摘要:
目的 探讨益气脱敏汤结合曲安奈德鼻喷雾剂对变应性鼻炎(allergic rhinitis,AR)患者Th1/Th2平衡的影响.方法 将符合入选标准的100例患者采用随机数字表法分为2组,每组50例.对照组给予曲安奈德鼻喷雾剂治疗,观察组在对照组基础上加服益气脱敏汤.2组均连续治疗4周,随访3个月.分别于治疗前后进行临床症状评分,采用ELISA法检测血清干扰素-γ(interferon-γ,IFN-γ)、IL-4水平,计算IFN-γ/IL-4比值;观察并记录治疗期间的不良反应,评价临床疗效.结果 观察组总有效率为94.0%(47/50)、对照组为80.0% (40/50),2组比较差异有统计学意义(x2=4.332,P=0.037).治疗后,观察组血清IFN-γ[(95.15±18.49) ng/L比(83.85±16.20) ng/L,t=3.250]水平及IFN-γ/IL-4[(1.35±0.21)比(0.93±0.19),t=5.878]比值均升高(P<0.01),血清IL-4[(71.14±14.15) ng/L比(89.86±17.52) ng/L,t=10.487]水平降低(P<0.01).观察组治疗后鼻塞、鼻痒、喷嚏、流涕评分均低于对照组(t值分别为11.229、8.921、8.253、10.464,P值均<0.01).结论 益气脱敏汤结合曲安奈德鼻喷雾剂可明显改善AR患者的临床症状,纠正Th1/Th2比例失衡,提高机体免疫力.%Objective To investigate the effect of Yiqi-Tuomin decoction combined with triamcinolone acetonide nasal spray on Th1/Th2 balance in allergic rhinitis (AR) and to observe the clinical efficacy.Methods A total of 100 patients who met the inclusion criteria were divided into two groups by random number table method,50 in each group.The control group was treated with triamcinolone acetonide nasal spray.The observation group was given Yiqi-Tuomin decoction on the basis of the control group.Both groups were treated for 4 weeks and followed up for 3 months.Clinical symptom score was performed before and after treatment.The serum level of interferon-γ (IFN-γ) and IL-4 was detected by ELISA,and the ratio of IFN-γ/IL-4 was calculated.The adverse reaction and recurrence rate during treatment was observed and recorded,and the clinical efficacy was evaluated.Results The total effective rate was 94.0% (47/50) in the observation group and 80.0% (40/50) in the control group.There was significant difference between the two groups (x2=4.332,P=0.037).After treatment,the serum IFN-γ (95.15 ± 18.49 ng/L vs.83.85 ± 16.20 ng/L,t=3.250) and the ratio of IFN-γ/IL-4 (1.35 ± 0.21 vs.0.93 ± 0.19,t=5.878) significantly increased (P<0.01),while serum level of IL-4 (71.14 ± 14.15 ng/L vs.89.8 6 ± 17.52 ng/L,t=10.487) significantly decreased in the observation group (P<0.01).After treatment,the score of nasal obstruction,rhinocnesmus,sneezing and nasal discharge in the observation group were significantly lower than those in the control group (t=11.229,8.921,8.253,10.464,respectively,all Ps<0.01).Conclusions The Yiqi-Tuomin decoction combined with triamcinolone acetonide nasal spray can significantly improve the clinical symptoms of AR patients,correct the imbalance of Th1/Th2 ratio and improve the immunity of the body.