补中益气汤联合穴位贴敷治疗变应性鼻炎肺脾气虚证临床观察

Clinical Observation of Buzhong Yiqi Decoction(补中益气汤)Combined with Acupoint Application on Allergic Rhinitis with Syndrome of Qi Deficiency of Lung and Spleen

目的观察补中益气汤联合穴位贴敷治疗变应性鼻炎(allergic rhinitis,AR)肺脾气虚证患者临床疗效。方法将80例AR肺脾气虚证患者随机分为中医综合治疗组和常规西药对照组,每组各40例,其中常规西药对照组予常规西药治疗,中医综合治疗组在常规西药对照组基础上予补中益气汤联合穴位贴敷治疗,两组患者均连续治疗4周。分析两组患者治疗前后中医证候积分、鼻部症状评分、肺功能指标[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、第1秒用力呼气量占用力肺活量百分率(FEV1/FVC)]、小气道功能指标[最大呼气中期流量(MMEF)、50%肺活量的最大呼气流量(MEF50)、25%肺活量的最大呼气流量(MEF25)]与血清炎症因子[血管细胞黏附因子-1(VCAM-1)、白细胞介素-4(IL-4)、白细胞介素-13(IL-13)]水平变化情况。结果治疗结束后中医综合治疗组临床有效率(85.00%)明显高于常规西药对照组(62.50%),差异具有统计学意义(P<0.05);治疗结束后两组患者的中医证候积分、鼻部症状评分较治疗前显著降低,且中医综合治疗组下降程度显著优于常规西药对照组(P<0.05);治疗结束后两组患者的肺功能指标(FEV1、FVC、FEV1/FVC)、小气道功能指标(MMEF、MEF50、MEF25)较治疗前显著升高,且中医综合治疗组上升程度显著优于常规西药对照组(P<0.05);治疗结束后两组患者的血清炎症因子(VCAM-1、IL-4、IL-13)水平较治疗前显著降低,且中医综合治疗组下降程度显著优于常规西药对照组(P<0.05)。结论补中益气汤联合穴位贴敷治疗AR肺脾气虚证患者能够有效改善临床症状与鼻部症状,提高肺通气功能与小气道功能,抑制血清VCAM-1、IL-4、IL-13水平,临床疗效显著,具有极高推广价值。

Objective To observe clinical efficacy of Buzhong Yiqi Decoction(补中益气汤)combined with acupoint application on allergic rhinitis(AR)with syndrome of Qi deficiency of lung and spleen.Methods 80 patients of AR with syndrome of Qi deficiency of lung and spleen were randomly divided into the treatment group and the control group,40 patients in each group.Patients in the control group were treated with conventional Western medicine.Patients in the treatment group were treated with Buzhong Yiqi Decoction combined with acupoint application on the basis of the control group.Four weeks was a treatment course.TCM syndrome score and nasal symptom score were recorded before and after treatment between two groups.The pulmonary function indexes[forced expiratory volume in one second(FEV1),forced vital capacity(FVC),percentage of forced expiratory volume in first second to forced vital capacity(FEV1/FVC)],small airway function indexes[maximal mid-expiratory flow(MMEF),maximal expiratory flow in 50%vital capacity(MEF50),maximal expiratory flow in 25%vital capacity(MEF25)]and serum inflammatory factors[vascular cell adhesion molecule-1(VCAM-1),interleukin-4(IL-4),IL-13]levels were tested before and after treatment between two groups.Results After treatment,the clinical effective rate of the treatment group was significantly higher than the control group(P<0.05).After treatment,the TCM syndrome score and nasal symptom score of the two groups were significantly lower than those before treatment,and the degree of decline of the treatment group for the above indexes was significantly better than the control group(P<0.05).After treatment,the pulmonary function indexes(FEV1,FVC,FEV1/FVC)and small airway function indexes(MMEF,MEF50,MEF25)of the two groups were significantly higher than those before treatment,and the degree of ascend of the treatment group for the above indexes was significantly better than the control group(P<0.05).After treatment,the serum inflammatory factors(VCAM-1,IL-4,IL-13)levels of the two groups were significantly lower than those before treatment,and the degree of decline of the treatment group for the above indexes was significantly better than the control group(P<0.05).Conclusion Buzhong Yiqi Decoction combined with acupoint application on AR with syndrome of Qi deficiency of lung and spleen can improve clinical symptom and nasal symptom,increase pulmonary ventilation and small airway function,reduce serum VCAM-1,IL-4,IL-13 levels,which has positive clinical significance.It has very high promotion value.