激光照射治疗过敏性鼻炎的临床研究

发布时间：2018-02-10 08:38

本文关键词： 肺气虚型过敏性鼻炎激光照射鼻三针穴外治疗法　出处：《广州中医药大学》2017年博士论文　论文类型：学位论文

【摘要】：目的:随着环境与生活习惯的改变,全球的过敏性鼻炎(allergic rhinitis,AR)患者有逐年升高的趋势。近年来,allergic rhinitis已成为高盛行率的慢性呼吸道病。如今人们生活的周遭环境大大的改变中,这种致敏性鼻炎的发作期时间也越来越快。过敏性鼻炎AR患者估计约有1/4的成人和1/3以上的儿童为此所苦忧。医疗保健新闻中所谓的使用低能量激光照射来治疗过敏性鼻炎,在医学文献中并没有收寻到太多实证医学的基础,低能量激光照射是否真的可以治疗过敏性鼻炎,目前的医学实证仍十分薄弱。本研究旨在通过多项客观疗效指标,全面量化评估激光疗法结合针刺治疗评策与分析的症状积分量表(Rhinitis symptom rating scale,RS)、血清特异性血清免疫球蛋白(Serum-specific serum immunoglobulin)IgE抗体及鼻腔渗出物涂片嗜酸性粒细胞Eosinophils计数等;以多项疗效指标的影响评策低能量激光照射治疗过敏性鼻炎的治疗效果与安全性,从而更进一步分析其治疗的机理反应程序,来提供治疗AR的临床参照。方法:将符合纳入标准的64位患者随机分配分成治疗和对照两组,组定32例;其中治疗组采用激光疗法配合常规针刺治疗,对照组采用单纯针刺治疗方案;通过对照治疗前后统计的RS症状积分量表、血清特异性血清免疫球蛋白(Serum-specific serumimmunoglobulin)IgE抗体、鼻腔渗出物涂片嗜酸性粒细胞Eosinophils计数指标、尼莫地平法计算JOA量表积分的改善率;在治疗的前后进行RS、IgE、Eosinophils治疗观察对照和数字化的统计分析评估,治疗组和对照组相关疗效指标数据输入Excel建立数据库后,再以SPSS19.0统计软体进行数据统计的分析及描述。成果:1、治疗组和对照组两组在性别、年龄、病程均无统计学上差异(P0.05),故治疗组和对照组两组具有可比性。2、治疗组和对照组两组两组患者在治疗前后比较,症状积分量表疗效指标数据、血清特异性IgE抗体疗效指标数据、鼻腔分泌物涂片嗜酸性粒细胞计数疗效指标数据均有显着差异(P0.05),表明治疗组和对照组两种射治疗方案,都能有效改善患者疗效指标数据。3、治疗后,两组患者症状积分的组间对照(P0.01),治疗组明显高于对照组,表明激光疗法配合针灸比单纯针灸更能有效缓解患者过敏性鼻炎(allergic rhinitis)症状。4、治疗组和对照组两组都没有出现副作用,表明两种治疗过敏性鼻炎(allergic rhinitis)方案,在治疗进行时都非常安全。结论:运用激光疗法配合针灸治疗肺气虚型过敏性鼻炎(allergic rhinitis)是一种两个疗程内即起效的新综合疗法,而且具有疗效较持久、高安全高清洁性、操作简易、具易于标准化及推广的特点,能为制订治疗allergic rhinitis规范化的外治方法提供高质量的循证医学证据;更可以成为中医居家医疗照护过敏性鼻炎的工具现代化。
[Abstract]:Objective: with the change of environment and living habits, the number of allergic rhinitis ARs in the world is increasing year by year. In recent years, allergic rhinitis has become a high prevalence of chronic respiratory diseases. The onset of allergic rhinitis is also getting faster and faster. AR patients with allergic rhinitis are estimated to be suffering from this problem in about 1/4 adults and more than 1/3 children. The so-called low-energy laser irradiation used in health care news is used to treat allergic rhinitis. In the medical literature, there is not much evidence of the basis of empirical medicine, whether low energy laser irradiation can really treat allergic rhinitis, the current medical evidence is still very weak. Total quantitative evaluation was made on the symptoms of laser therapy combined with acupuncture therapy evaluation and analysis, such as Rhinitis symptom rating scale-RSV, serum-specific serum immunoglobulin)IgE antibody and eosinophil Eosinophils count in nasal exudate smear. To evaluate the efficacy and safety of low energy laser irradiation in the treatment of allergic rhinitis with the influence of several therapeutic indexes, and to further analyze the mechanism and reaction procedure of the treatment. Methods: 64 patients who met the inclusion criteria were randomly divided into two groups: treatment group (n = 32) and control group (n = 32). The control group was treated with acupuncture alone, the RS symptom scale before and after treatment, the serum specific serum immunoglobulin Serum-specific serumimmunoglobulin)IgE antibody, the eosinophil Eosinophils count index of nasal exudate smear, The improvement rate of JOA scale integral was calculated by nimodipine method, and the statistical analysis and evaluation of control group and digitized treatment observation were carried out before and after treatment, and the data of treatment group and control group were inputted into Excel to establish the database. Then use SPSS19.0 statistical software to analyze and describe the data. Result: 1, treatment group and control group in sex, age, There was no statistical difference in the course of disease between the two groups, so the treatment group and the control group were comparable. The therapeutic index data of symptom integral scale and serum specific IgE antibody were compared between the treatment group and the control group before and after treatment. There were significant differences in eosinophils count index data between nasal secretion smear and control group (P 0.05). The results showed that both treatment group and control group could improve the effective index data of eosinophils. The scores of symptoms in the two groups were significantly higher than those in the control group, indicating that laser therapy combined with acupuncture and moxibustion was more effective than acupuncture in alleviating symptoms of allergic rhinitis in patients with allergic rhinitis.There were no side effects in both the treatment group and the control group. Conclusion: laser therapy combined with acupuncture and moxibustion in the treatment of allergic rhinitis is a new comprehensive therapy which is effective in two courses of treatment, and it is safe to treat allergic rhinitis of allergic rhinitis in two courses of treatment, conclusion: laser therapy combined with acupuncture and moxibustion for allergic rhinitis of asthenia of lung qi type is a new comprehensive therapy with immediate effect in two courses of treatment. Moreover, it has the characteristics of lasting curative effect, high safety and high cleanliness, simple operation, easy standardization and popularization, which can provide high quality evidence-based medical evidence for the formulation of standardized external treatment method for allergic rhinitis. More can become Chinese medicine home care allergic rhinitis tool modernization.
【学位授予单位】：广州中医药大学
【学位级别】：博士
【学位授予年份】：2017
【分类号】：R765.21

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