中医药治疗变应性鼻炎临床研究评述

Treatment of Allergic Rhinitis with Traditional Chinese Medicine:A Review

该文针对近年来中医药领域治疗变应性鼻炎(AR)的临床研究进行评述,AR是耳鼻喉科常见病及多发病,该病常见表现有鼻塞、打喷嚏、流清涕及鼻痒等,是鼻黏膜的慢性炎症性疾病。AR是中医药治疗耳鼻咽喉头颈疾病的优势病种,属于中医“鼻鼽”的范畴。其发病病因及病机在古代有着深厚的理论基础,现代医家根据古代文献、理论基础并结合自身经验,分为脏腑辨证与六经辨证,其中关于脏腑辨证的阐述较多,大多医家认为AR与脏腑功能失调有关,主要以肺脾肾三脏为主。临床研究大致分为单纯中药治疗、中西医结合治疗及中医外治法等,这些疗法在治疗AR的临床疗效方面均具有优势。其中单纯中药治疗在改善AR患者症状及鼻腔体征、降低相关量表评分、减少鼻分泌物嗜酸性粒细胞计数(EOS)等方面具有显著优势,且远期疗效确切;中西医结合治疗一般为中医药疗法结合西医常规治疗,可优势互补,各取所长;中医外治法包括针刺、艾灸、穴位埋线、穴位贴敷、中药鼻冲洗等,其安全简便,更易被患者接受,疗效较好。最后总结中医药治疗AR的临床研究现状,并从规范中医药临床研究方案、精准凸显中医药治疗优势及结合前沿探索中医药疗效机制3个方面提出建议,以期为后续临床研究提供更高等级的证据,并促进AR优势病种的推广。

This article reviews the clinical studies about the treatment of allergic rhinitis(AR)with traditional Chinese medicine(TCM)in recent years.AR is a common and frequently occurring disease in the department of otolaryngology.The common manifestations of AR include nasal congestion,sneezing,runny nose,and nasal itching.AR,belonging to the category of rhinitis,is a dominant disease in the TCM treatment of otorhinolaryngologic diseases and head and neck diseases.The ancient literature has laid a solid theoretical basis on the etiology and pathogenesis of AR.According to the ancient literature,the theoretical basis,and their own experience,modern doctors classified the causes of AR into the disorders in Zang-fu organs and six meridians.Most of the explanations focus on the disorders in Zang-fu organs,especially the lung,spleen,and kidney.The clinical studies in this field mainly involve TCM treatment alone,integrated TCM and Western medicine treatment,and TCM external treatment.These therapies have good efficacy in the clinical treatment of AR.Among them,TCM treatment alone has significant advantages in alleviating the symptoms and nasal signs,declining the scores of related scales,and reducing the eosinophil count(EOS)of nasal secretions,with definite long-term efficacy.Integrated TCM and Western medicine treatment can complement with each other.The TCM external treatment methods include acupuncture,moxibustion,acupoint catgut embedding,acupoint application,and nasal irrigation with TCM,which are safe,simple,acceptable by patients and have good therapeutic effect.Finally,the clinical research status of TCM treatment of AR was summarized,and suggestions were put forward from three aspects:standardizing the clinical research protocol of TCM,encouraging pure TCM research,and exploring the mechanism of TCM treatment on the basis of frontier research achievements.This review aims to provide higher-level evidence for subsequent clinical research and promote the research on dominant AR diseases.