摘要
目的 探究通窍鼻炎颗粒联合细菌溶解产物胶囊对过敏性鼻炎(AR)患者小气道功能及气道炎性反应的影响.方法 选取2022年6月至2023年6月浙江省金华市妇幼保健院收治的120例AR患者临床资料进行研究,按照治疗方法分为常规组(细菌溶解产物胶囊治疗60例)和联合组(通窍鼻炎颗粒联合细菌溶解产物胶囊治疗60例),2组治疗周期均为1个月.对比2组患者的治疗效果、中医证候积分、小气道功能[最大呼气中段流量(MMEF)、用力呼气50％流速(FEF50)、用力呼气75％流速(FEF75)]、气道炎性反应[呼出气一氧化氮(FeNO)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]、血清细胞因子[白细胞介素-4(IL-4)、白细胞介素-6(IL-6)、白细胞介素-17(IL-17)]及不良反应发生率.结果 联合组患者的治疗有效率(95.0％)高于常规组(81.7％)(x2=5.175,P＜0.05);治疗后,联合组患者的鼻塞、鼻痒、流涕中医证候积分[(1.4±0.4)分、(1.5±0.6)分、(1.4±0.5)分]均低于常规组[(2.5±0.8)分,(2.6±0.6)分、(2.6±0.6)分](t=9.947、10.563、10.906,P均＜0.05);联合组患者小气道功能 MMEF、FEF50、FEF75 分别为(2.2±0.4)L/s、(2.42±0.33)Us、(1.29±0.17)Us,均高于常规组的[(1.9±0.3)L/s、(2.17±0.27)Us、(1.07±0.14)L/s](t=5.301、4.542、7.738,P 均＜0.05);联合组患者气道炎性反应FeNO、CRP、TNF-α水平分别为(14±4)ppb、(16±4)ng/ml、(7.6±1.8)ng/ml,均低于常规组[(16±4)ppb、(20±4)ng/ml、(10.5±2.2)ng/ml](t=3.623、6.796、7.733,P 均＜0.05);联合组患者血清细胞因子IL-4、IL-6、IL-17 水平分别为(5.7±0.9)ng/L、(94±20)ng/L、(32.6±4.8)ng/L,均低于常规组[(8.3±1.1)ng/L、(125±22)ng/L、(43.5±5.4)ng/L](t=14.392、8.346、11.798,P 均＜0.05);联合组(3.3％)和常规组(8.3％)的不良反应发生率差异无统计学意义(x2=1.365,P＞0.05).结论 通窍鼻炎颗粒联合细菌溶解产物胶囊对AR患者的疗效显著,可改善患者的中医证候评分及患者的小气道功能,降低气道炎性反应.
Abstract
Objective To explore the effects of Tongqiao Biyan Granule combined with bacterial lysates capsule on small airway function and airway inflammatory response in patients with allergic rhinitis(AR).Methods A total of 120 clinical data of patients with AR admitted to Jinhua Maternal and Child Health Hospi-tal from June 2022 to June 2023 were selected for the study.According to the different treatment methods,they were divided into a conventional group(treated with bacterial lysates capsule,n=60)and a combination group(treated with Tongqiao Biyan Granules combined with bacterial lysates capsule,n=60),with a treatment period of one month for both groups.The treatment effects,traditional Chinese medicine(TCM)syndrome scores,small air-way function[maximal mid-expiratory flow(MMEF),forced expiratory flow at 50％(FEF50),forced expiratory flow at 75％(FEF75)],airway inflammatory response[fractional exhaled nitric oxide(FeNO),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)],serum cytokines[interleukin-4(IL-4),interleukin-6(IL-6),interleukin-17(IL-17)],and incidence of adverse reactions were compared between the two groups.Results The effective rate in the combination group was significantly higher than that in the conventional group(95.0％vs 81.7％,x2=5.175,P＜0.05).After treatment,the TCM syn-drome scores of nasal congestion,nasal itching,and runny nose in the combi-nation group[(1.4±0.4)points,(1.5±0.6)points,(1.4±0.5)points,respectively]were significantly lower than those in the control group[(2.5±0.8)points,(2.6±0.6)points,and(2.6±0.6)points](t=9.947,10.563,10.906,all P＜0.05);The levels of small airway function indicators,including MMEF,FEF50,and FEF75,in the combination group[(2.2±0.4)L/s,(2.42±0.33)L/s,(1.29±0.17)Us,respectively]were significantly higher than those in the conven-tional group[(1.9±0.3)L/s,(2.17±0.27)Us,(1.07±0.14)Us,respectively](t=5.301,4.542,7.738,all P＜0.05).The levels of airway inflammatory markers,including FeNO,CRP,and TNF-α,in the combination group[(14±4)ppb,(16±4)ng/ml,(7.6±1.8)ng/ml]were significantly lower than those in the conventional group[(16±4)ppb,(20±4)ng/mL,(10.5±2.2)ng/mL,respectively](t=3.623,6.796,7.733,all P＜0.05).The serum levels of cytokines IL-4,IL-6,and IL-17 in the combination group[(5.7±0.9)ng/L.(94±20)ng/L,(32.6±4.8)ng/L]were significantly lower than those in the conventional group[(8.3±1.1)ng/L,(125±22)ng/L,(43.5±5.4)ng/L,respectively](t=14.392,8.346,11.798,all P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the combination group(3.3％)and the conventional group(8.3％)(x2=1.365,P＞0.05).Conclusion The combination of Tongqiao Biyan Granules and bacterial lysates capsule has a significant therapeutic effect on pa-tients with AR,which can improve the traditional Chinese medicine syndrome scores and small airway function of patients,and reduce airway inflammation.
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