本文關(guān)鍵詞：和中止鼽湯治療肺脾氣虛型變應性鼻炎臨床研究　出處：《西南醫(yī)科大學》2017年碩士論文　論文類型：學位論文

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【摘要】：目的:和中止鼽湯治療肺脾氣虛型變應性鼻炎依從性與臨床療效觀察研究。方法:采用隨機對照試驗,把106例符合納入標準的變應性鼻炎患者隨機分成實驗組和對照組,均告知患者診療計劃,患者進行問卷調(diào)查填寫(見附表1-1、1-2)。實驗組患者60例,口服和中止鼽湯4周,之后每3個月復診1次,如觀察期間有復發(fā),則繼續(xù)服用和中止鼽湯4周;對照組患者46例,進行特異性免疫治療。治療第5周、第17周后分別比較兩組治療前后鼻塞、鼻分泌物、鼻癢、噴嚏自覺癥狀積分變化;鼻內(nèi)鏡檢查患者體征,觀察下鼻甲、鼻底、鼻中隔及中鼻甲解剖關(guān)系改變,之后每半年對患者癥狀、體征進行問卷調(diào)查,統(tǒng)計1次患者完成率。結(jié)果:(1)兩組患者的年齡、性別、文化程度等基本資料無明顯差異(P0.05),結(jié)果具有可比性。(2)治療前實驗組、對照組在患者自覺癥狀方面:鼻塞、鼻分泌物、鼻癢、噴嚏,嚴重程度相當(P0.05),無統(tǒng)計學意義。在治療后第5周,實驗組噴嚏、清鼻涕和鼻癢均比對照組的癥狀輕(P0.05),差異均具有統(tǒng)計學意義;在治療后第17周,實驗組鼻塞、清鼻涕和鼻癢均比對照組癥狀輕(P0.05),二者差異均具有統(tǒng)計學意義;治療后6月,1年,實驗組和對照組鼻塞、噴嚏、流清涕和鼻癢的癥狀嚴重程度(P0.05),差異均無統(tǒng)計學意義。(3)比較患者鼻內(nèi)鏡檢查客觀體征:在治療前,鼻粘膜淡白、水腫或充血、腫脹指數(shù)相近(P0.05),差異無統(tǒng)計學意義;治療后5周,實驗組和對照組鼻內(nèi)鏡評分的嚴重程度(P0.05),差異無統(tǒng)計學意義;治療后17周,實驗組鼻內(nèi)鏡癥狀嚴重程度比對照組輕(P0.05),二者差異有統(tǒng)計學意義;治療后6月、1年,兩組癥狀的嚴重程度無差別(P0.05),二者比較無統(tǒng)計學意義。(4)實驗組與對照組患者復發(fā)情況相同(P0.05),差異比較無統(tǒng)計學意義。(5)對比兩組治療前后,半年完成率無明顯差異(P0.05),但1年完成率實驗組高于對照組(P0.05)。結(jié)論:(1)和中止鼽湯、特異性免疫治療治療肺脾氣虛型變應性鼻炎均能夠緩解、改善患者鼻癢、噴嚏、鼻分泌物和鼻塞等癥狀。(2)和中止鼽湯、特異性免疫治療治療肺脾氣虛型變應性鼻炎能有效改變患者鼻腔粘膜具體體征。(3)和中止鼽湯治療肺脾氣虛型變應性鼻炎與特異性免疫治療組總體治療效果相當。(4)和中止鼽湯療效顯著,遠期改善提高患者生活質(zhì)量,且依從性較特異性免疫治療組好,適合臨床推廣。
[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.
【學位授予單位】：西南醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R276.1

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