扶正祛风汤治疗中-重度变应性鼻炎临床研究

Clinical Study on Fuzheng Qufeng Decoction in Treatment of Moderate to Severe Allergic Rhinitis

目的观察扶正祛风汤治疗中-重度变应性鼻炎的临床疗效,探讨其可能的起效机制。方法选择2018年5月—2018年12月于该院诊治的120例肺气虚寒证中-重度变应性鼻炎患者为研究对象,随机分为对照组和观察组各60例。对照组吸入布地奈德鼻喷雾剂,2μg/d,2周后剂量调整为1μg/d;观察组患者则给予自拟扶正祛风汤口服,连续治疗1个月为疗程。比较两组的临床效果,评价变应性鼻炎的相关临床症状,用鼻腔结膜炎患者生活质量问卷(RQLQ)评价患者生活质量,测定血清中总Ig E水平,随访3个月、6个月统计复发情况。结果对照组的有效率75.0%(45/60)明显低于观察组患者90.0%(54/60)(P <0.05);与治疗前相比,两组患者的鼻部症状、眼部症状均有所改善,评分均有所下降,以观察组评分明显低于对照组(P <0.05);患者的RQLQ评分较治疗前降低显著,观察组患者的RQLQ评分均显著低于对照组(P <0.05);两组患者的血清中总Ig E水平明显下降,以治疗4周后的总Ig E水平最低(P <0.05);组间同一时间点对比,以观察组明显低于对照组(P <0.05);观察组、对照组随访3个月的复发率分别为8.57%(3/35)、30.00%(6/20),随访6个月的复发率分别为14.29%(5/35)、45.00%(9/20),以观察组的复发率显著低于同期对照组(P <0.05)。结论自拟扶正祛风汤治疗中-重度变应性鼻炎(肺气虚寒证)疗效确切,能有效缓解患者的临床症状,提高生活质量,其机制与抑制Ig E分泌以纠正免疫紊乱、减轻过敏反应有关,值得临床深入研究运用。

Objective To observe the clinical efficacy of Fuzheng Qufeng Decoction in the treatment of moderate to severe allergic rhinitis and explore the possible mechanism of its effect. Methods A total of 120 cases of moderate to severe allergic rhinitis with lung Qi deficiency and cold syndrome diagnosed and treated in our hospital from May 2018 to December 2018 were selected as research objects,and were randomly divided into control group and observation group with 60 cases in each. The control group was given brinard nasal spray,2 μg/d,and the dose adjusted to 1 μg/d in two weeks. The patients in the observation group were given Fuzheng Qufeng Decoction,and they were treated for one month as a course. The clinical effects of the two groups were compared,and the related clinical symptoms of allergic rhinitis were evaluated. The quality of life questionnaire( RQLQ) was used to evaluate the quality of life of patients with nasal conjunctivitis,and the serum level of total Ig E was measured. The patients were followed up for 3 and 6 months for statistical recurrence. Results The effective rate was 75. 0%( 45/60) in the control group,significantly lower than that in the observation group( 90. 0%,54/60)( P < 0. 05). Compared with those before treatment,the nasal symptoms and eye symptoms of the two groups were improved,and the scores were decreased. The scores of the observation group were significantly lower than those of the control group( P < 0. 05). The RQLQ score of the patients was significantly lower than that before treatment,and the RQLQ score of the observation group was significantly lower than that of the control group( P <0. 05). The serum level of total Ig E in the two groups decreased significantly,and the lowest level was found after 4 weeks of treatment( P < 0. 05). At the same time,the observation group’ s level was significantly lower than that of the control group( P <0. 05). The recurrence rates of the observation group and the control group were 8. 57%( 3/35) and 30. 00%( 6/20) respectively after 3 months follow-up,and 14. 29%( 5/35) and 45. 00%( 9/20) respectively after 6 months follow-up. The recurrence rates of the observation group were significantly lower than those of the control group( P < 0. 05). Conclusion The Self-designed Fuzheng Qufeng Decoction is effective on treating moderate to severe allergic rhinitis( lung Qi deficiency and cold syndrome) and can effectively relieve the clinical symptoms of patients and improve the quality of life. Its mechanism is related to inhibiting Ig E secretion to correct immune disorders and reduce allergic reactions. It is worthy of further clinical study and application.