基于“肺鼻同治”研究麻杏石甘汤治疗过敏性鼻炎的疗效及机制(1)

http://www.100md.com 2017年4月15日 《世界中医药》 20178

     摘要 目的：基于“肺鼻同治”觀察麻杏石甘汤治疗过敏性鼻炎的疗效及机制。方法：取2015年8月至2017年2月，济宁医学院附属医院耳鼻咽喉科收治的过敏性鼻炎患者86例，通过选取随机数字法分为观察组和对照组，每组43例，对照组给予氯雷他定片，观察组在对照组治疗基础上予以麻杏石甘汤进行治疗。观察并记录过敏性鼻炎患者症状并进行评分和疗效指标；肺功能检测肺大小气道功能，包括PEF%、FEF25%、FEF50%、FEF75%和MMEF75/25%；血清免疫球蛋白IgE检测和流式细胞仪检测T淋巴细胞亚群CD3+、CD4+、CD8+表达情况。结果：1)治疗前2组过敏性鼻炎积分，差异无统计学意义(P>0.05)，治疗后均低于治疗前，差异有统计学意义(P<0.05)，且观察组优于对照组，差异有统计学意义(P<0.05)。2)治疗后肺功能PEF%、FEF25%、FEF50%、FEF75%和MMEF75/25%均高于治疗前(P<0.05)，且观察组优于对照组，差异有统计学意义(P<0.05)。3)与治疗前比较，治疗后T淋巴细胞亚群CD3+、CD4+、CD8+百分数均增高，差异有统计学意义(P<0.05)，IgE和CD4+/CD8+反而降低，差异有统计学意义(P<0.05)；其中观察组的CD3+、CD4+、CD8+百分数增高程度均高于对照组，差异有统计学意义(P<0.05)，而IgE和CD4+/CD8+的降低程度均低于对照组，差异有统计学意义(P<0.05)。结论：麻杏石甘汤基于“肺鼻同治”治疗过敏性鼻炎有效改善患者喷嚏、鼻涕等症状，改善肺大小气道功能，其疗效机制可能与下调IgE的表达水平及纠正T淋巴细胞亚群的紊乱有关。

    关键词 “肺鼻同治”；麻杏石甘汤；过敏性鼻炎；疗效；机制

    Study on the Curative Effect of Maxing Shigan Decoction in the Treatment of Allergic Rhinitis Based on “Simultaneous Treatment of Lung and Nose” and Its Mechanism

    Ma Dengdian， Sun Juxing， Ma Linxiang

    (Department of Otorhinolaryngology， Affiliated Hospital of Jining Medical College， Jining 272000， China)

    Abstract Objective：To study the curative effect of Maxing Shigan Decoction in the treatment of allergic rhinitis based on “simultaneous treatment of lung and nose” and its mechanism.Methods：Eighty-six cases with allergic rhinitis treated in the department of ENT of the hospital from August 2015 to February 2017 were selected and randomly divided into observation group and control group， with 43 patients in each group. Patients in the control group were given Loratadine tablets， while patients in the observation group were additionally taken Maxing Shigan decoction. Symptoms score and efficacy index were observed and recorded， and pulmonary function test of pulmonary airway function， including PEF%， FEF25%， FEF50%， FEF75% and MMEF75/25% serum immunoglobulin IgE and expression of T lymphocyte subsets CD3+， CD4+， CD8+ were detected and recorded.Results：1) There was no significant difference in symptom scores between the two groups before the treatment (P>0.05)； the scores were lower than that before the treatment in both the two groups (P<0.05)； the observation group was lower than the control group (P<0.05). 2) PEF%， FEF25%， FEF50%， FEF75% and MMEF75/25% were higher after the treatment (P<0.05)； the observation group was better than the control group (P<0.05). 3) T lymphocyte subsets CD3+， CD4+， CD8+ (P<0.05)， increased after the treatment； the percentage of CD4+/CD8+ decreased (P<0.05)； CD3+， CD4+， CD8+ in the observation group increased more greatly (P<0.05)， and IgE and CD4+/CD8+ were lower than those of the control group (P<0.05).Conclusion：Maxing Shigan Decoction in treating allergic rhinitis patients based on simultaneous treatment of lung and nose may improve symptoms like sneezing， running nose and others and enhance pulmonary airway function and its therapeutic mechanism may be related to the down-regulation of IgE and relief to the disorder of the expression level of T lymphocytes subsets.(马登殿 孙聚兴 马林祥)

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