中药辨证治疗肺脾气虚型常年性变应性鼻炎的临床研究

The Clinical Research on treating PAR of Lung and Spleen Qi Deficiency Type with Herb Medicine

目的:通过本实验,阐明Th1和Th2细胞因子水平与变应性鼻炎的相关性;评价中药治疗肺脾气虚型常年性变应性鼻炎的临床疗效,进而探讨中药治疗常年性变应性鼻炎临床疗效的可能作用机理,也为中药辨证治疗该病的诊疗标准收集一些客观的、量化的指标。方法:把临床符合常年性变应性鼻炎诊断标准和本实验纳入标准的40例常年性变应性鼻炎患者随机分为:中药治疗组15例、类固醇组(伯克纳)13例、综合(中药+类固醇)治疗组12例。以及健康对照组20例(体检者)。通过观察患者中药补肺健脾益气治疗前、后症状与体征评分,以及分别用放射免疫和双抗夹心酶联免疫吸附法测定外周静脉血中IL-4和IFN-γ、IL-12含量的变化,客观的评价中药的临床疗效,并初步探讨其作用机理。结果:常年性变应性鼻炎各组治疗有效率比较无明显差别,亦无统计学意义。患者治疗前血清中Th2细胞因子IL-4水平明显高于健康对照组,而Th1细胞因子IFN-γ、IL-12明显低于健康对照组。中药组治疗前后血清中IL-4、IFN-γ、IL-12水平有显著差异,而三组治疗后比较无明显差别,同时治疗后与健康对照组亦无明显差别。结论:本实验结果表明中药治疗PAR能取得较好的临床疗效,其可能作用机理是通过纠正体内Th1和Th2细胞因子水平。PAR的发病特征是大量表达Th2细胞因子的细胞浸润,Th1细胞因子分泌受到抑制,与文献资料相符。

Objective To evaluate the clinical therapeutic effect of chinese herb medicine on PAR of lung and spleen Qi deficiency type, to clarify the relationship between cytokine Th1 and Th2 and PAR, and to investigate the possible mechanism of herb medicine. Method 40 patients who accord with the diagnosis standard of PAR,and 20 healthy people as sample group are included in this study. 40 cases with PAR are randomly divided into three groups, group of treating by chinese herb medicine, group of treating by Steroids for nasal cavit use, group of treating by comprehensive method (Chinese herbal medicine and steroid). Through evaluating the patients’ symptom and manifestation with grade score after treatment, and measuring IL-4 content by RIA and IFN-γ, IL-12 by ELISA. We try to explore the relationship between the mechanism of PAR and the theory of cell cytokine network which is out of balance, and then to clarify the possible mechanism of clinical curative effect to perennial allergic rhinitis with Chinese herb medicine. Results Different groups have no difference on therapeutic effect after treatment. The level of Th2 cytokine and IL-4 of patients is obviously higher than that of healthy people, while the level of Th1 cytokine and IFN-γ、IL-12 of patients is obviously lower than that of healthy people, which all have statistic significance. After treatment, in chinese herb medicine group, the level change of IL-4,IFN-γ and IL-12 has obviously statistics significance, and on curative effect and the immunology index aspect . Conclusion The result shows that Herb Medicine can get good clinical effect on PAR, and the possible mechanism of herb medicine may be adjusting the level of Th1 and Th2.The character of PAR is the over expression of Th2 and inhibit of Th1, just as other magazine reported.