敏喘克颗粒联合常规西药治疗变应性鼻炎-哮喘综合征临床研究

Clinical Study on Minchuanke Granules Combined with Conventional Western Medicine for the Treatment of Allergic Rhinitis-Asthma Syndrome

目的观察敏喘克颗粒联合常规西药治疗变应性鼻炎-哮喘综合征(CARAS)的疗效并初步探讨其疗效机理。方法采用随机数字表法将69例CARAS患者分为对照组34例和治疗组35例。2组均予口服茶碱缓释片并外用布地奈德鼻喷雾剂,治疗组在对照组基础上予敏喘克颗粒,每日1剂,每日2次口服。2组均30 d为1个疗程,观察2个疗程。观察2组哮喘控制疗效及临床疗效,比较2组治疗前后中医症状评分及体征评分,血清免疫球蛋白E(IgE)、白细胞介素(IL)-4、IL-33、肿瘤坏死因子-α(TNF-α)、γ干扰素(IFN-γ)水平。监测2组安全性指标及不良反应情况。结果2组各脱落2例。治疗组哮喘控制总有效率为87.88%(29/33),对照组为65.63%(21/32),2组比较差异无统计学意义(P>0.05)。治疗组临床疗效总有效率为87.88%(29/33),对照组为56.25%(18/32),2组比较差异有统计学意义(P<0.05)。与本组治疗前比较,2组治疗后症状体征总分下降(P<0.05);2组治疗后比较,治疗组症状体征总分低于对照组(P<0.05)。与本组治疗前比较,2组治疗后鼻塞、鼻痒、流涕、咳嗽、喘促、气急、胸闷分级差异无统计学意义(P>0.05);2组治疗后比较,治疗组上述症状程度分级比较差异无统计学意义(P>0.05)。与本组治疗前比较,治疗组治疗后血清IgE、IL-4、IL-33水平显著降低,TNF-α、IFN-γ水平明显升高(P<0.05);2组治疗后比较,治疗组IgE、IL-4、IL-33、TNF-α、IFN-γ水平改善优于对照组(P<0.05)。2组安全性指标无明显异常,未见明显不良反应。结论敏喘克颗粒联合常规西药可有效改善CARAS患者的临床症状,其可能通过降低IgE、调节Th1/Th2水平、抑制炎性介质释放发挥治疗CARAS的作用。

Objective To observe the efficacy of Minchuanke Granules combined with conventional Western medicine in the treatment of allergic rhinitis-asthma syndrome(CARAS);To explore the mechanism of its efficacy.Methods Totally 69 patients with CARAS were divided into 34 cases in the control group and 35 cases in the treatment group using random number table method.Both groups were given oral theophylline extended-release tablets and topical budesonide nasal spray.The treatment group was given Minchuanke Granules on the basis of the control group,one dosage per day,twice a day,orally.30 d was one treatment course for both groups,and two courses were observed.Asthma control efficacy and clinical efficacy were observed.TCM symptom scores and sign scores,serum IgE,interleukin(IL)-4,IL-33,γinterferon(IFN-γ),and tumor necrosis factor-α(TNF-α)levels before and after treatment in two groups were compared.Safety indicators and adverse reactions of both groups were monitored.Results Two Cases were lost in each group.The total effective rate of asthma control in the treatment group was 87.88%(29/33),while in the control group it was 65.63%(21/32),without statistical significance(P>0.05).The total effective rate of clinical efficacy in the treatment group was 87.88%(29/33),while that in the control group was 56.25%(18/32),with statistical significance(P<0.05).Compared with before treatment,the total score of TCM symptoms decreased in both groups after treatment(P<0.05);after treatment,the total score of TCM symptoms in the treatment group was lower than that in the control group(P<0.05).Compared with before treatment,there was no statistically significant difference in nasal congestion,itching,runny nose,cough,wheezing,shortness of breath and chest tightness of the two groups after treatment(P>0.05);after treatment,there was no statistical significance(P>0.05)in the grading of the above symptoms in the treatment group.Compared with before treatment,the serum IgE,IL-4,and IL-33 levels in the treatment group significantly decreased after treatment,while TNF-αand IFN-γlevels significantly increased(P<0.05);after treatment,the treatment group showed better improvement in IgE,IL-4,IL-33,TNF-α,and IFN-γcompared to the control group(P<0.05).There were no significant abnormalities in the safety indicators of the two groups,and no obvious adverse reactions were observed.Conclusion Minchuanke Granules combined with conventional Western medicine can effectively improve the clinical symptoms of CARAS patients by lowering IgE,regulating Th1/Th2 levels,and inhibiting the release of inflammatory mediators,thereby exerting the effects of treating CARAS.