温针灸冬夏并治对变应性鼻炎患者生活质量的影响

Impacts on the life quality of the patients with allergic rhinitis treated with warming acupuncture in winter and summer

目的:探讨温针灸冬夏并治对变应性鼻炎患者生活质量的影响及作用机制。方法:将240例变应性鼻炎患者随机分成三伏三九针刺组(三伏三九组)、非三伏三九针刺组(非三伏三九组)及西药组,每组80例。两个针刺组取穴均为大椎、风门、肺俞、脾俞、肾俞。三伏三九组在三伏天的头伏日起和三九天的第一天起分别进行温针灸治疗,隔日1次,分别连续治疗15次,一年治疗30次;非三伏三九组在三伏天及三九天以外的时间进行温针灸,隔日1次,一年治疗30次;西药组口服西替利嗪,连续服用30天为一疗程。3组均1年为一疗程,次年起为第2疗程,共治疗2个疗程。于治疗前、治疗1个疗程后以及治疗2个疗程后比较各组患者生活质量量表(RQLQ)评分及血清免疫球蛋白E(IgE)水平。结果:治疗后3组患者生活质量评分的日常生活、非鼻/眼症状、行为问题、睡眠、眼部症状、鼻部症状以及情感反应7个方面均较治疗前改善(均P<0.05),且治疗2个疗程后三伏三九组优于其他两组(均P<0.05),非三伏三九组优于西药组(均P<0.05);治疗后3组血清IgE水平均较治疗前降低(均P<0.05),且治疗2个疗程后三伏三九组低于其他两组(均P<0.05),非三伏三九组低于西药组(P<0.05);治疗后三伏三九组总有效率为92.3%(72/78),优于非三伏三九组的80.5%(62/77)以及西药组的69.7%(53/76,均P<0.05)。结论:温针灸冬夏并治疗法对治疗变应性鼻炎疗效确切,其作用机制与降低血清IgE的水平有关。

Objective To explore the impacts on the life quality and the effect mechanism in the patients of allergic rhinitis （AR） treated with warm acupuncture in winter and summer. Methods Two hundred and forty patients of AR were randomized into a summer and winter acupuncture group, a non-summer and winter acupunc- ture group and a western medication group, 80 cases in each one. In the two acupuncture groups, Dazhui （GV 14）, Fengmen （BL 12）, Feishu （BL 13）, Pishu （BL 20） and Shenshu （BL 23） were selected. In the summer and winter acupuncture group, the warm acupuncture started at the first day of the three periods of hot season and the first day of the third nine-day period after the winter solstice. The treatment was given once every two days, continuously for 15 times. Totally, 30 treatments were required a year, In the non-summer and winter acupuncture group, the warm acupuncture was applied out of the three periods of the hot season and the third nine-day period after the winter solstice. The treatment was given once every two days and 30 treatments for a year. ]n the west- ern medication group, cetirizine was taken orally, continuously for 30 days as one session. In the three groups, the treatment for 1 year was taken as one session, The second session started in the next year. Totally, 2 sessions were required. The score of rhinoconjunctivitis quality of life questionnaire （RQLQ） and the level of serum immu- noglohulin E （IgE） were compared in the patients of each group before treatment and in 1 and 2 sessions of treatment. Results After treatment, the scores of 7 domains, named activities, common complaints, practical problems, sleep, ocular symptoms, nasal symptoms and emotions were all improved as compared with those before treatment in the patients of the three groups （all P〈0.05）. After 2 sessions treatment, the results in the summer and winter acupuncture group were better than those in the other two groups （all P〈0. 05）, and the results in the non-summer and winter acupuncture group were better than those in the western medication group （all P〈0.05）. After treatment, serum IgE level was lower averagely than that before treatment in the three groups （all P〈0.05）. After 2 sessions treatment, the result in the summer and winter aeupuneture group was lower than that in the other two groups （both P〈0.05）, and the result in the non-summer and winter acupuncture group was lower than that in the western medication group （P〈0.05）. After treatment, the total effective rate was 92.3% （72/78） in the summer and winter acupuneture group, better than 80, 5% （62/77） in the non-summer and winter acupuncture group and 69.7% （53/76） in the western medication group （both P〈0.05）. Conclusion The warm acupuncture in both summer and winter achieves the definite efficacy on AR and the effect mechanism is relevant with reducing serum IgE level.