本文關(guān)鍵詞： 益氣溫陽 粉塵螨滴劑 舌下免疫治療 變應(yīng)性鼻炎 鼻鼽　出處：《南京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：變態(tài)反應(yīng)性鼻炎簡(jiǎn)稱變應(yīng)性鼻炎(allergic rhinitis,AR),是常見的非特異性免疫性疾病。自1997年世界衛(wèi)生組織(Word Health Organization,WHO)提出對(duì)變應(yīng)性疾病應(yīng)采取避免接觸變應(yīng)原、規(guī)范的藥物治療、變應(yīng)原特異性免疫治療(Allergen specific immunotherapy,ASIT)和患者教育的"四位一體,"綜合治療策略[1],變應(yīng)原的特異性免疫治療便得到臨床的推廣與應(yīng)用。隨著中西醫(yī)聯(lián)合治療模式的發(fā)展,中西醫(yī)藥物聯(lián)合治療變應(yīng)性鼻炎的研究不在少數(shù),而中藥聯(lián)合免疫治療的研究較有限,本研究旨在研究對(duì)于變應(yīng)性鼻炎的治療,中藥聯(lián)合舌下免疫治療的協(xié)同作用,以指導(dǎo)臨床應(yīng)用。目的:通過中藥聯(lián)合粉塵螨滴劑舌下免疫與單純粉塵螨滴劑舌下免疫在治療中-重度持續(xù)性變應(yīng)性鼻炎的近期臨床療效的對(duì)比,探討中藥聯(lián)合舌下免疫治療的安全性及有效性,為中西醫(yī)聯(lián)合治療變應(yīng)性鼻炎提供新的治療思路及方法。方法:隨機(jī)選取符合納入標(biāo)準(zhǔn)的80例5～50歲中-重度持續(xù)性變應(yīng)性鼻炎患者,分為治療組(40例)和對(duì)照組(40例),治療組使用益氣溫陽方聯(lián)合粉塵螨滴劑舌下免疫治療,對(duì)照組采用粉塵螨滴劑舌下免疫治療,分別治療6個(gè)月后,通過兩組患者鼻部癥狀總評(píng)分(TNSS)、藥物總評(píng)分(TMS)以及視覺模擬量表評(píng)分(VAS)評(píng)價(jià)兩種方法的近期療效。結(jié)果:兩組患者治療后1月,鼻部癥狀均呈加重局勢(shì),TNSS與VAS較前無明顯差異,組間對(duì)比無統(tǒng)計(jì)學(xué)意義,但在TMS評(píng)分上,治療組較前降低,對(duì)照組則無明顯變化,組間對(duì)比具有統(tǒng)計(jì)學(xué)意義;治療后2、3月后,治療組在改善上述評(píng)分方面均優(yōu)于對(duì)照組(P0.05);治療后6月,兩組治療較治療前均有改善,具有統(tǒng)計(jì)學(xué)意義。組間對(duì)比,治療組在TNSS評(píng)分方面優(yōu)于對(duì)照組(P0.05),但在VAS及TMS評(píng)分上無統(tǒng)計(jì)學(xué)意義。經(jīng)過治療6個(gè)月后,治療組有效率為92.20%,對(duì)照組有效率為72.22%,兩組對(duì)比具有統(tǒng)計(jì)學(xué)意義,中藥益氣溫陽方聯(lián)合舌下免疫治療療效明顯優(yōu)于舌下免疫治療。結(jié)論:中藥益氣溫陽方聯(lián)合舌下免疫療法可以有效減輕患者的過敏癥狀、減少用藥及發(fā)作頻率,是為中西醫(yī)結(jié)合治療中-重度持續(xù)性變應(yīng)性鼻炎的良好方法,值得臨床推廣。
[Abstract]:Allergic rhinitis, allergic rhinitis (referred to as allergic, rhinitis, AR) is a nonspecific immune disease common. Since 1997, the WHO (Word Health Organization, WHO) proposed action to avoid contact allergens of allergic diseases, standard medical treatment, allergen specific immunotherapy (Allergen specific, immunotherapy, ASIT) four and one patient education "," comprehensive treatment strategies for [1], allergen specific immunotherapy has been promoted and applied in clinic. With the development of traditional Chinese medicine and Western medicine combined treatment mode, combined with western medicine in the treatment of allergic rhinitis in the minority, and the study of traditional Chinese medicine combined with immunotherapy is limited, this study aims to study for the treatment of allergic rhinitis, the synergistic effect of traditional Chinese medicine combined with sublingual immunotherapy, to guide the clinical application. Objective: through the combination of Dermatophagoides Farinae Drops under the tongue Dermatophagoides Farinae Drops pure immune and sublingual immunotherapy in the treatment of severe persistent allergic rhinitis curative effect contrast, evaluate the efficacy and safety of traditional Chinese medicine combined with sublingual immunotherapy treatment, provide new ideas and methods for the combined Chinese and Western medicine treatment of allergic rhinitis. Methods: 80 patients met the inclusion criteria at the age of 5~50 in patients with severe persistent allergic rhinitis, divided into treatment group (40 cases) and control group (40 cases), treatment group treated with Yiqi Wenyang recipe combined with Dermatophagoides Farinae Drops sublingual immunotherapy, the control group using Dermatophagoides Farinae Drops sublingual immunotherapy, respectively, after 6 months of treatment, the two groups of patients with nasal symptoms the total score, total score (TNSS) drug (TMS) and visual analogue scale (VAS) score to evaluate the short-term effect of the two methods. Results: two groups of patients after January, nasal symptoms were aggravated the situation, TNSS and VAS than before Significant differences between the groups was not statistically significant, but in the TMS score, the treatment group was lower than before, the control group did not change significantly, the comparison between the two groups has statistical significance; 2,3 months after treatment, the treatment group in improving the scores were better than the control group (P0.05); after June, the treatment in the two groups was improved compared with that before treatment, with statistical significance. The comparison between the two groups, the treatment group was better than the control group in TNSS (P0.05), but in VAS and TMS scores were not statistically significant. After 6 months of treatment, the treatment group was 92.20%, the control group was 72.22%, the two groups have statistical significance comparison of Yiqi Wenyang recipe combined with sublingual immunotherapy curative effect is obviously superior to sublingual immunotherapy. Conclusion: immunotherapy of Yiqi Wenyang recipe combined with sublingual can effectively reduce allergic symptoms of patients, reduce medication and seizure frequency, is the combination of traditional Chinese and Western medicine treatment A good method of treating moderate to severe persistent allergic rhinitis is worthy of clinical promotion.

【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R765.21

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