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国际中医中药杂志20153月第37卷第3Int J Trad Chin Med, March 2015, Vol. 37, No.3 ·209· ·论著· 针刺蝶腭神经节治疗中重度变应性鼻炎 陈陆泉 王奎吉 谭翊 张燕超 杨威 李新吾 房高丽 王成祥 【摘要】 目的 评价针刺蝶腭神经节治疗中重度变应性鼻炎(allergic rhinitis, AR)患者的临床疗 效。 方法 选取 2012 8 月-2013 11 月同仁医院耳鼻喉科及针灸科 42 例中重度 AR 患者为研究对象, 按随机数字表法随机分为 2 组各为 21 例,治疗组针刺蝶腭神经节,每周针刺 1 次,共 4 次。对照组针刺 风池、百会、迎香、上星、太阳、曲池及足三里穴,每周 3 次,连续 4 周。观察 2 组患者治疗前及治疗 1 周、 4 周时鼻症状总分量表(total nasal symptoms score, TNSS)、鼻炎伴随症状总分量表(total non-nasal symptom score, TNNSS)的变化,并采用鼻结膜炎生活质量问卷调查量表(rhinoconjunctivitis quality of life questionnaire, RQLQ)评价生活质量。结果 治疗后 1 周,治疗组和对照组 TNSSTNNSS RQLQ 分[治疗组:5.0 4.06.0)分比 9.0 7.010.0)分、1.0 1.01.5)分比 3.0 3.03.0)分、44.0 35.550.0)分比 60.053.575.0)分;对照组:6.05.58.0)分比 10.08.510.1)分、2.02.03.0)分 3.003.03.0)分、50.045.558.0)分比 43.027.048.0)分]与治疗前比较差异均有统计学意义 P 均<0.01),且 2 组间 TNSSTNNSS RQLQ 评分差异均有统计学意义(P 均<0.01)。治疗后 4 周, 治疗组 TNSS[2.01.03.0)分比 3.02.04.5)分]、TNNSS[1.00.01.0)分比 2.02.03.0)分]和 RQLQ[24.0 19.029.0)分比 43.0 27.048.5)分]评分比较,差异有统计学意义(P 均<0.01)。 结论 刺蝶腭神经节治疗中重度 AR 可改善患者临床症状,提高生活质量,疗效迅速持久,优于常规针刺疗法。 关键词鼻炎,变应性;针刺;神经节,副交感;生活质量;治疗结果 Acupuncture at the sphenopalatine ganglion for the treatment of patients with moderate-to-severe allergic rhinitis Chen Luquan * , Wang Kuiji, Tan Yi, Zhang Yanchao, Yang Wei, Li Xinwu, Fang Gaoli, Wang Chengxiang. * Department of Acupuncture, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China Corresponding author: Wang Chengxiang, Department of Respiratory Medicine, Beijing Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China; Email: [email protected] AbstractObjective To assess the clinical efficacy of acupuncture at the sphenopalatine ganglion for the treatment of patients with moderate to severe allergic rhinitis. Methods 42 cases of moderate to severe allergic rhinitis patients in Otorhinolaryngology clinic of Tongren Hospital between August 2012 to November 2013 were randomized into a treatment group and a control group. The treatment group was treated by acupuncturing sphenopalatine ganglion, once per week, altogether 4 times. The control group was treated by acupuncturing Fengchi (GB20), Baihui (GV20), Yingxiang (GV29), Shangxing (GV23),Taiyang (EX-HN5), Quchi (LI11) and Zusanli (ST36) was used in the control group, 3 times per week for 4 weeks. The changes of the Total Nasal Symptoms Score (TNSS) and the Total Non-Nasal Symptom Score (TNNSS) were evaluated before and after treatment. The Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) was used to evaluate DOI: 10.3760/cma.j.issn.1673-4246.2015.03.005 基金项目:北京市鼻病重点实验室开放课题(2014BBYJ01);北京市中医药管理局中医药科技基金(JJ2013-26); 首都医科大学附属北京同仁医院科研骨干培育基金(TRYY-KYJJ-2014-037作者单位:100730 首都医科大学附属北京同仁医院针灸科(陈陆泉、谭翊、张燕超、杨威),耳鼻咽喉科(王奎吉、 李新吾);100011 首都医科大学附属北京地坛医院耳鼻咽喉科(房高丽);100070 北京中医药大学东直门医院呼吸内 科(王成祥) 通信作者:王成祥,Email: [email protected]

