节与针刺常规穴对变应性鼻炎(allergic rhinitis,AR)患者生活质量的影响。方法:收集符合纳入标准的变应性鼻炎患者80例,随机分为观察组和对照组,每组40例。观察组采用毫针刺激蝶腭神经节治疗,以颧弓与下颌骨冠状突间骨间隙为进针点,进针约55mm;对照组施针刺常规穴,以迎香、印堂或风池为主穴,疗程均为4周,治疗结束后1个月随访。分别于治疗前后不同时点采用鼻眼结膜炎生活质量调查问卷(RQLQ)、鼻炎症状评分、视觉模拟量表(VAS)评分作为评价指标,并同时随访患者AR复发情况、治疗满意度及不良反应。结果:(1)RQLQ评分:治疗后两组患者RQLQ评分随时间变化而显著降低(均P<0.01),且观察组第1周到第2周降低趋势较对照组明显;治疗后各时点组间RQLQ评分差异无统计学意义(均P>0.05);时间因素与组别交互作用,差异具有统计学意义(P<0.01)。(2)鼻炎症状评分:治疗后两组患者评分随时间变化呈现降低趋势(P<0.01);治疗后两组评分比较及时间与组别的交互作用,差异均无统计学意义(均P>0.05)。(3)VAS评分:两组治疗后均较治疗前降低(均P<0.01);治疗前后组间评分差值比较,差异亦有统计学意义(P<0.01),且观察组差值变化高于对照组(P<0.05)。(4)随访复发天数:组间比较差异无统计学意义(P>0.05)。(5)患者接受度:观察组与对照组均在80%以上,差异无统计学意义(P>0.05)。(6)卫生经济学:观察组患者时间成本更低。(7)不良反应:观察组出现2例轻微不良反应,不需做特殊处理。结论:与传统针刺相比,针刺蝶腭神经节近期疗效较为显著,能在较短时间内缓解症状,提升生活质量,且时间成本支出更少。

Objective To compare the effects of acupuncture on sphenopalatine ganglion and acupuncture on the common acupoints for life quality of patients with allergic rhinitis（AR）.Methods Eighty patients with AR,who were in accord with the inclusive criteria,were randomly divided into an observation group and a control group,40 cases in each one.Acupuncture on sphenopalatine ganglion was used in the observation group.The needle was inserted into the gap between zygoma and mandibular coronoid process about 55 mm.Acupuncture was adopted on the main acupoints,Yingxiang（LI 20）,Yintang（GV 29）or Fengchi（GB 20）in the control group.The course was four weeks.Follow-up was applied one month after treatment.Rhinoconjunctivitis quality of life questionnaire（RQLQ）,rhinitis symptoms scale and visual analogue scale（VAS）were evaluated at different time points before and after treatment,and follow-up was implemented to know the recurrence situation,satisfactory degree and adverse reaction.Results（1）RQLQ scores：along with treatment,the RQLQ scores were gradually apparently decreased in the two groups（P〈0.01）,and the reducing trend from the first week to the second week of the observation group was more obvious than that of the control group.The differences of the RQLQ scores at all time points after treatment between the two groups were not statistically significant（all P〈0.05）.The interaction of the time factor and the group factor had statistical significance（P〈0.01）.（2）Rhinitis symptoms scores：along with treatment,the scores presented decreasing trend in the two groups（P〈0.01）.The scores of the two groups after treatment and the interaction of the time factor and the group factor were not statistically different（both P〈0.05）.（3）VAS scores：the VAS scores after treatment were lower than those before treatment（both P〈0.01）.The differences before and after treatment were statistically significant（P〈0.01）,with more change in the observation group（P〈0.05）.（4）There was no statistical significance about the number of recurrence days between the two groups（P〈0.05）.（5）Above 80 percent patients were content with the therapeutic method in each group,with no statistical difference（P〈0.05）.（6）The method of the observation group spent less time.（7）Two patients with light adverse reaction came up in the observation group,but no special treatment was needed.Conclusion Acupuncture on sphenopalatine ganglion acquires more obvious short-term effect than conventional acupuncture.It spends less time to relieve symptoms and improves life quality.