祛风宣窍、清肺化痰法治疗小儿过敏性鼻炎风痰蕴肺证的临床研究

Clinical Study on Treatment of Children’s Allergic Rhinitis with Wind and Phlegm Accumulating in Lung Syndrome by Methods of Dispelling Wind and Dispersing Orifices and Clearing Lung and Resolving Phlegm

目的探究祛风宣窍、清肺化痰法治疗小儿过敏性鼻炎风痰蕴肺证的临床疗效。方法选取医院2017年1月—2019年2月115例小儿过敏性鼻炎患儿作为研究对象,按照随机数字表法分为观察组(58例)、对照组(57例)。对照组给予西医常规治疗,观察组在对照组基础上给予祛风宣窍、清肺化痰法治疗。治疗1个月后,比较两组疗效、治疗前后中医证候积分、鼻腔灌洗液嗜酸性粒细胞(EOS)、嗜酸性粒细胞阳离子蛋白(ECP)、免疫抑制因子[白细胞介素-10(IL-10)、转化生长因子β(TGF-β)]水平及不良反应发生情况,并随访6个月,比较两组复发率。结果观察组治疗总有效率[94.83%(55/58) vs 78.95%(45/57)]高于对照组,随访6个月复发率[5.45%(3/55) vs 18.18%(10/55)]低于对照组(P<0.05);治疗1个月后,观察组鼻痒、鼻塞、流涕、喷嚏积分低于对照组(P<0.05);观察组鼻腔灌洗液EOS、ECP水平低于对照组,IL-10、TGF-β水平高于对照组(P<0.05);观察组不良反应发生率[12.07%(7/58) vs 8.77%(5/57)]与对照组相比,差异无统计学意义(P>0.05)。结论祛风宣窍、清肺化痰法治疗小儿过敏性鼻炎,可明显缓解患者临床症状,降低EOS、ECP水平,提高IL-10、TGF-β水平,减少复发,效果较为显著,且安全性高。

Objective To explore the clinical effect of dispelling wind and dispersing orifices and clearing lung and resolving phlegm method on the syndrome of wind and phlegm accumulating in lung syndrome in children with allergic rhinitis. Methods From January 2017 to February 2019, 115 children with allergic rhinitis in our hospital were selected as research objects. They were divided into observation group(58 cases) and control group(57 cases) according to the random number table method. The control group was given conventional western medicine treatment, and the observation group was given dispelling wind and dispersing orifices and clearing lung and resolving phlegm method based on the control group. After one month of treatment, the therapeutic effect, TCM syndrome score, nasal lavage fluid eosinophil(EOS), eosinophil cationic protein(ECP),the levels of immunosuppressive factors[interleukin-10(IL-10), transforming growth factor beta(TGF-β)] and adverse reactions before and after treatment were compared between the two groups. The patients were followed up for six months to compare the recurrence rates between the two groups. Results The total effective rate in the observation group was higher than that in the control group[94.83%(55/58) vs 78.95%(45/57)]. The six-month follow-up rate was lower than that in the control group(5.45% vs 18.18%)(P<0.05). After one month of treatment, the scores of itching, nasal congestion, runny nose and sneezing in the observation group were lower than those in the control group(P<0.05). The levels of EOS and ECP in the nasal lavage fluid of the observation group were lower than those of the control group, and the levels of IL-10 and TGF-β were higher than those of the control group(P<0.05). The incidence of adverse reactions in the observation group was not statistically significant compared with that of the control group[12.07%(7/58) vs 8.77%(5/57)](P>0.05). Conclusion For children with allergic rhinitis, dispelling wind and dispersing orifices and clearing lung and resolving phlegm methods can obviously alleviate clinical symptoms, reduce the levels of EOS and ECP, increase the levels of IL-10 and TGF-β and reduce recurrence. The effect is more significant, and the safety is high.