温肺益气方联合常规西药治疗肺气虚寒型变应性鼻炎疗效观察

Observation on the curative effect of Wenfei Yiqi Decoction combined with conventional western medicine in the treatment of allergic rhinitis with syndrome of lung Qi deficiency and cold

目的观察温肺益气方联合常规西药治疗肺气虚寒型变应性鼻炎的临床疗效。方法将2019年1月—2020年6月在上海中医药大学附属曙光医院宝山分院门诊就诊的97例常年性肺气虚寒型变应性鼻炎患者随机分为西药组33例、中药组30例及中西药联合组34例。西药组给予氯雷他定睡前口服,中药组给予温肺益气方煎汤口服,中西药联合组给予氯雷他定及温肺益气方煎汤口服,3组均治疗4周,随访3个月。记录3组患者治疗前及治疗4周、3个月后症状体征分级量化评分,评定3组患者治疗4周、3个月后临床疗效,检测3组患者治疗前及治疗4周后外周血嗜酸性粒细胞(EOS)计数,采用视觉模拟量表(VAS)及鼻眼结膜相关生活质量问卷调查量表(RQLQ)评估3组患者治疗前及治疗3个月后的生活质量。结果治疗4周、3个月后随访,3组患者鼻痒、流涕、鼻塞、喷嚏、下鼻甲肿胀评分均明显低于治疗前(P均<0.05),且中西药联合组各项评分明显低于同期西药组和中药组(P均<0.05)。治疗4周和3个月后,中西药联合组的总有效率分别为91.2%(31/34)和79.4%(27/34),中药组分别为73.3%(22/30)和63.3%(19/30),西药组分别为54.5%(18/33)和42.4%(14/33),中西药联合组的总有效率均明显高于同期中药组和西药组(P均<0.05)。3组患者治疗4周后EOS计数及治疗3个月后VAS评分和RQLQ评分均较治疗前明显降低(P均<0.05),且中西药联合组均明显低于西药组和中药组(P均<0.05)。结论温肺益气方联合常规西药治疗肺气虚寒型变应性鼻炎的近期和远期疗效均明显优于单独西药或中药治疗,且在降低EOS计数及改善生活质量方面具有明显优势。

Objective It is to observe the clinical effect of Wenfei Yiqi Decoction combined with conventional western medicine on allergic rhinitis with syndrome of lung Qi deficiency and cold.Methods Ninety-seven patients with allergic rhinitis with syndrome of lung Qi deficiency and cold who were treated in the outpatient department of Baoshan Branch of Shuguang Hospital of Shanghai University of Traditional Chinese Medicine from January 2019 to June 2020 were randomly divided into a western medicine group(n=33),a traditional Chinese medicine group(n=30),and a the combined Chinese and western medicine(n=34).The western medicine group was given loratadine orally before going to bed,the traditional Chinese medicine group was given Wenfei Yiqi Decoction orally,and the combined Chinese and western medicine group was given loratadine and Wenfei Yiqi Decoction orally.All the groups were treated for 4 weeks,followed-up for 3 months.The symptom and sign grading and quantitative scores before treatment and after treatment for 4 weeks and 3 months were recorded,the clinical efficacy was evaluated after treatment for 4 weeks and 3 months,the acidic granulocyte(EOS)count was detected before and after 4 weeks of treatment in the three groups,the visual analog scale(VAS)and nose,eye and conjunctival related quality of life questionnaire(RQLQ)were used to assess the quality of life of the three groups before treatment and after 3 months of treatment.Results After 4 weeks and 3 months of treatment,the scores of nasal itching,runny nose,nasal congestion,sneezing,and inferior turbinate swelling in the three groups were significantly lower than those before treatment(P<0.05),and the scores of the combination group were significantly lower than those of western medicine group and traditional Chinese medicine group at the same period(P<0.05).After 4 weeks and 3 months of treatment,the total effective rates of the combination group were 91.2%(31/34)and 79.4%(27/34),respectively,and those in the Chinese medicine group were 73.3%(22/30)and 63.3%(19/30),in the western medicine group were 54.5%(18/33)and 42.4%(14/33),respectively.The total effective rate of the combined group was significantly higher than those of the Chinese medicine group and the western medicine group during the same period(P<0.05).The EOS counts of the 3 groups after 4 weeks of treatment,and the VAS score and RQLQ scores after 3 months of treatment were significantly lower than those before treatment(P<0.05),and the combined group was significantly lower than the western medicine group and the Chinese medicine group(all P<0.05).Conclusion The short-term and long-term curative effect of Wenfei Yiqi Decoction combined with conventional western medicine in the treatment of allergic rhinitis with syndrome of lung Qi deficiency and cold is significantly better than that of western medicine or traditional Chinese medicine alone,and it has obvious advantages in reducing EOS count and improving quality of life.