天灸疗法治疗常年性变应性鼻炎的临床研究

Clinical research of medicinal vesiculation for perennial allergic rhinitis

目的:比较三伏天灸和平日天灸治疗常年性变应性鼻炎的疗效差异及对患者血清总免疫球蛋白(IgE)和白细胞介素4(IL-4)的影响。方法:将72例患者随机分为三伏天灸组(34例)和平日天灸组(38例),三伏天灸组于农历初伏、中伏、末伏分别进行天灸治疗3次,共9次;平日天灸组不择日,连续治疗9次。两组治疗前后进行症状体征评分、鼻结膜炎相关生活质量问卷(RQLQ)评分及血清总IgE和IL-4水平检测,并进行近期与第2年治疗结束后远期疗效评价。结果:短期疗效三伏天灸组总有效率为88.2%(30/34),平日天灸组为86.8%(33/38),两组间比较差异无统计学意义(P>0.05);远期疗效三伏天灸组为97.1%(33/34),优于平日天灸组的81.6%(31/38),差异有统计学意义(P<0.05);治疗后两组血清总IgE和IL-4、生活质量RQLQ评分均较治疗前明显降低(均P<0.01),两组间比较差异无统计学意义(均P>0.05)。结论:天灸可作为常年性变应性鼻炎的常规疗法,全年均可开展,三伏天灸可作为对此病的预防和加强治疗的手段。

Objective To compare the efficacy differences between dog-days medicinal vesiculation and regularday medicinal vesiculation for perennial allergic rhinitis （PAR）, and observe their effects on serum immune globulin E （IgE） and interleukin-4 （IL-4）. Methods Seventy-two patients were randomly divided into a dog-days moxibustion group （34 cases） and a regular-day moxibustion group （38 cases）. In the dog-days moxibustion group, medicinal vesieulation was applied on the 1st dog-day, 2nd dog-day and last dog-day in summer by lunar calendar, 3 treatments per dog-day for totally 9 times. In the regular-day moxibustion group, the moxibustion was given on the regular day for continuous 9 times. The symptom score, rhinoconjunctivitis quality of life questionnaire （RQLQ） and the level of IgE and IL-4 were compared before and after treatment in two groups; the short-term and two-year efficacy evaluation were performed too. Results The short-term total effective rate was 88.2M （30/34） in the dog-days moxibustion group, which was not significantly different to 86.8M （33/38） in the regular-day moxibustion group （P〈0.05）. The long-term total effective rate was 97.1M （33/34） in the dog-days moxibustion group, which was significantly superior to 81.6% （31/38） in the regular-day moxibustion group （P〈0.05）. After treatment, the serum IgE, IL-4 and RQLQ were significantly reduced （all P〈 0. 01）, but the difference between two groups was not significant （all P〈0.05）. Conclusion Medicinal moxibustion could be taken as a regular treatment for PAR, which could be performed during the whole year, and dog-days moxibustion could be considered as an enhanced method for prevention and treatment of PAR. KEY WORDS allergic rhinitis, perennials medicinal vesiculation; treatment opportunity