中药鼻宁方纱条填塞鼻腔法治疗变应性鼻炎患儿临床研究
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R276.1

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河南省中医药科学研究专项课题项目(TCM2019016);河南省中医药拔尖人才培养项目(豫卫中医函〔2021〕15号)


Clinical Study on Nasal Packing with Gauze Strips with Bi'ning Prescription in Chinese Medicine for Children with Allergic Rhinitis
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    摘要:

    目的:观察中药鼻宁方纱条填塞鼻腔法治疗变应性鼻炎患儿的临床疗效及对免疫功能的影响。方 法:将160 例变应性鼻炎患儿按随机数字表法分为观察组与对照组各80 例。对照组采用糠酸莫米松鼻喷雾剂 喷鼻,观察组采用中药鼻宁方纱条填塞鼻腔治疗,2 组均治疗28 d。比较2 组治疗前后视觉模拟评分 法(VAS) 评分、变应性鼻炎生存质量量表(RQLQ) 评分及患儿鼻分泌物中炎性细胞因子、嗜酸性粒细胞 数(EOS) 计数水平、患儿空腹外周血CD4+、CD8+、自然杀伤细胞(NK 细胞) 水平、CD4+/CD8+比值,并根 据症状积分下降指数(SSRI) 比较2 组临床疗效。结果:治疗前,2 组鼻部各症状VAS 评分比较,差异无统 计学意义(P>0.05);治疗后,2 组鼻部各症状VAS 评分均降低(P<0.05),且观察组低于对照组(P< 0.05)。治疗前,2 组鼻分泌物中白细胞介素-4(IL-4)、白细胞介素-10(IL-10)、转化生长因子-β1(TGF-β1)、 白细胞介素-13(IL-13) 水平比较,差异无统计学意义(P>0.05);治疗后,2 组鼻分泌物IL-4、IL-13 水平 均降低(P<0.05),IL-10、TGF-β1 水平均升高(P<0.05),且观察组鼻分泌物IL-4、IL-13 水平低于对照 组(P<0.05),IL-10、TGF-β1 水平高于对照组(P<0.05)。治疗前,2 组外周血CD4+、CD8+、CD4+/CD8+、 NK 细胞水平比较,差异无统计学意义(P>0.05);治疗后,2 组外周血中CD8+水平明显降低(P<0.05), CD4+、CD4+/CD8+、NK 细胞水平明显升高(P<0.05),且观察组CD8+水平低于对照组(P<0.05),CD4+、 CD4+/CD8+、NK 细胞水平高于对照组(P<0.05)。治疗前,2 组鼻分泌物EOS 计数、血清免疫球蛋白 E (IgE) 水平比较,差异无统计学意义(P>0.05);治疗后,2 组鼻分泌物EOS 计数、血清IgE 水平均降 低(P<0.05),且观察组低于对照组(P<0.05)。观察组临床总有效率97.50%,高于对照组86.25% (P< 0.05)。观察组不良反应发生率、3 个月复发率均低于对照组(P<0.05)。结论:中药鼻宁方纱条填塞鼻腔法 治疗变应性鼻炎疗效确切,可降低患儿炎性因子水平,抑制嗜酸性粒细胞活化,改善患儿相关免疫功能。

    Abstract:

    Abstract: Objective: To observe the clinical effect of nasal packing with gauze strips with Bi'ning Prescription in Chinese medicine for children with allergic rhinitis and its effect on immune function. Methods:A total of 160 cases of children with allergic rhinitis were divided into the observation group and the control group according to the random number table method,with 80 cases in each group. The control group was treated with Mometasone Furoate Nasal Spray, and the observation group was treated with nasal packing with gauze strips with Bi'ning Prescription. Both groups were treated for 28 days. Scores of Visual Analogue Scale (VAS) and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), levels of inflammatory cytokines and eosinophils (EOS) count in nasal secretions,and levels of CD4+,CD8+,natural killer cells (NK cells) and CD4+/CD8+ ratio in peripheral blood in fasting condition were compared between the two groups before and after treatment; clinical effects in the two groups were compared according to Symptom Score Reduction Index (SSRI). Results: Before treatment, there was no significant difference being found in the comparison of VAS scores of nasal symptoms between the two groups (P>0.05). After treatment, VAS scores of nasal symptoms in the two groups were decreased when compared with those before treatment (P<0.05), and the scores in the observation group were lower than those in the control group (P<0.05). Before treatment, there was no significant difference being found in the comparison of levels of interleukin- 4 (IL- 4), interleukin- 10 (IL- 10), transforming growth factor- β1 (TGF- β1), and interleukin- 13 (IL- 13) in nasal secretions between the two groups (P>0.05). After treatment, the levels of IL- 4 and IL- 13 in nasal secretions in the two groups were decreased when compared with those before treatment (P<0.05), and the levels of IL- 10 and TGF- β1 were increased when compared with those before treatment (P<0.05);the levels of IL-4 and IL-13 in nasal secretions in the observation group were lower than those in the control group (P<0.05),and the levels of IL- 10 and TGF-β1 were higher than those in the control group (P<0.05). Before treatment,there was no significant difference being found in the comparison of levels of CD4+,CD8+,CD4+/CD8+,and NK cells in peripheral blood between the two groups (P>0.05). After treatment,the levels of CD8+ in peripheral blood in the two groups were significantly decreased when compared with those before treatment (P<0.05),and the levels of CD4 + , CD4 +/CD8 + , and NK cells were significantly increased when compared with those before treatment (P<0.05);the level of CD8+ in the observation group was lower than that in the control group (P< 0.05),and the levels of CD4+,CD4+/CD8+,and NK cells were higher than those in the control group (P< 0.05). Before treatment,there was no significant difference being found in the comparison of EOS count in nasal secretions and immunoglobulin E (IgE) levels in serum between the two groups (P>0.05). After treatment,EOS count in nasal secretions and IgE levels in serum in the two groups were decreased when compared with those before treatment (P<0.05);EOS count in nasal secretions and IgE levels in serum in the observation group were lower than those in the control group (P<0.05). The total effective rate of clinical effect was 97.50% in the observation group,higher than that of 86.25% in the control group (P< 0.05). The incidence of adverse reactions and the recurrence rates within three months in the observation group were lower than those in the control group (P<0.05). Conclusion:Nasal packing with gauze strips with Bi'ning Prescription in Chinese medicine has a definite curative effect in treating allergic rhinitis,and can reduce the levels of inflammatory factors in children,inhibit the activation of eosinophils and improve the immune function of children.

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杨建莲,张晨,李慧佳,王旭.中药鼻宁方纱条填塞鼻腔法治疗变应性鼻炎患儿临床研究[J].新中医,2023,55(5):191-196

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  • 在线发布日期: 2023-03-15
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