本文關(guān)鍵詞： 肺氣虛型 過(guò)敏性鼻炎 激光照射 鼻三針穴 外治療法　出處：《廣州中醫(yī)藥大學(xué)》2017年博士論文　論文類型：學(xué)位論文

【摘要】：目的:隨著環(huán)境與生活習(xí)慣的改變,全球的過(guò)敏性鼻炎(allergic rhinitis,AR)患者有逐年升高的趨勢(shì)。近年來(lái),allergic rhinitis已成為高盛行率的慢性呼吸道病。如今人們生活的周遭環(huán)境大大的改變中,這種致敏性鼻炎的發(fā)作期時(shí)間也越來(lái)越快。過(guò)敏性鼻炎AR患者估計(jì)約有1/4的成人和1/3以上的兒童為此所苦憂。醫(yī)療保健新聞中所謂的使用低能量激光照射來(lái)治療過(guò)敏性鼻炎,在醫(yī)學(xué)文獻(xiàn)中并沒(méi)有收尋到太多實(shí)證醫(yī)學(xué)的基礎(chǔ),低能量激光照射是否真的可以治療過(guò)敏性鼻炎,目前的醫(yī)學(xué)實(shí)證仍十分薄弱。本研究旨在通過(guò)多項(xiàng)客觀療效指標(biāo),全面量化評(píng)估激光療法結(jié)合針刺治療評(píng)策與分析的癥狀積分量表(Rhinitis symptom rating scale,RS)、血清特異性血清免疫球蛋白(Serum-specific serum immunoglobulin)IgE抗體及鼻腔滲出物涂片嗜酸性粒細(xì)胞Eosinophils計(jì)數(shù)等;以多項(xiàng)療效指標(biāo)的影響評(píng)策低能量激光照射治療過(guò)敏性鼻炎的治療效果與安全性,從而更進(jìn)一步分析其治療的機(jī)理反應(yīng)程序,來(lái)提供治療AR的臨床參照。方法:將符合納入標(biāo)準(zhǔn)的64位患者隨機(jī)分配分成治療和對(duì)照兩組,組定32例;其中治療組采用激光療法配合常規(guī)針刺治療,對(duì)照組采用單純針刺治療方案;通過(guò)對(duì)照治療前后統(tǒng)計(jì)的RS癥狀積分量表、血清特異性血清免疫球蛋白(Serum-specific serumimmunoglobulin)IgE抗體、鼻腔滲出物涂片嗜酸性粒細(xì)胞Eosinophils計(jì)數(shù)指標(biāo)、尼莫地平法計(jì)算JOA量表積分的改善率;在治療的前后進(jìn)行RS、IgE、Eosinophils治療觀察對(duì)照和數(shù)字化的統(tǒng)計(jì)分析評(píng)估,治療組和對(duì)照組相關(guān)療效指標(biāo)數(shù)據(jù)輸入Excel建立數(shù)據(jù)庫(kù)后,再以SPSS19.0統(tǒng)計(jì)軟體進(jìn)行數(shù)據(jù)統(tǒng)計(jì)的分析及描述。成果:1、治療組和對(duì)照組兩組在性別、年齡、病程均無(wú)統(tǒng)計(jì)學(xué)上差異(P0.05),故治療組和對(duì)照組兩組具有可比性。2、治療組和對(duì)照組兩組兩組患者在治療前后比較,癥狀積分量表療效指標(biāo)數(shù)據(jù)、血清特異性IgE抗體療效指標(biāo)數(shù)據(jù)、鼻腔分泌物涂片嗜酸性粒細(xì)胞計(jì)數(shù)療效指標(biāo)數(shù)據(jù)均有顯著差異(P0.05),表明治療組和對(duì)照組兩種射治療方案,都能有效改善患者療效指標(biāo)數(shù)據(jù)。3、治療后,兩組患者癥狀積分的組間對(duì)照(P0.01),治療組明顯高于對(duì)照組,表明激光療法配合針灸比單純針灸更能有效緩解患者過(guò)敏性鼻炎(allergic rhinitis)癥狀。4、治療組和對(duì)照組兩組都沒(méi)有出現(xiàn)副作用,表明兩種治療過(guò)敏性鼻炎(allergic rhinitis)方案,在治療進(jìn)行時(shí)都非常安全。結(jié)論:運(yùn)用激光療法配合針灸治療肺氣虛型過(guò)敏性鼻炎(allergic rhinitis)是一種兩個(gè)療程內(nèi)即起效的新綜合療法,而且具有療效較持久、高安全高清潔性、操作簡(jiǎn)易、具易于標(biāo)準(zhǔn)化及推廣的特點(diǎn),能為制訂治療allergic rhinitis規(guī)范化的外治方法提供高質(zhì)量的循證醫(yī)學(xué)證據(jù);更可以成為中醫(yī)居家醫(yī)療照護(hù)過(guò)敏性鼻炎的工具現(xiàn)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.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2017
【分類號(hào)】：R765.21

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