中医药临床优势病种探讨——变应性鼻炎

Advantages of Traditional Chinese Medicine in Treating Dominant Disease:Allergic Rhinitis

为落实《中共中央国务院关于促进中医药传承创新发展的意见》和全国中医药大会精神,中华中医药学会组织中西医耳鼻咽喉头颈外科专家对变应性鼻炎(AR)的中医及中西医结合治疗的临床优势进行了重点讨论并反复推敲论证形成了该建议共识。近年来AR的患病率明显上升,导致较大的疾病负担,给患者生活质量和社会经济带来严重影响。AR的发生并非单纯的免疫力降低或亢进,而是免疫失衡导致的,契合于中医的阴阳失调。面对如此高的患病率及患者对生活质量改善的要求,西药存在起效快但易复发、手术创伤大、费用高昂等问题,而中医药治疗AR方法多样并且可用于AR的各个阶段。中医药对发作期鼻塞、流涕或嗅觉障碍等症状控制、缓解期预防复发、对经西药系统治疗无效的难治性AR或类固醇抵抗型AR有一定效果和优势,尤其是针刺治疗AR已得到广泛认可,并具有循证医学证据支持和指南推荐。中医药在治疗AR局部症状的同时可兼顾心身情况的调护,并易于进行慢病管理及长期随访。中西医应当整合优势,在互相借鉴的基础上,发挥中医药的不可忽视和替代的独有优势,形成便于学习和推广的综合诊疗方案,凝练成果,以AR为切入点,在中西医融合的视角下开展深入研究,推动AR相关的中医药理论创新。

In response to the Opinions of the CPC Central Committee and the State Council on Promoting the Inheritance,Innovation,and Development of traditional Chinese medicine(TCM)and the spirit of the National Conference on TCM,Chinese Association of Chinese Medicine organized experts in Otorhinolaryngology Head and Neck Surgery of traditional Chinese and western medicine to discuss the clinical advantages of TCM and integrated traditional Chinese and western medicine in the treatment of allergic rhinitis(AR)and they reached a basic consensus.In recent years,the prevalence of AR has been on the rise,threatening the quality of life of patients and giving rise to a heavy burden to both the patients and the society.AR is resulted from immune imbalance rather than reduced immunity or hyperimmunity,and the imbalance is similar to the Yin-yang disharmony in TCM.In the treatment of this disease,western medicine features rapid onset.However,it is cost-intensive and causes severe surgical trauma,and the recurrence is common.TCM boasts diverse methods for AR,which can be used in all stages of this disease.It has advantages in controlling symptoms such as nasal congestion,runny nose,or dysosmia in the attack stage,preventing recurrence in the remission stage,and treating refractory AR or steroid-resistant AR.In particular,acupuncture enjoys a reputation in treatment of AR,which has been supported by evidence-based medicine and recommended by guidelines.While treating local symptoms of AR,TCM regulates the psychosomatic conditions,which facilitates chronic disease management and long-term follow-up.We should integrate the advantages of TCM and western medicine,give full play to the unique nonnegligible and irreplaceable advantages of TCM,formulate a comprehensive diagnosis and treatment scheme for learning and promotion,and summarize the research outcomes to promote the theoretical innovation of TCM on AR from the perspective of integrated traditional Chinese and western medicine.