宣肺通窍针法治疗变应性鼻炎的临床疗效及对TLR2表达的影响

发布时间：2018-04-21 14:47

本文选题：变应性鼻炎 + 针灸　；参考：《南京中医药大学》2017年硕士论文

【摘要】：目的:观察宣肺通窍针法治疗变应性鼻炎的临床疗效,并探讨血清中的Tokl-likereceptor2(TLR2)在针刺治疗变应性鼻炎中的表达,为针刺在变应性鼻炎的治疗和推广中提供临床参考。方法:将2015年9月至2016年8月就诊于南京中医药大学第一附属医院耳鼻喉科及针灸康复科门诊符合AR纳入标准的患者,根据数字随机表法随机分为针刺组和对照组,每组各30例患者。针刺组采用宣肺通窍针法,隔日1次,每周3次,取穴风池、印堂、迎香、鼻通、合谷、足三里,对照组口服氯雷他定每日1次,每次1Omg,疗程均为4周,观察两组在治疗前、治疗2周后、治疗4周后症状和体征积分、视觉评分量表(VAS)、鼻症状总分(TNSS)、鼻炎伴随症状总分(TNNSS)、鼻结膜炎生命质量调查问卷(RQLQ)及随访复发,并通过Elisa法检测两组外周血TLR2的表达。结果:1.疗效比较针刺组治疗结束后总有效率92.59%,高于对照组的82.14%,差异统计学意义(P0.05);针刺组治疗后症状和体征、VAS、TNSS、TNNSS、RQLQ评分均显著优于对照组,具有统计学意义(P0.05)。结果还显示针刺组远期疗效优于对照组,有统计学差异(P0.05)。2.血清TLR2的表达比较两组患者治疗结束后的TLR2表达水平均低于治疗前(P0.05),组间比较,两组无统计学差异(P0.05)。结论:两组均能改善鼻痒、喷嚏、流涕等鼻部症状,提高生活质量,但针刺比西药疗效显著,且具有安全、无副作用、降低复发等优势。针刺与氯雷他定一样,可通过降低TLR2的表达水平,抑制NF-κB信号通路,降低下游炎性因子,从而减轻变应性鼻炎的炎性状态达到治疗效果。
[Abstract]:Objective: to observe the clinical effect of Xuanfei Tongqiao acupuncture in treating allergic rhinitis, and to explore the expression of Tokl-like receptor 2 TLR2 in serum in the treatment of allergic rhinitis, so as to provide clinical reference for the treatment and popularization of allergic rhinitis by acupuncture. Methods: from September 2015 to August 2016, the patients in the department of otolaryngology, otolaryngology and rehabilitation department of acupuncture and moxibustion in the first affiliated hospital of Nanjing University of traditional Chinese Medicine were randomly divided into acupuncture group and control group. There were 30 patients in each group. Acupuncture group was treated with Xuanfei Tongqiao acupuncture method, once every other day, 3 times a week. Points were collected from Fengchi, Yintang, Yingxiang, Bitong, Hegu, Zusanli, and the control group was treated with loratadine 1 Omg once a day for 4 weeks. After 2 weeks of treatment, the scores of symptoms and signs, visual score scale (VASA), total score of nasal symptoms (TNSS), total score of rhinitis associated with symptoms (TNNSS), rhinoconjunctivitis quality of life questionnaire (RQLQQ) and recurrence after 4 weeks of treatment were measured by Elisa method. The expression of TLR2 in peripheral blood of both groups was detected by Elisa method. The result is 1: 1. The total effective rate of acupuncture group was 92.599.It was higher than that of control group (82.14), the difference was statistically significant (P 0.05), and the scores of symptoms and signs of acupuncture group after treatment were significantly better than those of control group (P 0.05). The results also showed that the long-term curative effect of acupuncture group was better than that of control group, with statistical difference (P 0. 05. 2). Comparison of the expression of serum TLR2 in two groups after treatment, the expression of TLR2 was lower than that before treatment (P 0.05), and there was no significant difference between the two groups (P 0.05). Conclusion: both groups can improve nasal symptoms, such as nasal itching, sneezing and runny nose, and improve the quality of life, but acupuncture is more effective than western medicine, and has the advantages of safety, no side effect and low recurrence. Acupuncture, like loratadine, can reduce the level of TLR2 expression, inhibit NF- 魏 B signaling pathway, and reduce the downstream inflammatory factors, thus reducing the inflammatory state of allergic rhinitis.
【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】：R246.81

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