穴位贴敷治疗肺气虚寒型变应性鼻炎药物组合与敷贴时长选择的临床研究

Clinical observation on selection of acupoint application drug combinations and duration in the treatment of allergic rhinitis

目的观察穴位贴敷治疗肺气虚寒型变应性鼻炎(AR)药物与敷贴时长的优化组合。方法将240例肺气虚寒型AR患者按照随机数字表法分为3组。3组均采用穴位贴敷治疗,取穴相同,治疗1组80例(后剔除5例)用药物组1,贴敷时长4 h;治疗2组80例(后剔除6例)用药物组2,贴敷时长6 h;治疗3组80例(后剔除6例)用药物组2,贴敷时长4 h。3组均10 d治疗1次,共6次。治疗后第1、4周比较3组鼻部症状视觉模拟评分(VAS)、AR症状评分,并统计疗效,评估安全性。结果治疗1组总有效率61. 33%(46/75),治疗2组总有效率78. 38%(58/74),治疗3组总有效率79. 73%(59/74),治疗2组、治疗3组总有效率高于治疗1组(P <0. 05)。治疗后1、4周3组AR症状评分均较本组治疗前降低(P <0. 05),且治疗后1、4周治疗2组、治疗3组AR症状评分均低于治疗1组(P <0. 05)。治疗后1、4周3组鼻部症状VAS均较本组治疗前降低(P <0. 05),且治疗后1、4周治疗2组、治疗3组鼻部症状VAS均低于治疗1组(P <0. 05)。3组不良反应发生率比较差异无统计学意义(P> 0. 05)。结论穴位贴敷治疗肺气虚寒型AR药物的选择,在温阳的基础上针对性的加入解表通窍之品可取得更好的疗效;结合疗效及安全性考量,贴敷时长4 h更为适宜。

Objective To observe the optimal acupoint application drug combinations and duration in the treatment of allergic rhinitis(AR).Methods 240 AR patients were divided according to the random number table into the treatment group 1(n=80,but finally n=75)with the drug combination 1 and the duration of 4 hours,the treatment group 2(n=80,but finally n=74)with the drug combination 2 and the duration of 6 hours,and the treatment group 3(n=80,but finally n=74)with the drug combination 2 and the duration of 4 hours based on the same acupoint application.The one treatment cycle was 10 days and there were total of six treatment cycles for the three groups.The scores of nasal symptom VAS and AR symptom for patients in the three groups were compared at week 1 and 4 after the treatment.And the curative effect and safety for the three groups were evaluated.Results After treatment,the total effective rate was 61.33%(46/75)in the treatment group 1,and 78.38%(58/74)in the treatment group 2 and 79.73(59/74)in the treatment group 3.The total effective rate in the treatment group 2 and 3 was higher than that of the treatment group 1(P<0.05).The scores of AR symptom and nasal symptom VAS for patients in the three groups at week 1 and 4 after the treatment were lower than those before the treatment(P<0.05).However,scores of AR symptom and nasal symptom VAS for patients in the treatment group 2 and 3 at week 1 and 4 after the treatment were lower than those of the treatment group 1(P<0.05).There was no statistical significance in the adverse effects rate among the three groups(P>0.05).Conclusion For the selection of acupoint application drugs in the treatment of AR,adding of some drugs with the function of relieving exterior syndrome and freeing orifices on the basis of warming yang will get better effects.Combined with efficacy and safety,the acupoint application duration of 4 hours is more appropriate.