加味玉屏风汤治疗肺脾气虚型过敏性鼻炎

Modified Yupingfeng Decoction in Treatment of Allergic Rhinitis with Lung and Spleen Deficiency Syndrome

目的:基于肺鼻同治理论观察加味玉屏风汤治疗肺脾气虚型过敏性鼻炎的临床疗效及其对气道应激反应的影响。方法:122例肺脾气虚型过敏性鼻炎患者随机平均分为对照组、观察组,各61例。对照组给予常规西药治疗,观察组在对照组治疗基础上给予加味玉屏风汤。90 d后比较两组患者临床疗效、中医证候积分、气道应激反应指标、炎症因子、不良反应。结果:观察组有效率为91.80%(56/61),高于对照组的77.05%(47/61)(P<0.05)。治疗后,观察组中医证候积分包括喷嚏频繁、清稀鼻涕、嗅觉迟钝、气短懒言分别为(1.62±0.49)分、(1.69±0.50)分、(1.78±0.45)分、(1.86±0.56)分,分别低于对照组的(1.93±0.55)分、(2.15±0.69)分、(2.21±0.68)分、(2.43±0.66)分(P<0.05)。治疗后,观察组气道应激反应指标呼出气一氧化氮(exhaled nitric oxide,FeNO)、脂质过氧化氢(lipid hydrogen peroxide,LHP)、诱导型一氧化氮合酶(inducible nitric oxide synthase,iNOS)水平分别为(42.31±5.82)ppb、(22.67±3.84)ng·L^(-1)、(61.01±7.94)ng·L^(-1),分别低于对照组的(48.14±6.37)ppb、(27.91±4.26)ng·L^(-1)、(68.87±8.65)ng·L^(-1)(P<0.05)。治疗后,观察组炎症因子半胱氨酸白三烯受体1、肺表面活性蛋白-A、白细胞介素-33水平分别为(19.57±3.97)μg·L^(-1)、(72.41±8.94)μg·L^(-1)、(31.35±5.24)μg·L^(-1),分别低于对照组的(23.48±4.92)μg·L^(-1)、(79.95±9.63)μg·L^(-1)、(36.27±6.05)μg·L^(-1)(P<0.05)。治疗期间两组不良反应发生率分别为13.11%(8/61)、9.84%(6/61),差异无统计学意义(P>0.05)。结论:加味玉屏风汤治疗肺脾气虚型过敏性鼻炎效果良好,可降低患者中医证候积分,抑制气道应激反应,降低炎症因子水平,治疗安全性良好。

Objective:Based on observation of the theory of lung and nose treatment,the clinical efficacy of modified Yu Pingfeng Decoction in the treatment of allergic rhinitis with lung spleen deficiency and its impact on airway stress response.Method:122 patients with lung spleen deficiency type allergic rhinitis were randomly divided into a control group and an observation group,with 61 cases in each group.The control group was treated with conventional Western medicine,while the observation group was treated with modified Yu Pingfeng Decoction on the basis of the control group.After 90 days,compare the clinical efficacy,traditional Chinese medicine syndrome scores,airway stress response indicators,inflammatory factors,and adverse reactions between the two groups of patients.Result:The effective rate of the observation group was 91.80%(56/61),which was higher than 77.05%(47/61)of the control group(P<0.05).After treatment,the TCM syndrome scores of the observation group,including frequent sneezing,clear nasal discharge,delayed olfaction,and short breath and lazy speech,were(1.62±0.49)points,(1.69±0.50)points,(1.78±0.45)points,and(1.86±0.56)points,respectively,lower than the control group's(1.93±0.55)points,(2.15±0.69)points,(2.21±0.68)points,and(2.43±0.66)points(P<0.05).After treatment,the airway stress response indicators of exhaled nitric oxide(FeNO),lipid peroxide(LHP),and inducible nitric oxide synthase(iNOS)in the observation group were(42.31±5.82)ppb,(22.67±3.84)ng·L^(-1),and(61.01±7.94)ng·L^(-1),respectively,lower than those in the control group(48.14±6.37)ppb,(27.9±4.26)ng·L^(-1),and(68.87±8.65)ng·L^(-1).(P<0.05).After treatment,the levels of inflammatory factors cysteine leukotriene receptor 1,pulmonary surfactant protein-A,and interleukin-33 in the observation group were(19.57±3.97)ng·mL-1,(72.41±8.94)ng·mL-1,and(31.35±5.24)ng·mL-1,respectively,lower than those in the control group(23.48±4.92)ng·mL-1,(79.95±9.63)ng·mL-1,and(36.27±6.05)ng·mL-1(P<0.05).During the treatment period,the incidence of adverse reactions between the two groups was 13.11%(8/61)and 9.84%(6/61),with no statistically significant difference(P>0.05).Conclusion:Modified Yu Pingfeng Decoction has a good therapeutic effect on allergic rhinitis of lung spleen deficiency type,which can alleviate traditional Chinese medicine symptoms,inhibit airway stress response,reduce the expression of inflammatory factors,and have good treatment safety.