【摘要】：目的:變應(yīng)性鼻炎是以鼻粘膜病變?yōu)橹鞯淖儜B(tài)反應(yīng)性疾病,是耳鼻喉科的常見病之一,患者常常在接觸過敏原后出現(xiàn)鼻癢、陣發(fā)性鼻塞、連續(xù)噴嚏、流涕等癥狀。目前發(fā)病率不斷升高,常年性變應(yīng)性鼻炎患者病情反復(fù)發(fā)作,遷延不愈,嚴(yán)重者甚至合并或誘發(fā)哮喘等呼吸系統(tǒng)疾病。西醫(yī)藥物治療在短期內(nèi)能改善癥狀,但長期服用副作用明顯,不能從根本上改善患者的過敏體質(zhì);免疫治療、手術(shù)治療費(fèi)用較高,不能被廣泛接受。中醫(yī)針灸在治療上具有抗過敏、消炎、促進(jìn)血液循環(huán)、提高機(jī)體防御能力等療效,同時(shí)具有安全簡便、療效確切、副作用小的優(yōu)點(diǎn)。通過針刺特定的腧穴以補(bǔ)益脾胃,進(jìn)而達(dá)到增強(qiáng)肺氣、疏通鼻竅、緩解癥狀、減少復(fù)發(fā)的效果。本研究通過觀察"培土生金法"結(jié)合針刺治療常年性變應(yīng)性鼻炎的臨床療效,探究脾胃之氣的強(qiáng)弱對于常年性變應(yīng)性鼻炎的影響及其機(jī)制,為臨床治療變應(yīng)性鼻炎患者提供更有效的治療方法,豐富理論認(rèn)識,為實(shí)驗(yàn)研究提供一定的臨床依據(jù)。方法:本研究根據(jù)診斷標(biāo)準(zhǔn)、納入標(biāo)準(zhǔn)、排除標(biāo)準(zhǔn),選取2016年6月至2017年3月在廣州中醫(yī)藥大學(xué)第一附屬醫(yī)院耳鼻喉科門診、針灸科門診就診的患者。按照隨機(jī)對照原則,將60名患者分為治療組和對照組,治療組30例患者針刺以鼻局部腧穴、脾俞、胃俞、足三里為主治療,對照組30例患者針刺以鼻局部腧穴配合列缺、肺俞為主,結(jié)合對癥選穴。每周治療3次,10次為一個(gè)療程,共治3個(gè)療程。通過觀察鼻癥狀積分、鼻體征積分、鼻結(jié)膜炎相關(guān)生活質(zhì)量評分,治療3個(gè)療程后,評估兩組療效、患者鼻癥狀體征總積分的變化情況;治療結(jié)束后1月隨訪,比較兩組鼻炎生活質(zhì)量積分。運(yùn)用統(tǒng)計(jì)軟件SPSS17.0進(jìn)行數(shù)據(jù)統(tǒng)計(jì)處理,得出相應(yīng)的試驗(yàn)結(jié)果及結(jié)論。結(jié)果:1.比較治療后兩組療效,結(jié)果治療組顯效6例,有效20例,無效4例,總有效率為86.7%,對照組顯效2例,有效15例,無效13例,總有效率56.7%,經(jīng)統(tǒng)計(jì)學(xué)分析,P0.05,兩組總有效率差異具有統(tǒng)計(jì)學(xué)意義,說明治療組療效優(yōu)于對照組;2.比較兩組治療前、后鼻癥狀體征總積分,經(jīng)統(tǒng)計(jì)學(xué)分析,P0.05,差異具有統(tǒng)計(jì)學(xué)意義,說明兩組均有臨床療效;比較治療后兩組鼻癥狀體征總積分,經(jīng)統(tǒng)計(jì)學(xué)分析,P0.05,說明治療組療效優(yōu)于對照組;3.比較兩組治療前、治療結(jié)束后1月隨訪鼻炎患者生活質(zhì)量癥狀評分,經(jīng)統(tǒng)計(jì)學(xué)分析,P0.05,差異具有統(tǒng)計(jì)學(xué)意義,表明兩組均有臨床療效;比較治療后兩組鼻言患者生活質(zhì)量總評分,經(jīng)統(tǒng)計(jì)學(xué)分析,P0.05,說明治療組療效優(yōu)于對照組。結(jié)論:1.治療后治療組和對照組患者鼻癥狀體征較治療前均有改善,表明二者均有助于治療變應(yīng)性鼻炎,但治療組在改善鼻癥狀體征方面優(yōu)于對照組,說明治療組療效優(yōu)于對照組;2.治療結(jié)束后1月隨訪,兩組對于改善鼻炎患者生活質(zhì)量均有療效,但治療組在改善鼻炎生活質(zhì)量方面明顯優(yōu)于對照組,說明治療組在提高患者患者生活質(zhì)量、穩(wěn)定療效上優(yōu)于對照組,臨床上值得推廣使用。3.綜上所述,"培土生金法"結(jié)合針刺治療常年性變應(yīng)性鼻炎對于改善患者鼻塞、流涕、鼻癢、噴嚏均有顯著效果,且無明顯不良反應(yīng),有效的提高了鼻炎患者的生活質(zhì)量,療效穩(wěn)定,但本研究仍需要進(jìn)一步完善改進(jìn)。
[Abstract]:Objective: allergic rhinitis is a allergic reaction disease mainly with nasal mucosa disease. It is one of the common diseases in the Department of ENT. Patients often have symptoms of nasal itching, paroxysmal nasal congestion, continuous sneezing and runny nose after exposure to allergens. The treatment of Western medicine can improve the symptoms in the short term, but it can improve the symptoms in the short term, but the long-term side effect is obvious, it can not improve the allergic constitution of the patients fundamentally; the immunotherapy, the surgical treatment cost is high and can not be widely accepted. The acupuncture and moxibustion has anti allergy, anti-inflammatory and circulation of blood. It has the advantages of improving the defense ability of the body, at the same time, it has the advantages of safe, simple, effective, and small side effect. Through the acupuncture specific acupoints to replenish the spleen and stomach, then improve the lung qi, dredge the nose orifices, relieve the symptoms and reduce the effect of recurrence. This study is to observe the clinical effect of "the method of raising earth gold" combined with acupuncture in the treatment of perennial allergic rhinitis To explore the effect of spleen and stomach qi on perennial allergic rhinitis and its mechanism, provide more effective treatment for patients with allergic rhinitis, enrich theoretical understanding, and provide certain clinical basis for experimental research. Methods: This study was included in standard, excluding standards, from June 2016 to 201 according to diagnostic criteria. In the Department of ENT, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, in March, 7 patients were treated in the clinic of the Acupuncture Department. According to the principle of random control, 60 patients were divided into treatment group and control group. 