通窍鼻炎颗粒联合细菌溶解产物胶囊对过敏性鼻炎患者小气道功能及气道炎性反应的影响

Effects of Tongqiao Biyan Granules combined with bacterial lysates capsule on small airway function and airway inflammatory response in patients with allergic rhinitis

目的探究通窍鼻炎颗粒联合细菌溶解产物胶囊对过敏性鼻炎(AR)患者小气道功能及气道炎性反应的影响。方法选取2022年6月至2023年6月浙江省金华市妇幼保健院收治的120例AR患者临床资料进行研究,按照治疗方法分为常规组(细菌溶解产物胶囊治疗60例)和联合组(通窍鼻炎颗粒联合细菌溶解产物胶囊治疗60例),2组治疗周期均为1个月。对比2组患者的治疗效果、中医证候积分、小气道功能[最大呼气中段流量(MMEF)、用力呼气50%流速(FEF50)、用力呼气75%流速(FEF75)]、气道炎性反应[呼出气一氧化氮(FeNO)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]、血清细胞因子[白细胞介素-4(IL-4)、白细胞介素-6(IL-6)、白细胞介素-17(IL-17)]及不良反应发生率。结果联合组患者的治疗有效率(95.0%)高于常规组(81.7%)(χ2=5.175,P<0.05);治疗后,联合组患者的鼻塞、鼻痒、流涕中医证候积分[(1.4±0.4)分、(1.5±0.6)分、(1.4±0.5)分]均低于常规组[(2.5±0.8)分,(2.6±0.6)分、(2.6±0.6)分](t=9.947、10.563、10.906,P均<0.05);联合组患者小气道功能MMEF、FEF50、FEF75分别为(2.2±0.4)L/s、(2.42±0.33)L/s、(1.29±0.17)L/s,均高于常规组的[(1.9±0.3)L/s、(2.17±0.27)L/s、(1.07±0.14)L/s](t=5.301、4.542、7.738,P均<0.05);联合组患者气道炎性反应FeNO、CRP、TNF-α水平分别为(14±4)ppb、(16±4)ng/ml、(7.6±1.8)ng/ml,均低于常规组[(16±4)ppb、(20±4)ng/ml、(10.5±2.2)ng/ml](t=3.623、6.796、7.733,P均<0.05);联合组患者血清细胞因子IL-4、IL-6、IL-17水平分别为(5.7±0.9)ng/L、(94±20)ng/L、(32.6±4.8)ng/L,均低于常规组[(8.3±1.1)ng/L、(125±22)ng/L、(43.5±5.4)ng/L](t=14.392、8.346、11.798,P均<0.05);联合组(3.3%)和常规组(8.3%)的不良反应发生率差异无统计学意义(χ^(2)=1.365,P>0.05)。结论通窍鼻炎颗粒联合细菌溶解产物胶囊对AR患者的疗效显著,可改善患者的中医证候评分及患者的小气道功能,降低气道炎性反应。

Objective To explore the effects of Tongqiao Biyan Granule combined with bacterial lysates capsule on small airway function and airway inflammatory response in patients with allergic rhinitis(AR).Methods A total of 120 clinical data of patients with AR admitted to Jinhua Maternal and Child Health Hospital from June 2022 to June 2023 were selected for the study.According to the different treatment methods,they were divided into a conventional group(treated with bacterial lysates capsule,n=60)and a combination group(treated with Tongqiao Biyan Granules combined with bacterial lysates capsule,n=60),with a treatment period of one month for both groups.The treatment effects,traditional Chinese medicine(TCM)syndrome scores,small air-way function[maximal mid-expiratory flow(MMEF),forced expiratory flow at 50%(FEF50),forced expiratory flow at 75%(FEF75)],airway inflammatory response[fractional exhaled nitric oxide(FeNO),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)],serum cytokines[interleukin-4(IL-4),interleukin-6(IL-6),interleukin-17(IL-17)],and incidence of adverse reactions were compared between the two groups.Results The effective rate in the combination group was significantly higher than that in the conventional group(95.0%vs 81.7%,χ^(2)=5.175,P<0.05).After treatment,the TCM syn-drome scores of nasal congestion,nasal itching,and runny nose in the combination group[(1.4±0.4)points,(1.5±0.6)points,(1.4±0.5)points,respectively]were significantly lower than those in the control group[(2.5±0.8)points,(2.6±0.6)points,and(2.6±0.6)points](t=9.947,10.563,10.906,all P<0.05);The levels of small airway function indicators,including MMEF,FEF50,and FEF75,in the combination group[(2.2±0.4)L/s,(2.42±0.33)L/s,(1.29±0.17)L/s,respectively]were significantly higher than those in the conventional group[(1.9±0.3)L/s,(2.17±0.27)L/s,(1.07±0.14)L/s,respectively](t=5.301,4.542,7.738,all P<0.05).The levels of airway inflammatory markers,including FeNO,CRP,and TNF-α,in the combination group[(14±4)ppb,(16±4)ng/ml,(7.6±1.8)ng/ml]were significantly lower than those in the conventional group[(16±4)ppb,(20±4)ng/mL,(10.5±2.2)ng/mL,respectively](t=3.623,6.796,7.733,all P<0.05).The serum levels of cytokines IL-4,IL-6,and IL-17 in the combination group[(5.7±0.9)ng/L,(94±20)ng/L,(32.6±4.8)ng/L]were significantly lower than those in the conventional group[(8.3±1.1)ng/L,(125±22)ng/L,(43.5±5.4)ng/L,respectively](t=14.392,8.346,11.798,all P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the combination group(3.3%)and the conventional group(8.3%)(χ2=1.365,P>0.05).Conclusion The combination of Tongqiao Biyan Granules and bacterial lysates capsule has a significant therapeutic effect on patients with AR,which can improve the traditional Chinese medicine syndrome scores and small airway function of patients,and reduce airway inflammation.