双侧星状神经节阻滞联合穴位注射治疗过敏性鼻炎的临床价值
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摘要
目的探讨双侧星状神经节阻滞(SGB)联合穴位注射治疗过敏性鼻炎的临床价值。方法将该院2015年1月至2017年8月就诊的120例过敏性鼻炎患者根据随机分配原则分为SGB组、穴位注射组、联合治疗(SGB+穴位注射)组,每组各40例。SGB组给予双侧SGB治疗,穴位注射组给予大椎、曲池穴位注射黄芪注射液治疗,联合治疗组给予SGB合穴位注射治疗。比较3组治疗效果、不良反应发生情况及治疗前后的白三烯B4(LTB4)、白细胞介素(IL)-4、IL-6、IL-10、IgE、Th1/Th2水平变化。结果联合治疗组的治疗总有效率均高于SGB组、穴位注射组(P<0.05),穴位注射组与SGB组治疗总有效率比较差异无统计学意义(P>0.05);治疗后3组患者LTB4、IL-4、IL-6、IL-10水平均较治疗前下降(P<0.05),且联合治疗组LTB4、IL-4、IL-6、IL-10水平均低于SGB组、穴位注射组(P<0.05),穴位注射组治疗后LTB4、IL-4、IL-6、IL-10水平与SGB组比较差异无统计学意义(P>0.05);治疗后3组患者IgE、临床症状评分均较治疗前下降,Th1/Th2均较治疗前上升(P<0.05),联合治疗组IgE、临床症状评分均低于SGB组及穴位注射组(P<0.05),Th1/Th2高于SGB组及穴位注射组(P<0.05),穴位注射组治疗后IgE、Th1/Th2、临床症状评分和SGB组比较差异无统计学意义(P>0.05);3组患者不良反应总发生率比较差异无统计学意义(P>0.05)。结论双侧星状神经节阻滞联合穴位注射治疗过敏性鼻炎临床疗效显著,可有效地降低相关炎症介质水平,且不良反应少。
Objective To investigate the clinical value of bilateral stellate ganglion block combined with acupoint injection in the treatment of allergic rhinitis.Methods Totally 120 patients with allergic rhinitis in this hospital from January 2015 to August 2017 were selected as the study subjects and divided into the bilateral stellate ganglion block(SGB)group,acupoint injection group and combined therapy group(SGB+acupoint injection)according to the random allocation principle,40 cases in each group.The SGB group was given bilateral block lidocaine and triamcinolone acetonide,the acupoint injection group was given Astragalus Injection at Dazhui and Quchi points,and the combined treatment group was given bilateral stellate ganglion block combined with acupoint injection.The therapeutic effects,adverse reactions occurrence and changes of LTB4,IL-4,IL-6,IL-10,IgE and Th1/Th2 levels before and after treatment were compared among the three groups.Results The total effective rate of the combined treatment group was higher than that of the SGB group and the acupoint injection group(P<0.05).There was no difference in the total effective rate between the acupoint injection group and the SGB group(P>0.05).After treatment,the levels of LTB4,IL-4,IL-6,IL-10 in three groups were decreased compared with those before treatment(P<0.05),moreover the levels of LTB4,IL-4,IL-6 and IL-10 in the combined treatment group were lower than those in the SGB group and acupoint injection group(P<0.05).The levels of LTB4,IL-4,IL-6,IL-10 after treatment had no statistical difference between the acupoint injection group and SGB group(P>0.05).The IgE level and clinical symptom scores after treatment in the three groups were decreased compared with those before treatment(P<0.05).The level of IgE and clinical symptom score after treatment in the combined treatment group were lower than those in the SGB group and acupoint injection group(P<0.05).The level of IgE,Th1/Th2 and clinical symptom score in acupoint injection group were higher than those in the SGB group and acupoint injection group(P<0.05).There was no statistically significant difference in IgE,Th1/Th2,clinical symptom score between the acupoint injection group and SGB group(P>0.05).There was no statistically significant difference in the total incidence of adverse reactions among the three groups(P>0.05).Conclusion Bilateral stellate ganglion block combined with acupoint injection in the treatment of allergic rhinitis has remarkable clinical efficacy,can effectively reduce the level of related inflammatory mediators with fewer adverse reactions,which is worthy of further clinical research and application.
