益气温阳方联合舌下免疫治疗中—重度持续性变应性鼻炎的近期疗效分析

发布时间：2018-02-14 01:24

本文关键词： 益气温阳粉尘螨滴剂舌下免疫治疗变应性鼻炎鼻鼽　出处：《南京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：变态反应性鼻炎简称变应性鼻炎(allergic rhinitis,AR),是常见的非特异性免疫性疾病。自1997年世界卫生组织(Word Health Organization,WHO)提出对变应性疾病应采取避免接触变应原、规范的药物治疗、变应原特异性免疫治疗(Allergen specific immunotherapy,ASIT)和患者教育的"四位一体,"综合治疗策略[1],变应原的特异性免疫治疗便得到临床的推广与应用。随着中西医联合治疗模式的发展,中西医药物联合治疗变应性鼻炎的研究不在少数,而中药联合免疫治疗的研究较有限,本研究旨在研究对于变应性鼻炎的治疗,中药联合舌下免疫治疗的协同作用,以指导临床应用。目的:通过中药联合粉尘螨滴剂舌下免疫与单纯粉尘螨滴剂舌下免疫在治疗中-重度持续性变应性鼻炎的近期临床疗效的对比,探讨中药联合舌下免疫治疗的安全性及有效性,为中西医联合治疗变应性鼻炎提供新的治疗思路及方法。方法:随机选取符合纳入标准的80例5～50岁中-重度持续性变应性鼻炎患者,分为治疗组(40例)和对照组(40例),治疗组使用益气温阳方联合粉尘螨滴剂舌下免疫治疗,对照组采用粉尘螨滴剂舌下免疫治疗,分别治疗6个月后,通过两组患者鼻部症状总评分(TNSS)、药物总评分(TMS)以及视觉模拟量表评分(VAS)评价两种方法的近期疗效。结果:两组患者治疗后1月,鼻部症状均呈加重局势,TNSS与VAS较前无明显差异,组间对比无统计学意义,但在TMS评分上,治疗组较前降低,对照组则无明显变化,组间对比具有统计学意义;治疗后2、3月后,治疗组在改善上述评分方面均优于对照组(P0.05);治疗后6月,两组治疗较治疗前均有改善,具有统计学意义。组间对比,治疗组在TNSS评分方面优于对照组(P0.05),但在VAS及TMS评分上无统计学意义。经过治疗6个月后,治疗组有效率为92.20%,对照组有效率为72.22%,两组对比具有统计学意义,中药益气温阳方联合舌下免疫治疗疗效明显优于舌下免疫治疗。结论:中药益气温阳方联合舌下免疫疗法可以有效减轻患者的过敏症状、减少用药及发作频率,是为中西医结合治疗中-重度持续性变应性鼻炎的良好方法,值得临床推广。
[Abstract]:Allergic rhinitis, allergic rhinitis (referred to as allergic, rhinitis, AR) is a nonspecific immune disease common. Since 1997, the WHO (Word Health Organization, WHO) proposed action to avoid contact allergens of allergic diseases, standard medical treatment, allergen specific immunotherapy (Allergen specific, immunotherapy, ASIT) four and one patient education "," comprehensive treatment strategies for [1], allergen specific immunotherapy has been promoted and applied in clinic. With the development of traditional Chinese medicine and Western medicine combined treatment mode, combined with western medicine in the treatment of allergic rhinitis in the minority, and the study of traditional Chinese medicine combined with immunotherapy is limited, this study aims to study for the treatment of allergic rhinitis, the synergistic effect of traditional Chinese medicine combined with sublingual immunotherapy, to guide the clinical application. Objective: through the combination of Dermatophagoides Farinae Drops under the tongue Dermatophagoides Farinae Drops pure immune and sublingual immunotherapy in the treatment of severe persistent allergic rhinitis curative effect contrast, evaluate the efficacy and safety of traditional Chinese medicine combined with sublingual immunotherapy treatment, provide new ideas and methods for the combined Chinese and Western medicine treatment of allergic rhinitis. Methods: 80 patients met the inclusion criteria at the age of 5~50 in patients with severe persistent allergic rhinitis, divided into treatment group (40 cases) and control group (40 cases), treatment group treated with Yiqi Wenyang recipe combined with Dermatophagoides Farinae Drops sublingual immunotherapy, the control group using Dermatophagoides Farinae Drops sublingual immunotherapy, respectively, after 6 months of treatment, the two groups of patients with nasal symptoms the total score, total score (TNSS) drug (TMS) and visual analogue scale (VAS) score to evaluate the short-term effect of the two methods. Results: two groups of patients after January, nasal symptoms were aggravated the situation, TNSS and VAS than before Significant differences between the groups was not statistically significant, but in the TMS score, the treatment group was lower than before, the control group did not change significantly, the comparison between the two groups has statistical significance; 2,3 months after treatment, the treatment group in improving the scores were better than the control group (P0.05); after June, the treatment in the two groups was improved compared with that before treatment, with statistical significance. The comparison between the two groups, the treatment group was better than the control group in TNSS (P0.05), but in VAS and TMS scores were not statistically significant. After 6 months of treatment, the treatment group was 92.20%, the control group was 72.22%, the two groups have statistical significance comparison of Yiqi Wenyang recipe combined with sublingual immunotherapy curative effect is obviously superior to sublingual immunotherapy. Conclusion: immunotherapy of Yiqi Wenyang recipe combined with sublingual can effectively reduce allergic symptoms of patients, reduce medication and seizure frequency, is the combination of traditional Chinese and Western medicine treatment A good method of treating moderate to severe persistent allergic rhinitis is worthy of clinical promotion.

【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R765.21

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