和中止鼽汤治疗肺脾气虚型变应性鼻炎临床研究

发布时间：2018-01-14 15:09

本文关键词：和中止鼽汤治疗肺脾气虚型变应性鼻炎临床研究　出处：《西南医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:和中止鼽汤治疗肺脾气虚型变应性鼻炎依从性与临床疗效观察研究。方法:采用随机对照试验,把106例符合纳入标准的变应性鼻炎患者随机分成实验组和对照组,均告知患者诊疗计划,患者进行问卷调查填写(见附表1-1、1-2)。实验组患者60例,口服和中止鼽汤4周,之后每3个月复诊1次,如观察期间有复发,则继续服用和中止鼽汤4周;对照组患者46例,进行特异性免疫治疗。治疗第5周、第17周后分别比较两组治疗前后鼻塞、鼻分泌物、鼻痒、喷嚏自觉症状积分变化;鼻内镜检查患者体征,观察下鼻甲、鼻底、鼻中隔及中鼻甲解剖关系改变,之后每半年对患者症状、体征进行问卷调查,统计1次患者完成率。结果:(1)两组患者的年龄、性别、文化程度等基本资料无明显差异(P0.05),结果具有可比性。(2)治疗前实验组、对照组在患者自觉症状方面:鼻塞、鼻分泌物、鼻痒、喷嚏,严重程度相当(P0.05),无统计学意义。在治疗后第5周,实验组喷嚏、清鼻涕和鼻痒均比对照组的症状轻(P0.05),差异均具有统计学意义;在治疗后第17周,实验组鼻塞、清鼻涕和鼻痒均比对照组症状轻(P0.05),二者差异均具有统计学意义;治疗后6月,1年,实验组和对照组鼻塞、喷嚏、流清涕和鼻痒的症状严重程度(P0.05),差异均无统计学意义。(3)比较患者鼻内镜检查客观体征:在治疗前,鼻粘膜淡白、水肿或充血、肿胀指数相近(P0.05),差异无统计学意义;治疗后5周,实验组和对照组鼻内镜评分的严重程度(P0.05),差异无统计学意义;治疗后17周,实验组鼻内镜症状严重程度比对照组轻(P0.05),二者差异有统计学意义;治疗后6月、1年,两组症状的严重程度无差别(P0.05),二者比较无统计学意义。(4)实验组与对照组患者复发情况相同(P0.05),差异比较无统计学意义。(5)对比两组治疗前后,半年完成率无明显差异(P0.05),但1年完成率实验组高于对照组(P0.05)。结论:(1)和中止鼽汤、特异性免疫治疗治疗肺脾气虚型变应性鼻炎均能够缓解、改善患者鼻痒、喷嚏、鼻分泌物和鼻塞等症状。(2)和中止鼽汤、特异性免疫治疗治疗肺脾气虚型变应性鼻炎能有效改变患者鼻腔粘膜具体体征。(3)和中止鼽汤治疗肺脾气虚型变应性鼻炎与特异性免疫治疗组总体治疗效果相当。(4)和中止鼽汤疗效显著,远期改善提高患者生活质量,且依从性较特异性免疫治疗组好,适合临床推广。
[Abstract]:Objective: to observe the compliance and clinical efficacy of Hexiaotu decoction in the treatment of allergic rhinitis with deficiency of lung and spleen qi. Methods: a randomized controlled trial was used. 106 patients with allergic rhinitis who met the inclusion criteria were randomly divided into experimental group and control group. The patients were informed of the diagnosis and treatment plan and completed with questionnaire (see schedule 1-1). 60 patients in the experimental group were given orally and Xianqiu decoction for 4 weeks, after which they were treated once every 3 months. If there was recurrence during the observation period, they continued to take and stop Qiu decoction for 4 weeks. 46 patients in the control group were treated with specific immunotherapy. After 5 weeks and 17 weeks of treatment, the scores of nasal congestion, nasal secretion, nasal itching and sneezing were compared between the two groups. The anatomic relationship of inferior turbinate, nasal fundus, nasal septum and middle turbinate was observed by endoscopy. After that, the symptoms and signs of the patients were investigated by questionnaire every six months. Results there was no significant difference in the basic data of age, sex and education between the two groups (P 0.05). The results were comparable. In the control group, the symptoms of nasal obstruction, nasal secretion, nasal itching, sneezing, the severity of P0.05 were not statistically significant. In the 5th week after treatment, the experimental group sneezed. The symptoms of snot and itching in the control group were lighter than those in the control group (P 0.05), and the difference was statistically significant. At the 17th week after treatment, the nasal congestion, nasal clear nose and nasal itching in the experimental group were lighter than those in the control group (P 0.05), and the difference was statistically significant. On June, 1 year after treatment, the severity of nasal congestion, sneezing, runny and itchy nose in the experimental group and the control group was P0.05). The difference was not statistically significant. (3) the objective signs of nasal endoscopy were compared: before treatment, the nasal mucosa was pale white, edema or hyperemia, and the swelling index was similar (P 0.05), the difference was not statistically significant. At 5 weeks after treatment, there was no significant difference in the severity of nasal endoscopy score between the experimental group and the control group (P 0.05). 17 weeks after treatment, the severity of nasal endoscopy in the experimental group was significantly higher than that in the control group (P 0.05). On June, one year after treatment, there was no difference in the severity of symptoms between the two groups (P 0.05). There was no significant difference between the two groups (P 0.05). There was no significant difference between the two groups before and after treatment, there was no significant difference in half a year completion rate (P 0.05). However, the 1-year completion rate in the experimental group was higher than that in the control group (P0.050.Conclusion: 1) and suspension of Qiu decoction, the specific immunotherapy for allergic rhinitis with deficiency of lung and spleen qi can relieve the symptoms and improve the itching and sneezing of the patients. Nasal discharge and nasal congestion and other symptoms. 2) and stop Qiu decoction. Specific immunotherapy for allergic rhinitis with deficiency of lung and spleen qi can effectively change the specific signs of nasal mucosa. Hexiqiu decoction in the treatment of allergic rhinitis due to deficiency of lung and spleen qi was as effective as that in the specific immunotherapy group. The long-term improvement improved the quality of life of patients, and the compliance was better than that of the specific immunotherapy group, which was suitable for clinical application.
【学位授予单位】：西南医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R276.1

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