Objective To investigate the clinical value of bilateral stellate ganglion block combined with acupoint injection in the treatment of allergic rhinitis.Methods Totally 120 patients with allergic rhinitis in this hospital from January 2015 to August 2017 were selected as the study subjects and divided into the bilateral stellate ganglion block(SGB)group,acupoint injection group and combined therapy group(SGB+acupoint injection)according to the random allocation principle,40 cases in each group.The SGB group was given bilateral block lidocaine and triamcinolone acetonide,the acupoint injection group was given Astragalus Injection at Dazhui and Quchi points,and the combined treatment group was given bilateral stellate ganglion block combined with acupoint injection.The therapeutic effects,adverse reactions occurrence and changes of LTB4,IL-4,IL-6,IL-10,IgE and Th1/Th2 levels before and after treatment were compared among the three groups.Results The total effective rate of the combined treatment group was higher than that of the SGB group and the acupoint injection group(P<0.05).There was no difference in the total effective rate between the acupoint injection group and the SGB group(P>0.05).After treatment,the levels of LTB4,IL-4,IL-6,IL-10 in three groups were decreased compared with those before treatment(P<0.05),moreover the levels of LTB4,IL-4,IL-6 and IL-10 in the combined treatment group were lower than those in the SGB group and acupoint injection group(P<0.05).The levels of LTB4,IL-4,IL-6,IL-10 after treatment had no statistical difference between the acupoint injection group and SGB group(P>0.05).The IgE level and clinical symptom scores after treatment in the three groups were decreased compared with those before treatment(P<0.05).The level of IgE and clinical symptom score after treatment in the combined treatment group were lower than those in the SGB group and acupoint injection group(P<0.05).The level of IgE,Th1/Th2 and clinical symptom score in acupoint injection group were higher than those in the SGB group and acupoint injection group(P<0.05).There was no statistically significant difference in IgE,Th1/Th2,clinical symptom score between the acupoint injection group and SGB group(P>0.05).There was no statistically significant difference in the total incidence of adverse reactions among the three groups(P>0.05).Conclusion Bilateral stellate ganglion block combined with acupoint injection in the treatment of allergic rhinitis has remarkable clinical efficacy,can effectively reduce the level of related inflammatory mediators with fewer adverse reactions,which is worthy of further clinical research and application.
引文
[1]梁薇,李晓燕,李尊元,等.三伏针与三伏贴对比治疗过敏性鼻炎的临床研究[J].针灸临床杂志,2017,33(10):1-5.
[2]魏邦基,赵嬿,张翠红,等.穴位疗法治疗过敏性鼻炎机制探讨[J].辽宁中医药大学学报,2015,16(10):60-64.
[3]陈阳静,李宏慧,赵瑞敏,等.鼻舒适片联合枸地氯雷他定治疗过敏性鼻炎的临床研究[J].现代药物与临床,2016,31(4):525-528.
[4]中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组,中华医学会耳鼻咽喉头颈外科学分会鼻科学组.变应性鼻炎诊断和治疗指南(2015年,天津)[J].中华耳鼻咽喉头颈外科杂志,2016,51(1):6-18.
[5]贾明辉,陈晓云,张悦,等.鼻用激素联合氯雷他定或孟鲁司特钠治疗变应性鼻炎的疗效分析[J].临床耳鼻咽喉头颈外科杂志,2017,30(5):369-373.
[6]孔繁勇,赵玉梅,王彩云.玉屏风颗粒联合盐酸氮卓斯汀喷鼻剂治疗过敏性鼻炎的临床研究[J].现代药物与临床,2016,31(5):673-677.
[7]曲良,张杨.针灸治疗过敏性鼻炎临床研究进展[J].辽宁中医药大学学报,2016,17(1):207-210.
[8]ZHANG Y,HOU X R,LI H,et al.Effect of acupoint injection on eosinophil counts,protein and mRNA expressions of eotaxin in nasal mucosa of allergic rhinitis rats[J].Zhen Ci Yan Jiu,2017,42(2):141-144.
[9]朱秀平,陈宝维,钟慈琼,等.温针灸颈夹脊穴联合穴位敷贴治疗过敏性鼻炎临床研究[J].陕西中医,2017,38(1):107-108.
[10]马鹏,冯俊,陈柏林.玉屏风颗粒结合枸地氯雷他定片治疗过敏性鼻炎临床研究[J].国际中医中药杂志,2017,39(10):332-334.
[11]王俐红,李东红,张俊清,等.星状神经节阻滞联合穴位注射治疗月经性偏头痛临床效果观察及评价[J].环球中医药,2015,7(6):754-756.
[12]朱秀平,陈宝维,钟慈琼,等.温针灸颈夹脊穴联合穴位敷贴治疗过敏性鼻炎临床研究[J].陕西中医,2017,38(1):107-108.
