王亚琴 葛灏 傅晓东

摘要 目的：观察三伏贴敷联合鼻敏方防治肺气虚寒型变应性鼻炎（AR）的疗效及对血清总IgE、血清白细胞介素-4（IL-4）、IL-17水平的影响。方法：选取2017年7月至2018年9月南通市中医院收治的肺气虚寒型AR且处于发作期的患者160例作为研究对象，按照随机数字表法分为对照组和观察组，每组80例。对照组单独服用鼻敏方治疗，观察组采用三伏贴敷联合口服中药鼻敏方治疗，记录并比较2组患者治疗前（T0）、治疗结束（T1）和治疗结束6个月（T2）的症状、体征及VAS评分，临床疗效和血清總IgE、IL-4、IL-17水平的变化。结果：观察组T1、T2时的症状、体征及VAS评分和血清总IgE、IL-4、IL-17水平均显著低于对照组（P<0.05）;观察组患者治疗结束时、治疗结束6个月时的总有效率均明显高于对照组（P<0.05）。结论：三伏贴敷联合中药鼻敏方可较好的防治肺气虚寒型变应性鼻炎，改善过敏体质，防止复发，其机制可能与调节Thl/Th2、Th17/Treg平衡有关;同时能够显著改善患者的生命质量和心理状态，有很好的临床应用价值。

关键词 变应性鼻炎;肺气虚寒;三伏贴敷;鼻敏方

Efficacy of Sanfu Acupoint Application Combined with Bimin Formula in the Prevention and Treatment of Allergic Rhinitis

WANG Yaqin，GE Hao，FU Xiaodong

（Nantong Hospital of Traditional Chinese Medicine，Nantong 226001，China）

Abstract Objective：To observe the efficacy of Sanfu acupoint application combined with Bimin Formula in the prevention and treatment of allergic rhinitis （AR） with pulmonary-qi deficiency and cold type and its effect on serum total IgE，interleukin 4 （IL-4） and IL-17 levels.Methods：From July 2017 to September 2018，a total of 160 patients with AR of pulmonary-qi deficiency and cold type who were diagnosed in Nantong Hospital of Traditional Chinese Medicine were selected and divided into a control group and an observation group.The observation group was treated with Sanfu acupoint application combined with Bimin Formula，while the control group was treated with Bimin Formula alone.Symptoms，signs，VAS scores，clinical efficacy，and serum total IgE，IL-4 and IL-17 levels were recorded and compared between the 2 groups before treatment （T0），at the end of treatment （T1），and 6 months after treatment （T2）.Results：After treatment，the symptoms，signs，VAS scores and serum total IgE，IL-4 and IL-17 levels in the observation group were significantly lower than those in the control group at T1 and T2 （P<0.05）.The total effective rate of patients in the observation group at the end of treatment and 6 months after treatment were significantly higher than those in the control group （P<0.05）.Conclusion：Sanfu acupoint application combined with Bimin Formula can effectively prevent and treat allergic rhinitis with pulmonary-qi deficiency and cold type，improve allergic constitution，prevent recurrence.Its mechanism may be related to the regulation of Th1/Th2、Th17/Treg balance.It also can significantly improve the quality of life and psychological state of patients，and has good clinical application value.

Keywords Allergic rhinitis; Pulmonary-qi deficiency and cold type; Sanfu acupoint application; Bimin Formula

中图分类号：R245.82;R276.1文献标识码：Adoi：10.3969/j.issn.1673-7202.2020.24.019

变应性鼻炎（Allergic Rhinitis，AR）是耳鼻喉科的常见病、多发病，据其症候特点中医学将其归属“鼻鼽”的范畴，国内外研究显示其与多种疾病关系密切，发病率逐年上升，严重影响患者的生命质量[1-2]。现代医学认为AR是由IgE介导的鼻黏膜非感染性炎性疾病，属于I型变态反应，以T细胞依赖、肥大细胞启动和嗜酸性粒细浸润为主要特征[3]。西药治疗AR疗效确切，起效快，但易复发;而中医药学作为传统医学，对AR的预防和治疗都有较好的疗效。三伏贴择时而治，驱散内伏寒邪，属中医外治疗法，其疗效肯定，已得到临床广泛推广[4]。本研究将两者结合治疗肺气虚寒型AR，发现三伏贴敷联合中药鼻敏方能明显减轻AR患者症状，且在改善过敏体质、控制症状复发、改善生命质量和心理状态方面更具有优势，有很好的临床应用价值。……