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  • 20153373 Int J Trad Chin Med, March 2015, Vol. 37, No.3 209

    allergic rhinitis, AR 2012 8 2013 11 42 AR 2 21 1 4 3 4 2 1 4 total nasal symptoms score, TNSStotal non-nasal symptom score, TNNSSrhinoconjunctivitis quality of life questionnaire, RQLQ 1 TNSSTNNSS RQLQ [5.04.06.0 9.07.010.01.01.01.5 3.03.03.044.035.550.0 60.053.575.06.05.58.0 10.08.510.12.02.03.0 3.003.03.050.045.558.0 43.027.048.0]P 0.01 2 TNSSTNNSS RQLQ P 0.01 4 TNSS[2.01.03.0 3.02.04.5]TNNSS[1.00.01.0 2.02.03.0]RQLQ[24.019.029.0 43.027.048.5]P 0.01 AR Acupuncture at the sphenopalatine ganglion for the treatment of patients with moderate-to-severe allergic rhinitis Chen Luquan*, Wang Kuiji, Tan Yi, Zhang Yanchao, Yang Wei, Li Xinwu, Fang Gaoli, Wang Chengxiang. *Department of Acupuncture, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China Corresponding author: Wang Chengxiang, Department of Respiratory Medicine, Beijing Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China; Email: [email protected]

    Abstract Objective To assess the clinical efficacy of acupuncture at the sphenopalatine ganglion for the treatment of patients with moderate to severe allergic rhinitis. Methods 42 cases of moderate to severe allergic rhinitis patients in Otorhinolaryngology clinic of Tongren Hospital between August 2012 to November 2013 were randomized into a treatment group and a control group. The treatment group was treated by acupuncturing sphenopalatine ganglion, once per week, altogether 4 times. The control group was treated by acupuncturing Fengchi (GB20), Baihui (GV20), Yingxiang (GV29), Shangxing (GV23),Taiyang (EX-HN5), Quchi (LI11) and Zusanli (ST36) was used in the control group, 3 times per week for 4 weeks. The changes of the Total Nasal Symptoms Score (TNSS) and the Total Non-Nasal Symptom Score (TNNSS) were evaluated before and after treatment. The Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) was used to evaluate DOI: 10.3760/cma.j.issn.1673-4246.2015.03.005

    2014BBYJ01JJ2013-26TRYY-KYJJ-2014-037 100730 100011 100070 Email: [email protected]

  • 210 20153373 Int J Trad Chin Med, March 2015, Vol. 37, No.3

    the quality of life. Results One week after treatment, the scores of TNSS, TNNSS and RQLQ in both groups were significantly improved than before the treatment (treatment group: 5.0[4.0, 6.0] vs. 9.0[7.0, 10.0], 1.0[1.0, 1.5] vs. 3.0[3.0, 3.0], 44.0[35.5, 50.0] vs. 60.0[53.575.0]; control group: 6.0[5.5, 8.0] vs. 10.0[8.5, 10.1], 2.0[2.0, 3.0] vs. 3.00[3.0, 3.0], 50.0[45.5, 58.0] vs. 43.0[27.0, 48.0]; all P

  • 20153373 Int J Trad Chin Med, March 2015, Vol. 37, No.3 211

    13 mm 20 min 1 3 4 12 1.3 TNSS 4 5 0 1 23 4 TNSS total non-nasal symptom score, TNNSS0 1 TNNSS [7]rhinoconjunctivitis quality of life questionnaire, RQLQ7 24 0 1 2 3 4 5 6 RQLQ 2 1 4 1 1.4 SPSS 13.0 sx

    MQ1Q3[8]P0.05

    2 2 45 3 2 1 2.1 2 1 2 TNSSTNNSSRQLQ P0.01 1 4 P0.01 1 2.2 1 24 h 24 h 3 d

    3 AR

    AR

    1 2 TNSSTNNSSRQLQ [M(Q1Q3)]

    TNSS TNNSS RQLQ 23 9.0(7.0,10.0) 3.0(3.0,3.0) 60.0(53.5,75.0) 1 21 5.0(4.0, 6.0)a 1.0(1.0,1.5)a 44.0(35.5,50.0)a 4 21 2.0(3.0, 1.0)ab 1.0(1.0,0.0)ab 24.0(29.0,19.0)ab 22 10.0(8.5,10.1) 3.0(3.0,3.0) 43.0(27.0,48.0) 1 21 6.0(5.5, 8.0)a 2.0(2.0,3.0)a 50.0(45.5,58.0)a 4 21 3.0(2.0, 4.5)a 2.0(2.0,3.0)a 43.0(27.0,48.5)a

    TNSSTNNSSRQLQaP0.01bP0.01

  • 212 20153373 Int J Trad Chin Med, March 2015, Vol. 37, No.3

    [9][10][11] 4 1

    1 4 1 3 20 min

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