刮痧治疗不同证型变应性鼻炎的临床疗效观察

Clinical therapeutic effects of scraping therapy on allergic rhinitis of different syndromes

目的:比较刮痧与西药西替利嗪治疗变应性鼻炎的疗效差异,并观察刮痧疗法对不同证型变应性鼻炎的临床疗效差异。方法:将符合纳入标准的变应性鼻炎患者随机分为西药组、肺气虚寒型刮痧组(肺气虚寒组)、脾气虚弱型刮痧组(脾气虚弱组)和肾阳亏虚型刮痧组(肾阳亏虚组),每组20例。西药组每日口服西替利嗪10 mg,每日1次,共治疗4周。3个刮痧组采用刮痧疗法,刮拭的部位包括手阳明大肠经、督脉和足太阳膀胱经循行部位,重点刮拭迎香、印堂、合谷、风门。肺气虚寒组重点刮拭手太阴肺经及肺俞、太渊、风池、列缺;脾气虚弱组重点刮拭足太阴脾经及脾俞、足三里;肾阳亏虚组重点刮拭足少阴肾经及命门、肾俞。每周刮痧1次,4次为一疗程,治疗1个疗程(4周)。观察治疗前、治疗后、治疗后3个月随访时变应性鼻炎主要症状(喷嚏、流涕、鼻塞、鼻痒)总积分,并评价临床疗效。结果:4组患者主要症状总积分治疗后较治疗前均降低(均P<0.05);治疗后以及随访时,3个刮痧组症状总积分低于西药组(均P<0.05),且肺气虚寒组低于脾气虚弱组和肾阳亏虚组(均P<0.05)。治疗后及随访时,3个刮痧组疗效均优于西药组(均P<0.05),且肺气虚寒组优于脾气虚弱组和肾阳亏虚组(均P<0.05)。结论:变应性鼻炎根据不同证型辨证选经选穴进行刮痧治疗效果确切,优于西替利嗪治疗,且对肺气虚寒型的近期和远期疗效更加显著。

Objective To compare the differences in the therapeutic effects on allergic rhinitis between scraping therapy and cetirizine and observe the differences in the clinical therapeutic effects of scraping therapy on the disease of different differentiated patterns/syndromes.Methods The included participants of allergic rhinitis were randomized into a western medication group and three scraping therapy groups,named a lungqi deficiency and cold group,a spleenqi deficiency group and a kidneyyang deficiency group,20 cases in each one.In the western medication group,cetirizine was prescribed for oral administration,10 mg,once a day,totally for 4 weeks. In the scraping therapy groups, the scraping therapy was applied to the running courses of the large intestine meridian of hand-yangming,the governor vessel and the bladder meridian of foot-taiyang,focusing on Yingxiang （LI 20）,Yintang （GV29）,Hegu （LI 4） and Fengmen （BL 12）.In the lungqi deficiency and cold group, the scraping focused on the lung meridian of hand-taiyin, Feishu （BL 13）,Taiyuan （LU 9）,Fengchi （GB 20） and Lieque （LU 7）.In the spleenqi deficiency group, the scraping focused on the spleen meridian of foot-taiyin,Pishu （BL 20） and Zusanli （ST 36）. In the kidneyyang deficiency,the scraping focused on the kidney meridian of foot-shaoyin, Mingmen （GV 4） and Shenshu （BL 23）. The scraping therapy was given once a week, 4 treatments as one session and 1 session required （4 weeks）.Separately before treatment, after treatment and in 3-month follow-up visit,the total score of the main symptoms of allergic rhinitis （sneezing,runny nose, nasal obstruction and nasal itch） was observed and the clinical therapeutic effects were evaluated.Results The total symptom scores in the patients of the 4 groups after treatment were all reduced as compared with those before treatment （allP〈0.05）. After treatment and in the follow-up visit,the total symptom scores of the 3 scraping therapy groups were lower than those in the western medication group （allP〈0.05）,and the score in the lungqi deficiency and cold group was lower than those in the spleenqi deficiency group and the kidneyyang deficiency group （allP〈0.05）. After treatment and in the follow-up visit,the therapeutic effects in the 3 scraping therapy groups were better than those in the western medication group （allP〈0.05）.Conclusion The scraping therapy on the basis of the meridians and acupoints selection achieves the definite therapeutic effects on allergic rhinitis of different differentiated patterns/syndromes,which is better than cetirizine.This therapy achieves the much significant short-term and long-term therapeutic effects on allergic rhinitis differentiated as lungqi deficiency and cold.