摘要
研究背景：
变应性鼻炎,也称为鼻敏感,随着大城市生活模式的改变,已经跃居成耳鼻喉科首位常见病。根据世界卫生组织1996-2006的调查发现,全球近4亿人患有鼻敏感。发达地区城市的儿童发病率高达20-40%。在西方生活文化逐渐东进,我国国民的生活模式和饮食模式正朝西式转变。大城市空气素质的下降、机动车辆肺气排放增多、小孩幼儿在室外活动减少等因素,促使变应性鼻炎的发病率上升。这种情况早已引起世界各医学团体的关注。
流涕、喷嚏、鼻塞和鼻痒等症经常反复的出现,困扰着众多的患者。同时影响患者的情绪、工作和学习,对他们的生理和心理健康造成负面的影响。变应性鼻炎的治疗费用随着通胀率的升高和医药原材料的上涨,也成为家庭和社会的另一种财政压力。探讨更有实效治疗变应性鼻炎的治疗方法,具有重要的临床意义和社会价值。
本次研究首要目标是在缓解症状的同时,并同时让患者的发作频率减低,因而提高生活质量。近年来,现代医学对付变应性鼻炎轻度症状的患者的首选疗法是抗组胺类药物。而症状属于中度及重度的病人,则使用鼻用类固醇或加上口服抗组胺药,也有患有给与些应用上了,抗白三烯药、色酮类药、或减充血剂配合治疗,可是这一类的治疗主要目的只是为了把症状控制。然而,没有对全身进行调节,没有让患者的身体真正康复。
变应性鼻炎是一种全身免疫紊乱性疾病,若只是使用抗组胺药、类固醇等药物,常常在停药后反复发病。中医从整体出发,对身体作出系统性的调整,调节人体的全身状态,增强体质,提高自身免疫力。在预防和减少变应性鼻炎发病率方面出发,达到治未病的概念。
目的：
本次研究将从临床对受试验者进行实际观察,客观评价灵龟八法治疗变应性鼻炎的临床疗效,以将灵龟八法,时间治疗学等治疗方法应用在临床病症上,让更多人推广应用灵龟八法。
方法
在这次的研究当中,经过详细的诊查,符合变应性鼻炎诊断的患者,将随机分为治疗组、对照组、空白对照组三组。每组30例。诊断的标准是根据2004年,经过多个专家小组在兰州商议确定的《变应性鼻炎的诊治原则和推荐方案》,治疗组使用灵龟八法配合针刺治疗,而对照组30例,则使用单侧常规针刺。治疗组取穴：应用灵龟八法开穴,使用病人的就诊治疗时间推算出相应穴位,另外,配合常规针刺穴位：迎香、印堂、合谷、太渊、肺俞。对照组为纯针刺组,取穴：迎香、印堂、合谷、太渊、肺俞。两组患者都采用局部常规消毒灭菌,单手快速进针法进针。行焊插捻转法让患者得气,得气后留针20min,期隔10分钟行平补平泻法1次。每周治疗3次,共治疗4周。观察指标为鼻症状总分表(Total Nasal Symptom Score, TNSS),伴随症状总分(Total Non Nasal Symptom Score, TNNSS),鼻结膜炎患者生活质量问答卷(Rhinoconjunctivitis Quality of Life Questionnaire, RQLQ)。空白对照组将不给与任何治疗。
结果：
三组治疗前,经统计学处理,各患者的性别、年龄、病程、鼻症状总分表(TNSS)评分,伴随症状总分(TNNSS)评分、鼻结膜炎患者生活质量问答卷(RQLQ)评分,它们的差异性均无统计学意义(P>0.05),三组都具有可比性。冶疗组和对照组比较在治疗前后比较,鼻症状总分表(TNSS)评分,伴随症状总分(TNNSS)评分、鼻结膜炎患者生活质量问答卷(RQLQ)评分,都有下降,差异有统计学意义(P<0.01)。治疗后,治疗组和对照组两组鼻症状总分表(TNSS)评分比较,差异有统计学意义(P<0.05)；伴随症状总分(TNNSS)评分、鼻结膜炎患者生活质量问答卷(RQLQ)评分比较差异均有统计学意义(P<0.05)。
结论：
1.治疗组和对照组治疗变应性鼻炎均有较好疗效,两组有效率都非常接近,但前者有效率稍微高于对照组。2.治疗组和对照组都可以降低变应性鼻炎患者鼻症状总分表(TNSS)评分,伴随症状总分(TNNSS)评分、鼻结膜炎患者生活质量问答卷(RQLQ)评分,但治疗组对伴随症状总分(TNNSS)评分、鼻结膜炎患者生活质量问答卷(RQLQ)评分下降作用更优；3.在随访时发现治疗组鼻症状总分表(TNSS)评分,伴随症状总分(TNNSS)评分、鼻结膜炎患者生活质量问答卷(RQLQ)评分比对照组高,说明前者对变应性鼻炎的在治疗后的远期生活质量上的提高起到更大的疗效。使用灵龟八法治疗变应性鼻炎是在临床上可以应用的,能提升疗效的治疗方法。
Objective
This clinical research is to observe the evaluation of Acupuncture Treatment of Allergic Rhinitis by the Eight Method of Intelligent Turtle plus Acupuncture.
