鼻内针刺联合穴位自血疗法治疗肺脾气虚型变应性鼻炎临床疗效观察

Clinical efficacy of intranasal acupuncture combined with acupoint autohemotherapy for allergic rhinitis of lung-spleen qi deficiency

目的观察鼻内针刺联合穴位自血疗法治疗肺脾气虚型变应性鼻炎的临床疗效。方法将87例肺脾气虚型变应性鼻炎患者按照随机数字表法分为2组。对照组43例采用鼻内针刺治疗,治疗组44例在对照组治疗基础上联合穴位自血疗法治疗。2组疗程均为2个月。比较2组治疗前后临床症状体征评分、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、白细胞介素25(IL-25)、IL-34、甲壳质酶蛋白40(YKL-40)水平及生活质量综合评定问卷-74(GQOL-74)评分,并统计疗效及治疗后3、6个月复发情况。结果治疗组总有效率93.18%(41/44),对照组总有效率76.74%(33/43),治疗组疗效优于对照组(P<0.05)。治疗1、2个月2组临床症状体征各项评分及总分均较本组治疗前降低(P<0.05),治疗2个月2组均低于本组治疗1个月(P<0.05),且治疗1、2个月治疗组均低于对照组同期(P<0.05)。治疗1、2个月2组血清CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均较本组治疗前升高(P<0.05),血清CD8^(+)水平均降低(P<0.05),治疗2个月2组血清CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均高于本组治疗1个月(P<0.05),血清CD8^(+)水平均低于本组治疗1个月(P<0.05),且治疗1、2个月治疗组血清CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均高于对照组同期(P<0.05),血清CD8^(+)水平低于对照组同期(P<0.05)。治疗1、2个月2组血清IL-25、IL-34、YKL-40水平均较本组治疗前降低(P<0.05),治疗2个月2组均低于本组治疗1个月(P<0.05),且治疗1、2个月治疗组均低于对照组同期(P<0.05)。治疗1、2个月2组GQOL-74评分均较本组治疗前升高(P<0.05),治疗2个月2组均高于本组治疗1个月(P<0.05),且治疗1、2个月治疗组GQOL-74评分均高于对照组同期(P<0.05)。治疗后3个月2组复发率比较差异无统计学意义(P>0.05),治疗后6个月治疗组复发率低于对照组(P<0.05)。结论鼻内针刺联合穴位自血疗法治疗肺脾气虚型变应性鼻炎患者的临床效果显著,可有效缓解临床症状体征,提升患者生活质量,且可明显改善机体免疫功能及炎性反应,减少疾病复发。

Objective To investigate the clinical efficacy of intranasal acupuncture combined with acupoint autohemotherapy(AA)for allergic rhinitis(AR)of lung-spleen qi deficiency.MethodsTotally 87 patients with AR of lung-spleen qi deficiency were randomly divided into two groups,43 cases in control group were treated with intranasal acupuncture,and 44 cases in treatment group were treated with intranasal acupuncture combined with AA.Treated 2 months,aiming to compare clinical symptoms,sign score,and t lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),Interleukin 25(IL-25),IL-34,chitinase protein 40(YKL-40),and generic quality of life inventory-74(GQOL-74),and the curative effect and recurrence in 3-,6-month were counted.ResultsThe total effective rates were better in treatment group than in control group[93.18%(41/44)vs 76.74%(33/43),(P<0.05),respectively].Compared with before treatment,score and total score of clinical symptoms and physical signs in 1-,2-month of groups were lower(P<0.05),which in treatment group were significantly decreased(P<0.05),which in 2-month of groups were lower than in 1-month(P<0.05);serum CD3^(+),CD4^(+),CD4^(+)/CD8^(+)levels in 1-,2-month of groups were higher(P<0.05),which in treatment group were significantly increased(P<0.05),which in 2-month of groups were higher than in 1-month(P<0.05);while serum CD8^(+)level in 1-,2-month of groups was lower(P<0.05),which in treatment group was significantly decreased(P<0.05),which in 2-month of groups were lower than in 1-month(P<0.05);serum IL-25,IL-34,YKL-40 levels in 1-,2-month of groups were lower(P<0.05),which in treatment group were significantly decreased(P<0.05),which in 2-month of groups were lower than in 1-month(P<0.05);GQOL-74 score in 1-,2-month of groups was higher(P<0.05),which in treatment group was significantly increased(P<0.05),which in 2-month of groups was higher than in 1-month(P<0.05).There was no statistically significant difference in the recurrence rate between groups at 3 months after treatment(P>0.05),the recurrence rate in treatment group was lower than that in control group at 6 months after treatment(P<0.05).ConclusionFor patients with AR of lung-spleen qi deficiency,intranasal acupuncture combined with AA has a significant clinical effect,can effectively relieve the clinical symptoms and sign,improve quality-of-life,significantly improve the immune function and inflammatory response,and reduce the recurrence of disease.