鼻炎灵丸对变应性鼻炎患者Th1/Th2细胞因子的影响

Effect of Rhinitis Pill on Th1/Th2 Cytokines of Patients with Allergic Rhinitis

目的：观察鼻炎灵丸对变应性鼻炎外邪犯肺证的临床疗效,及对Th1/Th2细胞因子的影响。方法：将128例变应性鼻炎外邪犯肺证患者随机分为对照组和观察组,每组4例。两组均予布地奈德比喷雾剂、氯雷他定片治疗,观察组在对照组治疗基础上加用鼻炎灵丸治疗。观察两组患者的临床疗效,治疗前后血清中Th1/Th2细胞因子（白细胞介质-4、干扰素-γ）的变化,主要症状（鼻塞、鼻痒、喷嚏、流涕）积分、主要症状减轻时间及消失时间、生活质量,并记录治疗过程中的不良反应。结果：两组患者治疗后血清中白细胞介质-4、干扰素-γ水平均明显低于同组治疗前（P〈0.01）,而干扰素-γ/白细胞介质-4比值均高于同组治疗前（P〈0.05）;观察组治疗后血清中白细胞介质-4、干扰素-γ水平均低于对照组（P〈0.05）,而干扰素-γ/白细胞介质-4比值高于对照组（P〈0.05）。两组治疗后鼻塞、鼻痒、喷嚏、流涕主要症状积分均明显低于同组治疗前（P〈0.01）;观察组治疗后鼻痒、喷嚏主要症状积分均低于对照组（P〈0.05）。两组患者鼻塞、鼻痒、喷嚏、流涕主要症状减轻时间比较,差异无统计学意义（P〉0.05）;观察组在治疗后鼻塞、鼻痒、喷嚏主要症状消失时间均快于对照组（P〈0.05）,而两组在流涕消失时间比较,差异无统计学意义（P〉0.05）。两组治疗后7个维度评分（鼻部症状、非鼻眼症状、眼部症状、活动、睡眠、相关行为、情感）及鼻结膜炎生命质量调查问卷总分均明显低于治疗前（P〈0.01）;观察组治疗后鼻部症状、眼部症状、活动及鼻结膜炎生命质量调查问卷总分均低于对照组（P〈0.05）。对照组有效率为71.9%,观察组有效率为93.7%,两组比较差异有统计学意义（χ2=7.341,P=0.007〈0.01）。两组治疗过程中均未见严重不良反应。结论：鼻炎灵丸治疗变应性鼻炎外邪犯肺证疗效显著,安全性高,能有效改善患者临床症状及生活质量,可能与改善Th1/Th2细胞因子平衡相关。

Objective： To observe the clinical efficacy of rhinitis Pill in treatment of allergic rhinitis and its effect on Th1/Th2 cytokines. Methods： 128 cases of allergic rhinitis were randomly divided into control and observation group with 64 cases in each group. Both groups were given budesonide sprays and loratadine tablets in treatment,and the observation group were treated with Rhinitis Pill in addition to that. The clinical efficacy of the two groups of patients before and after treatment,serum Th1/Th2 cytokine（ IL-4,IFN-γ）,the main symptoms（ nasal congestion,nasal itching,sneezing,runny nose） scores,the major symptoms relief time and disappearance time and the quality of life of the both groups before and after treatment were compared. And the adverse reactions were also recorded. Results： The serum IL-4,IFN-γ levels of the two groups before treatment were significantly lower than that before treatment（ P〈0. 01）,and IFN-γ/IL-4 ratio was higher than that before treatment（ P〈0. 05）. The serum IL-4,IFN-γ levels of the observation group after treatment were lower（ P〈0. 05） and the IFN-γ/IL-4 ratio was higher（ P〈0. 05） than that of the control group. After treatment,the main symptom scores of nasal congestion,nasal itching,sneezing,runny nose were significantly lower than those before treatment（ P〈0. 01）; The main symptom scores of nasal itching and sneezing of the observation group after treatment were lower than that of the control group（ P〈0. 05）. The effective rate of the control group and the observation group was 71. 9% and 93. 7% respectively,with the difference being statistically significant（ χ~2= 7. 341,P = 0. 007 0.01）. During and after treatment there were no serious adverse reactions. Conclusion： The treatment of allergic rhinitis with Rhinitis Pill is significantly effective with high safety,which can effectively improve the clinical symptoms and quality of patients＇ life and the effectiveness may be related to the improvement of Th1/Th2 cytokines.