Methods
Total90subjects were randomly divided into3groups, treatment group30cases, and control groups30cases empty control groups30cases. Treatment group were cured by the points selected according to the date and time while the patient attending the treatment calculated by Eight Method of Intelligent Turtle (Ling Gui Ba Fa) plus regulation treatment points. Control group30cases were cured by normal acupuncture treatment.
Samples
3groups of subjects of90cases, they were from the source of the Guangzhou University of Traditional Chinese Medicine First Affiliated Hospital of acupuncture out patients.
[Treatment]
In this study, after a detailed investigation, in accord with the diagnosis of allergic rhinitis patients, which were divided into treatment group, control group, blank control group. Each of30cases. Diagnostic criteria are based on2004, after a group of experts in Lanzhou agreed " allergic rhinitis treatment principle and the recommended scheme", the treatment group used eight methods of intelligent turtle with acupuncture treatment, while the control group30cases, using the unilateral routine acupuncture. The treatment group points:application of eight methods of intelligent turtle to open the hole, using the patient's diagnosis and treatment time calculate the (?)spending acupuncture points, in addition, combined with conventional (?)are:greet sweet, YINGXIANG(LI2O), YINTANG(EX-HN3), HEGU (LI4), TAIYUAN(LU9), FEISHU(BL13).The control group for the pure acupuncture group, acupuncture:YINGXIANG(LI20), YINTANG(EX-HN3), HEGU (LI4), TAIYUAN(LU9), FEISHU (BL13). Two groups of patients with localized conventional disinfection and sterilization, single hand fast puncture needle. Lifting, inserting, twist the needle, wait for the arrival of Qi of patients, stay the needle for20mins,faintng during acupuncture treatment every10minutes,3times per week, a total of4weeks treatment. Outcome measures for Total Nasal Symptom Score,(TNSS), Total Non Nasal Symptom Score (TNNSS), Rhinoconjunctivitis Quality of Life Questionnaire(RQLQ). Blank control group will not give any treatment.
Result
Three groups before treatment, after statistics processing, the patient's sex, age, course of disease, Total Nasal Symptom Score,(TNSS), Total Non Nasal Symptom Score (TNNSS), Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), their differences were not statistically significant (P>0.05), the three groups which can not be compared. Treatment group and control group before and after treatment Total Nasal Symptom Score,(TNSS), Total Non Nasal Symptom Score (TNNSS), Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), has declined, the difference was statistically significant (P<0.01). In two groups after the treatment of nasal symptoms score table (TNSS) score can be compared, the difference was statistically significant (P<0.05), score comparitable, Total Non Nasal Symptom Score (TNNSS), Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) differences were statistically significant (P<0.05).
Conclusions
1. Eight methods of Intelligent Turtle group and pure acupuncture treatment group treating allergic rhinitis were both effective.Effective rates of treatment group and control groups were very close, but the efficiency of treatment group is slightly higher than control group.
2. Eight methods of Intelligent Turtle group and pure acupuncture group can reduce Total Nasal Symptom Score (TNSS), Total Non Nasal Symptom Score (TNNSS), Rhinoconjunctivitis Quality of Life Questionnaire(RQLQ), but the eight methods of Intelligent Turtle group on Total Non Nasal Symptom Score (TNNSS), Rhinoconjunctivitis Quality of Life Questionnaire(RQLQ) score decreased. Treatment group on allergic rhinitis in life quality rise to better efficacy. The use of eight methods of intelligent turtle in treatment of allergic rhinitis in need of clinical use, improving the efficacy of treatment method.
引文
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