和利阳气法治疗变应性鼻炎对患者鼻腔灌洗液中IL-17A表达水平的影响及其临床意义

Effect of Harmonizing and Supplement Yangqi Therapy on Expression of IL-17A inNasal Lavage Fluid of Patients with Allergic Rhinitis and Its Clinical Significance

目的 明确变应性鼻炎患者不同发病阶段鼻腔灌洗液中IL-17A的分泌水平,探讨其与变应性鼻炎最轻持续性炎症状态的相关性。方法 选取2020年9月—2020年12月就诊于山东中医药大学附属医院的变应性鼻炎患者,另同期招募部分健康志愿者。符合纳入标准的患者,签署知情同意书,在疾病发作期和症状消失期要求患者回忆1周以内变应性鼻炎发作最严重的的情况,对鼻部症状总评分(TNNS)、视觉模拟评分(VAS)及迷你鼻结膜炎生活质量问卷(MiniRQLQ)进行自主打分,并在疾病发作期、症状消失时和最轻持续性炎症期分别进行鼻腔灌洗,收集灌洗液。志愿者仅进行一次评分和鼻腔灌洗。利用MSD电化学发光技术检测鼻腔灌洗液中IL-17A的水平,分析其在健康人以及变应性鼻炎患者不同发病阶段的差异及与最轻持续性炎症状态的相关性。结果 变应性鼻炎患者在疾病发作期的TNNS、VAS、MiniRQLQ评分均明显大于健康志愿者及变应性鼻炎症状消失期(P<0.001)。与健康志愿者相比,变应性患者疾病发作期鼻腔灌洗液中IL-17A的水平无明显差异(P>0.05)。与疾病发作期相比,IL-17A在症状消失期的水平明显降低(P<0.05),IL-17A在最轻持续性炎症状态期无明显差异(P>0.05)。与症状消失期比较,IL-17A的水平在最轻持续性炎症状态期明显升高(P<0.05)。结论 变应性鼻炎患者较健康人生活质量明显下降。在症状消失时,IL-17A的水平相对降低,在最轻持续性炎症状态期,IL-17A的水平相对升高,这可能是变应性鼻炎患者最轻持续性炎症状态期慢性炎症反复存在的原因。

Objective To clarify the secretion level of IL-17 A in the nasal lavage fluid of patients with allergic rhinitis at different stages and explore its correlation with the minimal persistent inflammation.Methods Patients with allergic rhinitis in the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from September 2020 to December 2020 were selected andsome healthy volunteers were recruited at the same period.Patients who meet the inclusion criteria should sign an informed consent form.During the attack period and symptom disappearance period, the patients were required to recall the most severe case of allergic rhinitis within one week, and scored the Total Nasal Symptoms Score(TNNS),Visual Analogue Scale(VAS) and Mini Rhinoconjunctivitis Quality of Life Questionnaires(MiniRQLQ) independently.The nasal lavage fluid was collected during the attack period and symptom disappearance period and the minimal persistent inflammation period.Volunteers only performed scoring and nasal lavage once.MSD electrochemiluminescence technology was used to detect the level of IL-17 A in nasal lavage fluid and analyze the difference of IL-17 A in healthy people and patients with allergic rhinitis at different stages and its correlation with the minimal persistent inflammation.Results The TNNS, VAS and MiniRQLQ scores of patients with allergic rhinitis during the attack period were significantly higher than those of healthy volunteers and the symptom disappearance period(P<0.001).Compared with that of the healthy volunteers, the level of IL-17 A in the nasal lavage fluid of allergic patients during the attack period had no significant difference(P>0.05).Compared with that in the attack period, the level of IL-17 A was significantly reduced in the period of symptom disappearance(P<0.05), and there was no significant difference in the level of IL-17 A in the minimal persistent inflammation period(P>0.05).Compared with the symptom disappearance period, the level of IL-17 A was significantly increased in the minimal persistent inflammation period(P<0.05).Conclusion The quality of life of patients with allergic rhinitis is significantly lower than that of healthy people.When the symptoms disappear, the level of IL-17 A is relatively reduced, and the level of IL-17 A is relatively increased in the minimal persistent inflammation period.This may be the reason for the recurrence of chronic inflammation in patients with allergic rhinitis during the minimal persistent inflammation period.