通窍止鼽汤辅助治疗小儿变应性鼻炎肺脾气虚证52例临床观察

Clinical observation on Tongqiao Zhiqiu Tang(通窍止鼽汤)in adjuvant treatment of 52 cases of allergic rhinitis in children with qi deficiency of lung and spleen syndrome

目的观察通窍止鼽汤辅助治疗小儿变应性鼻炎(AR)肺脾气虚证的临床疗效及对炎症反应、免疫功能的影响。方法选取2021年3月至2022年3月在浙江萧山医院儿科接受治疗的104例AR肺脾气虚证患儿作为研究对象,按照随机数字表法分为治疗组与对照组,各52例。对照组给予氯雷他定片口服治疗,治疗组在对照组治疗方法的基础上联合中药通窍止鼽汤治疗,2组均连续治疗4周后统计临床疗效。结果治疗组总有效率为94.23%(49/52),显著高于对照组的80.77%(42/52),2组比较,差异有统计学意义(P<0.05)。治疗前2组鼻痒、鼻塞、流涕、打喷嚏评分比较,差异无统计学意义(P>0.05),具有可比性;治疗后2组鼻痒、鼻塞、流涕、打喷嚏评分均显著下降,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组下降更显著(P<0.05)。治疗前2组血清炎症因子水平比较,差异无统计学意义(P>0.05),具有可比性;治疗后2组血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平显著下降,白细胞介素-12(IL-12)水平显著升高,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组下降或升高更显著(P<0.05)。治疗前2组血清白细胞介素-4(IL-4)、γ-干扰素(INF-γ)及免疫球蛋白E(IgE)水平比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组血清IL-4、IgE水平显著下降,INF-γ水平显著升高,与同组治疗前比较,差异均有统计学意义(P<0.05),且治疗组下降或升高更显著(P<0.05)。结论通窍止鼽汤辅助治疗AR肺脾气虚证疗效显著,可明显改善患儿临床症状和体征,有效抑制机体炎症反应,提高免疫功能,值得临床推广应用。

Objective To observe the clinical efficacy and the effect on inflammatory response and immune function of Tongqiao Zhiqiu Tang(通窍止鼽汤)in the adjuvant treatment of pediatric allergic rhinitis(AR).Methods 104 children with qi deficiency of lung and spleen in AR treated in the Department of Pediatrics,Zhe-jiang Xiaoshan Hospital from March 2021 to March 2022 were selected as the study subjects,and were divided into a treatment group and a control group according to the method of random number table,each with 52 cases.The con-trol group was given oral treatment with loratadine tablets,and the treatment group was combined with the traditional Chinese medicine Tongqiao Zhiqiu Tang on the basis of the treatment method of the control group,and the clinical efficacy of the two groups was counted after 4 consecutive weeks of treatment.Results The total effective rate of the treatment group was 94.23%(49/52),which was higher than that of the control group(80.77%),and the differ-ence between the two groups was statistically significant(P<0.05).Before treatment,the difference between the scores of nasal itching,nasal congestion,runny nose and sneezing of the 2 groups was not statistically significant(P>0.05),and it was comparable;after treatment,the scores of nasal itching,nasal congestion,runny nose and sneezing of the 2 groups were significantly decreased,and compared with that of the same group before treatment,the difference was statistically significant(P<0.05),and the decrease in the treatment group was more significant(P<0.05).Comparison of serum inflammatory factor levels between the 2 groups before treatment,the difference was not statistically significant(P>0.05),and was comparable;after treatment,serum interleukin-6(IL-6)and tumour necrosis factor-α(TNF-α)levels decreased significantly,and interleukin-12(IL-12)levels increased sig-nificantly in the 2 groups,and the difference was statistically significant compared with that of the same group before treatment(P<0.05),and the decrease or rise was more significant in the treatment group(P<0.05).Before treat-ment,there was no statistically significant difference between the serum interleukin-4(IL-4),interferon gamma(INF-γ)and immunoglobulin E(IgE)levels of the two groups(P>0.05),and the differences were comparable;after treatment,there was a significant decrease in the levels of IL-4 and IgE,and a significant increase in the level of INF-γin the two groups,which was statistically significant when compared with that of the same group(P<0.05),and the decrease or increase was more significant in the treatment group(P<0.05).Conclusion The effi-cacy of Tongqiao Zhiqiu Tang in the adjuvant treatment of AR with qi deficiency of lung and spleen is remarkable,which can significantly improve the clinical symptoms and signs of children,effectively inhibit the inflammatory re-sponse of the body and improve the immune function,which is worthy of clinical promotion and application.