摘要
【目的】探究桂枝加黄芪汤联合穴位敷贴治疗过敏性鼻炎(AR)患儿的疗效及其对血清炎症因子、T淋巴细胞亚群水平的影响。【方法】选取2023年1月至2024年3月昆山市中医医院儿科门诊收治的100例脾肺气虚型AR患儿,按照治疗方式的不同将患儿分为联合组和对照组,每组各50例。对照组给予穴位敷贴治疗(取穴肺俞、膏肓、大椎、印堂、迎香等),联合组给予桂枝加黄芪汤联合穴位敷贴治疗,疗程均为4周。观察2组患儿治疗前后中医证候积分、鼻结膜炎生活质量量表(RQLQ)评分、血清炎症因子及T淋巴细胞亚群的变化情况,并评价2组患儿的临床疗效。【结果】(1)疗效方面,治疗4周后,联合组的总有效率为98.00%(49/50),对照组为84.00%(42/50),组间比较(χ^(2)检验),联合组的疗效明显优于对照组(P<0.05)。(2)生活质量方面,治疗后,2组患儿的RQLQ评分均较治疗前下降(P<0.05),且联合组的下降幅度明显优于对照组(P<0.01)。(3)中医证候积分方面,治疗后,2组患儿的鼻塞、鼻涕清稀或黏白、畏寒肢冷、四肢困倦积分均较治疗前下降(P<0.05),且联合组的下降幅度均明显优于对照组(P<0.01)。(4)炎症因子方面,治疗后,2组患儿的血清白细胞介素4(IL-4)、白细胞介素1β(IL-1β)、肿瘤坏死因子α(TNF-α)水平均较治疗前下降(P<0.05),且联合组的下降幅度均明显优于对照组(P<0.01)。(5)T淋巴细胞亚群方面,治疗后,2组患儿的T细胞亚群CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均较治疗前升高(P<0.05),CD8^(+)水平均较治疗前下降(P<0.05),且联合组对CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平的升高幅度及对CD8^(+)水平的下降幅度均明显优于对照组(P<0.01)。【结论】桂枝加黄芪汤联合穴位敷贴治疗AR患儿,不仅疗效佳,还有助于改善血清炎症因子以及T淋巴细胞亚群水平,提高患儿生活质量。
Objective To investigate the therapeutic efficacy of Cinnamomi Ramulus Plus Astragali Radix Decoction combined with acupoint application in treating children with allergic rhinitis(AR)and to observe its effects on serum inflammatory factors and T-cell subset levels.Methods A retrospective analysis was conducted on 100 children with AR of spleen-lung qi deficiency type treated in the pediatric outpatient department of Kunshan Hospital of Traditional Chinese Medicine between January 2023 and March 2024.According to treatment methods,patients were divided into a combination group and a control group,with 50 patients in each group.The control group received acupoint application at Feishu[BL13],Gaohuang[BL43],Dazhui[GV14],Yintang[GV29],and Yingxiang[LI20],while the combination group received Cinnamomi Ramulus Plus Astragali Radix Decoction combined with acupoint application.Both treatments lasted for 4 weeks.Traditional Chinese medicine(TCM)syndrome scores,Rhinoconjunctivitis Quality of Life Questionnaire(RQLQ)scores,serum inflammatory factors,and T lymphocyte subset levels were observed before and after treatment,and clinical efficacy was evaluated.Results(1)Clinical efficacy:After 4 weeks of treatment,the total effective rate was 98.00%(49/50)in the combination group versus 84.00%(42/50)in the control group.The intergroup comparison(by chi-square test)demonstrated significantly superior efficacy in the combination group compared to the control group(P<0.05).(2)Quality of life:After treatment,the RQLQ scores decreased in both groups compared to pre-treatment levels(P<0.05).The reduction in RQLQ scores was significantly greater in the combination group than in the control group(P<0.01).(3)TCM syndrome scores:After treatment,scores for nasal congestion,clear or white nasal discharge,cold intolerance with cold limbs,and limb fatigue were all decreased in both groups compared to those before treatment(P<0.05).The reduction in these scores was significantly greater in the combination group than in the control group(P<0.01).(4)Inflammatory factors:After treatment,serum levels of interleukin-4(IL-4),interleukin-1β(IL-1β),and tumor necrosis factor-α(TNF-α)were decreased in both groups compared to pretreatment levels(P<0.05).And the reduction was significantly greater in the combination group than in the control group(P<0.01).(5)T lymphocyte subsets:After treatment,the levels of CD3^(+)T cells,CD4^(+)T cells,and the CD4^(+)/CD8^(+)ratio increased(P<0.05),while the level of CD8^(+)T cells decreased(P<0.05)in both groups compared to pre-treatment values.The increases in CD3^(+),CD4^(+),CD4^(+)/CD8^(+)and the decrease in CD8^(+)were all significantly greater in the combination group than in the control group(P<0.01).Conclusion Cinnamomi Ramulus Plus Astragali Radix Decoction combined with acupoint application demonstrates excellent therapeutic efficacy in treating children with AR,contributes to the improvement of serum inflammatory factors and T lymphocyte subset levels,and enhances quality of life.
作者
王静怡
金悠悠
金振宇
WANG Jingyi;JIN Youyou;JIN Zhenyu(Dept.of Pediatrics,Kunshan Hospital of Chinese Medicine,Kunshan 215300 Jiangsu,China;Dept.of Preventive Medicine,Kunshan Hospital of Traditional Chinese Medicine,Kunshan 215300 Jiangsu,China;Dept.of Spleen,Stomach,Liver and Gallbladder,Kunshan Traditional Chinese Medicine Hospital,Kunshan 215300 Jiangsu,China)
出处
《广州中医药大学学报》
2026年第2期363-369,共7页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
江苏省基础研究计划(自然科学基金)资助项目(编号:BK20210260)。
关键词
桂枝加黄芪汤
穴位敷贴
肺俞
膏肓
过敏性鼻炎
脾肺气虚型
生活质量
炎症因子
T淋巴细胞亚群
Cinnamomi Ramulus Plus Astragali Radix Decoction
acupoint application
Feishu(BL13)
Gaohuang(BL43)
allergic rhinitis(AR)
spleen-lung qi deficiency type
quality of life
inflammatory factors
T-cell subsets
