埋线与针刺蝶腭神经节及穴位治疗过敏性鼻炎肺脾气虚证疗效比较研究

Comparative study of sphenopalatine ganglion combined with acupoints catgut embedding and acupuncture in the treatment of allergic rhinitis lung spleen qi deficiency syndrome

目的比较埋线与针刺蝶腭神经节及穴位治疗过敏性鼻炎肺脾气虚证的临床疗效。方法根据治疗方案不同将64例过敏性鼻炎肺脾气虚证患者分为对照组31例和治疗组33例。2组均选取蝶腭神经节(双)、风门(双)、肺俞(双)、脾俞(双)、气海、足三里(双)穴,对照组采用针刺疗法治疗,隔日1次,每周治疗3次;治疗组采用埋线疗法治疗,每周治疗1次。治疗4周后比较2组的临床疗效、治疗时间及费用,以及治疗前后视觉模拟评分法(VAS)评分、鼻结膜炎生存质量量表(RQLQ)评分、中医证候积分;治疗后随访3个月,比较2组的远期疗效及复发率。结果对照组总有效率为87.1%(27/31),治疗组为93.9%(31/33),2组比较差异无统计学意义(P>0.05)。治疗后2组VAS、RQLQ各项评分及总评分、中医证候积分均明显降低,与同组治疗前比较差异有统计学意义(P<0.05),且治疗组鼻塞、鼻痒评分及VAS总评分,RQLQ鼻部症状及行为问题评分降低更明显,与对照组治疗后比较差异均有统计学意义(P<0.05)。治疗组治疗时间明显短于对照组,治疗费用明显少于对照组,2组比较差异均有统计学意义(P<0.05或P<0.01)。治疗后随访3个月,对照组总有效率为70.97%(22/31),复发率为29.0%(9/31);治疗组总有效率为90.90%(30/33),复发率为9.1%(3/33),2组比较差异均有统计学意义(P<0.05)。结论埋线与针刺蝶腭神经节及穴位治疗过敏性鼻炎肺脾气虚证患者均有显著疗效,但埋线疗法在改善患者鼻塞、鼻痒、鼻部症状、解决日常行为问题、缩短治疗时间、减少治疗费用、降低复发率及改善远期疗效等方面优于针刺疗法,值得临床推广应用。

Objective To compare the clinical curative effect of catgut embedding and acupuncture at sphenopalatine ganglion combined with acupoints in the treatment of allergic rhinitis lung spleen qi deficiency syndrome.Methods 64 cases of allergic rhinitis lung spleen qi deficiency syndrome were divided into control group(31 cases)and treatment group(33 cases)according to different treatment plans.Sphenopalatine ganglia(both sides),Fengmen(both sides)(BL12),Feishu(both sides)(BL13),Pishu(both sides)(BL20),Qihai(RN6),Zusanli(both sides)(ST36)were selected in 2 groups,and the control group was treated with acupuncture once every other day,3 times a week.The treatment group was treated with catgut embedding method once a week.After 4 weeks of treatment,the clinical efficacy,treatment time and cost of the two groups were compared,as well as visual analogue scale(VAS)score,rhinoconjunctivitis quality of life questionnaire(RQLQ)score and TCM syndrome score before and after treatment.Follow-up for 3 months after treatment was performed to compare the long-term clinical efficacy and recurrence rate of the two groups.Results The total effective rate was 87.1%(27/31)in the control group and 93.9%(31/33)in the treatment group.There was no significant difference between the two groups(P>0.05).After treatment,VAS,RQLQ scores,total scores and TCM syndrome score of the 2 groups were significantly reduced,a nd the differences were statistically significant compared with those before treatment(P<0.05).In addition,nasal congestion,nasal itchiness score,total VAS score,RQLQ nasal symptoms and behavioral problems in the treatment group were significantly reduced.There was statistical significance between the two groups after treatment(P<0.05).The treatment time of the treatment group was significantly shorter than that of the control group,and the medical cost was significantly less than that of the control group,with statistical significance between the two groups(P<0.05 or P<0.01).In the control group,the total effective rate was 70.97%(22/31)and the recurrence rate was 29.0%(9/31).In the treatment group,the rates were 90.90%(30/33)and 9.1%(3/33),respectively,with statistical significance between the two groups(P<0.05).Conclusion Catgut embedding and acupuncture of sphenopa-latine ganglion combined with acupoints have significant curative effect in the treatment of allergic rhinitis patients with lung spleen qi deficiency syndrome,but catgut embedding is superior to acupuncture in improving nasal congestion,nasal itchiness,nasal symptoms,solving daily behavior problems,shortening treatment time,reducing medical costs,reducing recurrence rate and in long-term curative effect,and it is worthy of clinical promotion and application.