[13]张治成,杨晓,杨晓刚.自拟醒窍益气汤联合穴位针刺治疗过敏性鼻炎的疗效探讨[J].中国现代医学杂志,2016,27(3):137-140.
[14]张桂桃,粱利伟,宋德锋.香菊胶囊联合氮卓斯汀治疗过敏性鼻炎的临床研究[J].现代药物与临床,2016,31(6):886-889.
[15]庞湃,韩佳利,魏宏权.匹多莫德治疗过敏性鼻炎临床观察[J].解放军医药杂志,2016,28(1):101-105.
[16]MI J P,CHEN X Y,LIN X Y,et al.Treatment of persistent allergic rhinitis via acupuncture at the sphenopalatine acupoint:a randomized controlled trial[J].Trials,2018,19(1):28-30.
[17]金禹彤,宣丽华.穴位贴敷治疗过敏性鼻炎作用机制及临床应用[J].吉林中医药,2015,35(1):84-87.
[18]杨元.星状神经节阻滞联合蝶腭神经节阻滞治疗过敏性鼻炎临床观察[J].河北医学,2013,19(6):938-939.
[2]魏邦基,赵嬿,张翠红,等.穴位疗法治疗过敏性鼻炎机制探讨[J].辽宁中医药大学学报,2015,16(10):60-64.
[3]陈阳静,李宏慧,赵瑞敏,等.鼻舒适片联合枸地氯雷他定治疗过敏性鼻炎的临床研究[J].现代药物与临床,2016,31(4):525-528.
[4]中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组,中华医学会耳鼻咽喉头颈外科学分会鼻科学组.变应性鼻炎诊断和治疗指南(2015年,天津)[J].中华耳鼻咽喉头颈外科杂志,2016,51(1):6-18.
[5]贾明辉,陈晓云,张悦,等.鼻用激素联合氯雷他定或孟鲁司特钠治疗变应性鼻炎的疗效分析[J].临床耳鼻咽喉头颈外科杂志,2017,30(5):369-373.
[6]孔繁勇,赵玉梅,王彩云.玉屏风颗粒联合盐酸氮卓斯汀喷鼻剂治疗过敏性鼻炎的临床研究[J].现代药物与临床,2016,31(5):673-677.
[7]曲良,张杨.针灸治疗过敏性鼻炎临床研究进展[J].辽宁中医药大学学报,2016,17(1):207-210.
[8]ZHANG Y,HOU X R,LI H,et al.Effect of acupoint injection on eosinophil counts,protein and mRNA expressions of eotaxin in nasal mucosa of allergic rhinitis rats[J].Zhen Ci Yan Jiu,2017,42(2):141-144.
[9]朱秀平,陈宝维,钟慈琼,等.温针灸颈夹脊穴联合穴位敷贴治疗过敏性鼻炎临床研究[J].陕西中医,2017,38(1):107-108.
[10]马鹏,冯俊,陈柏林.玉屏风颗粒结合枸地氯雷他定片治疗过敏性鼻炎临床研究[J].国际中医中药杂志,2017,39(10):332-334.
[11]王俐红,李东红,张俊清,等.星状神经节阻滞联合穴位注射治疗月经性偏头痛临床效果观察及评价[J].环球中医药,2015,7(6):754-756.
[12]朱秀平,陈宝维,钟慈琼,等.温针灸颈夹脊穴联合穴位敷贴治疗过敏性鼻炎临床研究[J].陕西中医,2017,38(1):107-108.
[13]张治成,杨晓,杨晓刚.自拟醒窍益气汤联合穴位针刺治疗过敏性鼻炎的疗效探讨[J].中国现代医学杂志,2016,27(3):137-140.
[14]张桂桃,粱利伟,宋德锋.香菊胶囊联合氮卓斯汀治疗过敏性鼻炎的临床研究[J].现代药物与临床,2016,31(6):886-889.
[15]庞湃,韩佳利,魏宏权.匹多莫德治疗过敏性鼻炎临床观察[J].解放军医药杂志,2016,28(1):101-105.
[16]MI J P,CHEN X Y,LIN X Y,et al.Treatment of persistent allergic rhinitis via acupuncture at the sphenopalatine acupoint:a randomized controlled trial[J].Trials,2018,19(1):28-30.
[17]金禹彤,宣丽华.穴位贴敷治疗过敏性鼻炎作用机制及临床应用[J].吉林中医药,2015,35(1):84-87.
[18]杨元.星状神经节阻滞联合蝶腭神经节阻滞治疗过敏性鼻炎临床观察[J].河北医学,2013,19(6):938-939.
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