针刺蝶腭神经节与皮下免疫治疗变应性鼻炎的临床疗效对比

Comparison of clinical efficacy between sphenopalatine ganglion acupuncture and subcutaneous immunotherapy in allergic rhinitis

目的对比变应性鼻炎患者的针刺蝶腭神经节治疗与皮下免疫治疗的临床疗效,为寻求个体化治疗患者提供临床参考。方法随机选取2018年6月~2019年6月于张家港市第一人民医院耳鼻咽喉科门诊就诊、确诊为变应性鼻炎患者118位,根据患者意愿,分成两组,A组64例采用针刺蝶腭神经节,B组64例行皮下免疫治疗。在治疗前、治疗后第1个月、3个月、6个月、12个月进行患者症状、体征及用药评估,去除B组中失访2例,对比两组患者临床疗效。结果相比治疗前,A组TNSS、TMS、VAS在接受治疗的第1个月、3个月、6个月明显下降,差异有统计学意义(P均<0.05);B组TNSS、TMS、VAS在第3个月、6个月、12个月明显下降,差异有统计学意义(P均<0.05);两组间的疗效指标在第1个月、12个月差异有统计学意义(P均<0.05),在第3个月、6个月无显著差异(P均>0.05),A组第1个月疗效明显高于B组,B组第12个月疗效明显高于A组。两组患者不良反应发生率及满意度差异有统计学意义(P均<0.05),A组患者不良反应发生率低于B组,从治疗所需时间、费用、不良反应发生接受程度以及持续时间方面比较,A组患者满意程度高于B组。治疗过程中偶尔出现的不良反应,经过对症处理后均及时缓解,无严重不良反应。结论两种治疗方法相比,针刺蝶腭神经节疗程短、起效快,针刺期间无需辅助用药,不良反应发生率低,患者满意度较高,但无法长期维持疗效,一年后基本恢复原有症状。皮下免疫治疗疗程长、起效慢,期间偶需配合辅助用药,不良反应发生率相对较高,但疗效维持时间长,且疗效恒定。

Objective The clinical efficacy of acupuncture on Sphenopalatine ganglion and specific immunotherapy in patients with allergic rhinitis were compared to discuss the advantages and disadvantages of the two treatment schemes.Methods From June2017 to June 2019,118 patients diagnosed with allergic rhinitis who visited the otolaryngology department of Zhangjiagang First People’s Hospital were randomly divided into two groups,64 patients in group A were treated with CT guided puncture of sphenopalatine ganglion,and 64 patients in group B were treated with subcutaneous specific immunotherapy.Removed two cases of lost follow-up in group B,the symptoms and signs of patients were evaluated before treatment,1 month,3 months,6 months and 12 months after treatment.Result Compared with before treatment,TNSS,TMS and VAS in group A decreased significantly in the first month,third month and sixth month after treatment,in group B decreased significantly at the third,sixth and twelfth months.The curative effect indexes between the two groups were significantly different at the first month and the twelfth month.The curative effect of group A at the first month was significantly higher than that of group B,and that of group B at the twelfth month was significantly higher than that of group A.The incidence of adverse reactions in group A was lower than that in group B.The satisfaction degree of patients in group A was higher than that in group B.the adverse reactions of all patients were relieved after timely symptomatic treatment Reaction.Conclusion Compared with the two treatment methods,acupuncture on sphenopalatine ganglion has shorter course of treatment,faster onset,lower incidence of adverse reactions and higher patient satisfaction,but it can not maintain the long-term curative effect.Subcutaneous specific immunotherapy has a long course of treatment,slow onset,high incidence of adverse reactions,and low patient satisfaction,but the curative effect remains long and the curative effect is constant.