依巴斯汀片联合玉屏风颗粒对过敏性鼻炎患者血清Th1、Th2及VCAM-1水平的影响

Effects of Ebastine tablet combined with Yupingfeng granules on the levels of serum helper T cell 1, helper T cell 2 and vascular cell adhesion molecule-1 in patients with allergic rhinitis

目的探讨玉屏风颗粒与依巴斯汀片联合治疗对过敏性鼻炎患者血清辅助性T细胞1（Th1）、T细胞2（Th2）、血管细胞间黏附分子-1（VCAM-1）水平的影响。方法选取过敏性鼻炎患者137例，依据治疗方式分为观察组和对照组，对照组68例予以依巴斯汀片治疗，研究组69例于对照组基础上联合玉屏风颗粒治疗。分析比较两组临床效果、不良反应发生率、生活质量（WHOQOL-100）评分、肺功能[第1秒用力呼气容积（FEV1）、峰值呼气流速（PEF）]、血清Th1[肿瘤坏死因子β（TNF-β）、γ-干扰素（IFN-γ）]因子、Th2[白细胞介素-4（IL-4）、白细胞介素-5（IL-5）]因子、VCAM-1水平。结果研究组临床效果优于对照组，且研究组治疗总有效率[92.75%（64/69）]高于对照组[77.94%（53/68）]，差异有统计学意义（P〈0.05）；研究组治疗后1个月血清TNF-β、IFN-γ水平[（57.23±4.21）μg/ml、（43.28±4.06）pg/ml]高于对照组[（53.84±3.76）μg/ml、（38.41±3.18）pg/ml]，血清IL-4、IL-5、VCAM-1水平[（72.48±3.68）pg/ml、（17.29±6.83）pg/ml、（583.79±143.28）μg/ml]低于对照组[（78.24±5.91）pg/ml、（24.84±7.03）pg/ml、（840.61±201.78）μg/ml]，差异有统计学意义（P〈0.05）；治疗后1个月，研究组PEF、FEV1[（435.91±42.16）L/min，78.64%±7.34%]高于对照组[（397.32±36.51）L/min，70.54%±6.37%]，差异有统计学意义（P〈0.05）。研究组不良反应总发生率[8.70%（6/69）]与对照组[5.88%（4/68）]比较差异未见统计学意义（P〉0.05）。研究组治疗后1个月WHOQOL-100评分[（91.13±6.42）分]高于对照组[（85.54±5.23）分]，差异有统计学意义（t＝5.582，P＝0.000）。结论玉屏风颗粒与依巴斯汀片联合治疗过敏性鼻炎患者效果显著，可明显改善其肺功能及血清TNF-β、IFN-γ、IL-4、IL-5、VCAM-1水平，提高预后，且安全性较高。

Objective To investigate the effects of Ebastine tablet combined with Yupingfeng granules on the levels of serum helper T cell 1（Th1）, helper T cell 2 （Th2） and vascular cell adhesion molecule-1 （VCAM-1） in patients with allergic rhinitis.Methods A total of 137 allergic rhinitis patients were divided into study group and control group according to treatment methods. Sixty-eight cases in control group were treated with Ebastine tablets, and 69 cases in study group were treated with Yupingfeng granules on the basis of treatment of control group. The clinical effects, incidence of adverse reactions, quality of life （WHOQOL-100） score, pulmonary function [forced expiratory volume in one second （FEV1） and peak expiratory flow （PEF）], serum Th1 cytokine [tumor necrosis factor-β （TNF-β）, interferon-γ （IFN- γ）], Th2 cytokine [interleukin-4 （IL-4）, interleukin-5 （IL-5）]and VCAM-1 levels were compared and analyzed between the two groups.Results The clinical effect of study group was better than that of control group, and the total effective rate of study group was 92.75% （64/69）, which was significantly higher than that of control group [77.94%（53/68）], P〈0.05. After 1 month of treatment, the levels of serum TNF-β and IFN-γ in study group [（57.23±4.21）μg/ml, （43.28±4.06）pg/ml]were significantly higher than those in control group [（53.84±3.76）μg/ml, （38.41±3.18）pg/ml], and the levels of serum IL-4, IL-5 and VCAM-1 [（72.48±3.68）pg/ml, （17.29±6.83）pg/ml, （583.79±143.28）μg/ml] were significantly lower than those in control group [（78.24±5.91）pg/ml, （24.84±7.03）pg/ml, （840.61±201.78）μg/ml], P〈0.05. After 1 month of treatment, the PEF and FEV1 of study group [（435.91±42.16）L/min, 78.64%±7.34%] were higher than those of control group [（397.32±36.51）L/min, 70.54%±6.37%], P〈0.05. There was no significant difference in the total incidence of adverse reactions between study group [8.70% （6/69）] and control group [5.88%（4/68）], P〉0.05. After 1 month of treatment, the WHOQOL-100 score of study group （91.13±6.42） was higher than that of control group （85.54±5.23）, t=5.582, P=0.000.Conclusions The effect of Ebastine tablet combined with Yupingfeng granulesin on patients with allergic rhinitis is significant. It can improve the pulmonary function, serum TNF-β, IFN-γgamma, IL-4, IL-5 and VCAM-1 levels, and improve the prognosis, with higher safety.