小柴胡汤加味对变应性鼻炎中医症状、免疫功能影响

Effects of Modified Xiaochaihu Decoction on TCM Symptoms and Immune Function in Allergic Rhinitis

目的:探讨小柴胡汤加味联合鼻喷糠酸莫米松对变应性鼻炎患者中医症状、免疫功能的影响。方法:选取2019年8月至2021年8月陕西中医药大学附属医院收治的变应性鼻炎患者116例作为研究对象,按照随机数字表法随机分为对照组和观察组,每组58例。对照组以鼻喷糠酸莫米松治疗,观察组增加加味小柴胡汤治疗。评估患者的临床疗效、中医症状积分、炎症介质水平、T淋巴细胞亚群水平、治疗安全性。结果:治疗后观察组总有效率为91.38%,高于对照组的75.86%(P<0.05);观察组中医症状积分包括鼻涕清稀、鼻燥咽干、嗅觉减退、心烦耳鸣均低于对照组(P<0.05);观察组炎症介质包括可溶性血管细胞黏附分子-1(VCAM-1)、缺氧诱导因子(HIF-1)、促分裂原活化的蛋白激酶(MAPK)水平均低于对照组(P<0.05),观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于对照组,CD8^(+)低于对照组(P<0.05)。治疗期间2组患者不良反应发生率分别为13.79%、8.62%,差异无统计学意义(P>0.05)。结论:加味小柴胡汤联合鼻喷糠酸莫米松对变应性鼻炎患者的治疗效果显著,能够显著改善患者中医症状,降低炎症介质水平,提高患者机体免疫力,治疗安全性良好。

Objective:To study the effects of modified Xiaochaihu Decoction combined with nasal spray of mometasone furoate on TCM symptoms and immune function in the patients with allergic rhinitis.Methods:A total of 116 patients with allergic rhinitis treated in the Affiliated Hospital of Shaanxi University of Chinese Medicine from August 2019 to August 2021 were enrolled in this study and randomized by the random number table method into an observation group and a control group,with 58 patients in each group.The control group was treated with nasal spray of mometasone furoate,and the observation group with modified Xiaochaihu Decoction on the basis of the therapy in the control group.The clinical efficacy,TCM symptom scores,inflammatory cytokine levels,T lymphocyte subpopulations,and treatment safety were evaluated.Results:The total response rate in the observation group was 91.38%,which was higher than that(75.86%)in the control group(P<0.05).After treatment,the scores of TCM symptoms including runny nose,dry nose and throat,declined smell,upset,and tinnitus in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of inflammatory cytokines including soluble vascular cell adhesion molecule-1(VCAM-1),hypoxia-inducible factor-1(HIF-1),and mitogen-activated protein kinase(MAPK)in the observation group were lower than those in the control group(P<0.05).The observation group had high levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)but lower level of CD8^(+)than the control group(P<0.05).The incidence rates of adverse reactions in the two groups were 13.79%and 8.62%,respectively,which showed no significant difference(P>0.05).Conclusion:Modified Xiaochaihu Decoction combined with nasal spray of mometasone furoate demonstrated a definite therapeutic effect on the patients with allergic rhinitis.This therapy alleviates the TCM symptoms,lowers the levels of inflammatory cytokines,and improves the immunity of the patients.