【作者】 冯荣昌；

【导师】 严道南；

【作者基本信息】 南京中医药大学 ， 中医五官科学， 2009， 博士

【摘要】 变应性鼻炎(也称过敏性鼻炎)是指以突然的反复发作的喷嚏、流涕、鼻塞和鼻痒为主要症状的鼻病,中医学称之为鼻鼽。随着工业的发展,本病的发病率有逐年升高的趋势,世界范围内的发病率约在15～20%左右,而香港6～12岁儿童的发病率更高达40.8%,严重危害人们的健康,造成生活质量的下降。在香港西医一般用药物治疗为主,少数采用免疫疗法,药物治疗以抗组胺药、血管收缩剂、糖皮质激素、抗胆碱能药、肥大细胞稳定剂等为主,虽可控制症状的发作,但有些药副作用大;免疫疗法见效慢,甚至有不良刺激,且疗程长,患者不易坚持。中药、针灸、贴敷等疗法取得较好的疗效,但各家的疗效差异大,方法不一致。本研究选择香港地区发病率较高的气虚型(肺气虚、脾气虚和肺脾气虚)变应性鼻炎患者为研究对象,观察及比较中药和西药的疗效,通过研究结果的分析与探讨,以验证中医药的疗效。研究目的:探讨益气脱敏汤治疗气虚型变应性鼻炎的疗效。研究方法:以香港大学中医临床中心为基地,选择2008年1月3日至2009年2月28日收治的100例气虚型变应性鼻炎的病人,分为治疗组和对照组。治疗组50例,用益气脱敏汤加减治疗,对照组50例,轻度用:佳力天(Clarityne与国内名“开瑞坦”成分Loratding相同)治疗,中、重度:佳力天,加上雷诺考特(Rhinocort成分budesonide)鼻用喷雾剂。研究结果:治疗组和对照组治疗后主症和体征都有明显改善,两组总有效率相同为90%。治疗组显效率为72%,对照组显效率为34%。疗效指标分析两组治疗后总有效率无差异,显效率治疗组明显优于对照组(p＜0.01);提示中药治疗组实质疗效明显高于西药对照组。研究结论:益气脱敏汤治疗气虚型变应性鼻炎在喷嚏、鼻塞、体征和次症畏风、自汗、腰酸、肢冷、食少、便溏、口干、烦热方面优于西药对照组。流涕、鼻痒两组都有较好疗效。更多还原

【Abstract】 "Allergic rhinitis" is a nasal disease with symptoms of acute recurrence of sneezing, rhinorrhoea, nasal obstruction and nasal itch. In Chinese medicine, it is called "bi-qiu". with the industrial growth,Its Incidence rate.Reaches 15-20% of the population globally.However in Hong Kong, the incidence rate even comes to 40.8% in children between 6 to 12 of age year. It certainly affects their health and quality of life substantially.In Hong Kong, western medication acts as major therapeutic approach of Allergic rhinitis by using medication such as antihistamine drugs, vasoconstriction drugs, glucocorticosteroid therapy, anticholinergic drugs and mast cells stabilizers to alleviate the symptoms, but the corresponding side-effects are huge. Immunotherapy is another therapeutic method but it is rarely used because of its irritation and low efficiency. In addition the course of treatment is so long that it is not easy for patients to get through.Chinese medication comes to use different therapeutic methods including medical herbs, acupuncture and plasters and have gained comparatively more efficient in this aspect. However, the recipes and the observed efficiencies vary from case to case. This study had selected Hong Kong, as a place of high incidence rate, to recruit patients suffering from Allergic rhinitis caused by Qi-deficiency of either lung or both lung and spleen. A comparative study was implemented to investigate the differences of drug efficiency between Chinese medicine and western medicine, through which to examine the therapeutic effect of Chinese medicine.Aim: To investigate the therapeutic effect of Qi invigoration and desensitization method ("Yi Qi Tuo Min Tang") in healing Allergic rhinitis caused by Qi-deficiency.Methodology: From 3rd Jan, 2008 to 28th February, 2008, 100 patients suffering from Allergic rhinitis caused by Qi-deficiency were recruited in HKU Chinese Medicine Clinics. They were randomized into 2 groups with 50 patients each. One group was treated with "Yi Qi Tuo Min Tang", a type of Chinese medicine formulated to reinforce the lungs and invigorate the spleen. Another group of patients acted as positive control by treated with Clarityne (Loratadine) and/or in combination with Rhinocort (Budesonide), a kind of nasal spray, depending on the disease severity.Results: Observable improvements were found in both Chinese medicine group and Western medicine control group, in which the total efficiency rates of both groups were 90%. There was no significant difference in total efficiency rate between these two groups, but the efficiency rate was significantly higher in treatment group (72%) compared with that in control group (34%, p<0.01). This implied that the therapeutic effect of Chinese medicine is better than that of Western medicine.Conclusion: Although both treatment and control groups alleviated symptoms of rhinorrhoea and nasal itch."Yi Qi Tuo Min Tang" in treatment group is apparently more efficient than control group in relieving nasal obstruction, primary and secondary symptoms of aversion to cold, sweating, aching lumbus, cold limbs, anorexia, clear urine, thirst and uncomfortable warm.更多还原