30 patients in the treatment group were treated with nasal local acupoints, spleen Yu, Wei Yu and Zusanli, and 30 patients in the control group were combined with local acupoints of the nose. 3 times a week, 10 times a course of treatment, 3 courses of treatment. Through observation of nasal symptom score, nasal sign score, rhinoconjunctivitis related quality of life score, after treatment of 3 courses, the evaluation of two groups of curative effect, the total integral of nasal symptoms and signs of patients; after the end of the treatment in January, the two groups were compared. Compared the two groups in January, compared two groups, compared the comparison of the two groups in January, compared two groups, compared the comparison of the two groups in January, compared the two groups, compared the comparison of the two groups in January, compared two groups, compare the comparison of the two groups in January, compared two groups, compare the comparison of the two groups in January, compare the two groups, compared the comparison of the two groups in January, compare the two groups, compare the January follow-up, compared two groups The quality of life score of rhinitis. Statistical software SPSS17.0 was used to get the results and conclusions. Results: 1. compared the results of two groups after treatment, 6 cases were significantly effective in the treatment group, 20 cases were effective, 4 cases were invalid, the total effective rate was 86.7%, 2 cases in the control group, 15 cases effective, 13 cases ineffective, the total effective rate 56.7%, the statistical credits were 56.7%. Analysis, P0.05, the total efficiency difference between the two groups was statistically significant, indicating that the curative effect of the treatment group was better than the control group; 2. compared with the two groups before treatment, the total integral of the symptoms and signs of the posterior nasal symptoms was statistically analyzed, and the difference was statistically significant, indicating that the two groups had clinical curative effect, and the total integral of the nasal symptoms and signs after the treatment were compared with the two groups after the treatment, and the statistical analysis, P0.05 The curative effect of the treatment group was better than that of the control group; 3. compared with the two groups before the treatment, after the end of the treatment, the quality of life symptom score of the patients with rhinitis after the end of the treatment in January was statistically analyzed, P0.05, the difference was statistically significant, indicating that the two groups had clinical effect, and the total score of the quality of life in the two groups of patients after the treatment was compared with the statistical analysis, P0.05, to explain the treatment. The curative effect of the treatment group was better than that of the control group. Conclusion: after 1. treatment, the symptoms of nasal symptoms in the treatment group and the control group were better than before the treatment, indicating that the two were all helpful for the treatment of allergic rhinitis, but the treatment group was superior to the control group in improving the nasal symptoms, indicating that the curative effect of the treatment group was better than that in the treatment group; after the end of the 2. treatment, the two groups were followed up. The quality of life of the patients with good rhinitis has a curative effect, but the treatment group is obviously superior to the control group in improving the quality of the rhinitis. It shows that the treatment group is better than the control group in improving the quality of life and the stability of the patients. It is worth popularizing the.3. in clinical, and "the cultivation of earth gold" combined with the acupuncture treatment of perennial allergic rhinitis Good patients with nasal congestion, runny nose, nose itching, sneezing have significant effects, and there is no obvious adverse reaction, effectively improving the quality of life of patients with rhinitis, the curative effect is stable, but this study still needs to be further improved.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R246.81
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本文編號：2142618