穴位敷贴辅助曲安奈德治疗中重度常年性变应性鼻炎临床疗效观察

Clinical observation on acupoint application and triamcinolone acetonide for the treatment of moderate to severe perennial allergic rhinitis

目的评估穴位敷贴辅助曲安奈德鼻喷雾剂治疗中重度常年性变应性鼻炎的临床疗效。方法将80例患者随机分为试验组和对照组,每组40例。两组均予曲安奈德鼻喷雾剂治疗(疗程为1个月),试验组同时加用穴位敷贴(治疗15天)。分别于治疗前、治疗后、治疗后6个月观察临床疗效,以及症状体征积分及嗜酸性粒细胞变化情况,同时记录两组曲安奈德用量、随访进展率。结果①试验组治疗后、治疗后6个月(随访)总有效率分别为94.7%、76.3%,对照组分别为97.5%、59.4%;两组治疗后的临床疗效差异无统计学意义(P>0.05),试验组治疗后6个月的临床疗效优于对照组(P<0.05)。②两组治疗后、治疗后6个月鼻痒、流涕、喷嚏、鼻塞、鼻部体征积分均明显减少(P<0.05);试验组在治疗后6个月,鼻痒、流涕、喷嚏、鼻塞、鼻部体征积分低于对照组(P<0.05)。③两组治疗后、治疗后6个月外周血及鼻黏膜分泌物EOS水平均明显降低(P<0.05);组间比较,治疗后6个月的鼻黏膜分泌物EOS差异有统计学意义(P<0.05)。④治疗后6个月试验组患者疾病进展率及控制症状所需曲安奈德累计用量均显著低于对照组(P<0.05)。结论穴位敷贴辅助曲安奈德鼻喷雾剂治疗中重度常年性变应性鼻炎临床疗效良好、稳定,疾病进展率低。

Objective To evaluate the therapeutic effect of acupoint application and triamcinolone acetonide nasal spray for the treatment of moderate to severe perennial allergic rhinitis （ PAR ）. Methods Eighty eases with moderate or severe PAR were randomized into experimental group and control group, with 40 eases in each group. Both the groups were treated with triamcinolone aeetonide nasal spray for 1 month, and experimental group was treated by acupoint application for 15 days additionally. We observed the clinical efficacy, symptom score and changes of eosinophilic granulocyte before treatment, after treatment or at the 6th month after treatment. We recorded the dosage of triamcinolone acetonide, and followed up the progression. Results （1） The total effective rate at the 1st and 6th month were94.7% and 76.3% in experimental group, and were 97. 5% and 59.4% in control group, respectively, without difference between the two groups （ P 〉 0.05）. Six months after treatment, the clinical efficacy in experimental group was more obvious than that of the controls （ P 〈 0.05 ）. （2） After treatment or 6 months＇ treatment in experimental group, the symptom scores of rhioocnesmus, running nose, sneezing, rhinobyon and nasal performance were decreased markedly （P 〈0.05 ）; after 6 months＇ treatment, the symptom scores of rhinocnesmus, tanning nose, sneezing, rhinobyon and nasal performance in the experimental group were lower than that of the control group （ P 〈 0.05）. （3） After treatment or 6 months of treatment in both groups, the levels of eosinophils in peripheral blood and nasal secretions were reduced markedly （P 〈 0.05） ; after 6 months of treatment, the level of eosinophils in nasal secretions in experimental group was lower than that of the eontrols（ P 〈0.05 ）. （4） After 6 months of treatment, the rate of disease progression and dosage of triameinolone acetonide for symptoms contrnllong in experimental group were lower than that of the controls （P 〈 0.05 ）. Conclusion Combined acupoint application and triameinolone acetonide is effective and stable, and has low rate of diseaseon progression in treating PAR.