【作者】 许杏莲；

【导师】 汪受传；

【作者基本信息】 南京中医药大学 ， 中医儿科学， 2009， 博士

【摘要】 过敏性鼻炎,属于中医学“鼻鼽”的范畴,本病常伴有其他相关性疾病如支气管哮喘、湿疹等,是小儿临床最为常见的慢性呼吸道疾病之一。近年来儿童过敏性鼻炎的发病率有逐年升高的趋势,引起国际医学界的广泛关注。根据流行病学相关资料统计,全球平均发病率在10%至25%,且常伴有哮喘,随着发病率的逐步上升,目前已成为影响全球儿童健康的重要疾病之一。新加坡国立大学耳鼻喉科部门Dr De-Yun Wang于2003年在刊登于Allergy刊物的文章中指出:在新加坡,社区调查研究显示过敏性鼻炎患者约占13.1%。目的:中医药对于小儿过敏性鼻炎的防治由来已久,且具有自身的优势和特色,本研究的目的旨在贯彻中医学因人因地制宜的原则,结合新加坡当地环境和小儿的体质特点,提出以祛风宣窍、清肺化痰法作为治疗小儿过敏性鼻炎的主要方法,进一步探讨其临床疗效,为造福儿童健康服务。方法:研究对象为新加坡宜康中医药中心诊治的过敏性鼻炎患儿80例,以随机数字表方法按1:1比例将其分为试验组(A组)和对照组(B组),试验组以祛风宣窍、清肺化痰法为治则组方用药并做小儿推拿,对照组单纯用祛风宣窍、清肺化痰方药治疗,两组均治疗12周。对治疗前后的鼻炎症状及发病程度进行客观评价,通过治疗前后及两组之间积分变化,进行统计学处理,评判两组疗效的差异。结果:两组患儿治疗前性别、年龄、起病病程、病情均无显著性差异,两组具有可比性。经治疗后,A组患儿在喷嚏、流涕、鼻塞、鼻痒、易感风邪、目痒、皮肤瘙痒、皮疹、咳嗽、喉中痰嘶、疲劳、睡眠、食积、舌象情况改善方面明显优于治疗前,在哮喘情况方面无明显差异;经治疗后,B组患儿在喷嚏、流涕、鼻塞、鼻痒、易感风邪、目痒、皮肤瘙痒、皮疹、咳嗽、喉中痰嘶、舌象情况改善方面明显优于治疗前,在哮喘、疲劳、睡眠、食积情况方面无明显差异;两组间对比,经治疗后,A组在喷嚏、鼻塞、喉中痰嘶、疲劳、睡眠、食积情况改善方面优于B组,在流涕、鼻痒、易感风邪、目痒、皮肤瘙痒、皮疹、咳嗽、哮喘、舌象情况改善方面无明显差异。两组总疗效分析A组显著优于B组。两组均未见临床不良反应。结论:祛风宣窍、清肺化痰法是治疗小儿过敏性鼻炎风痰蕴肺证的有效治法,加用推拿治疗疗效更佳。该法有效、安全,使用方便,具有推广应用价值。更多还原

【Abstract】 Allergic rhinitis belonging to Biniu(鼻鼽) in Chinese medicine is one of the most common chronic airway diseases during childhood along with other related disorders such as bronchial asthma,eczema etc.According to epidemiology data,the average incidence rate of allergic rhinitis is about 10%to 25%worldwide and is one of the most common illnesses affecting children health.A research in 2003 by Dr De-Yun Wang of the E.N.T.department in the National University of Singapore,found that 13.1%of the surveyed Singapore population had been affected by allergic rhinitis.Objective:TCM has a long history of the prevention and treatment of allergic rhinitis and has obtained its own advantage and characteristic.This task is to study the clinical effect of the method of "dispelling pathogenic wind(Qufeng-xuanqiao祛风宣窍) and clearing the lung with resolving phlegm(Qingfei-huatan清肺化痰)" in treating children’s allergic rhinitis which is depended on the local condition and children’s constitution in Singapore.Methods:Using a single-blind experiment,80 child-patients with allergic rhinitis in Singapore ECON T.C.M.center were randomly divided into two equal groups of group A and B.For 12 weeks,40 patients in the test group(group A) were treated by Qufeng-xuanqiao and Qingfei-huatan Decoction combined with child massage.While,40 patients in the control group were treated only by Qufeng-xuanqiao and Qingfei-huatan Decoction. After treatment,the difference of scores between pre and post-treatment in the same groups,the difference of terminal scores between two groups were compared and evaluated.Results:The difference between two groups was statistically insignificant(P＞0.05) in terms of sex,age,initiating of disease and course of disease.After treatment,the comparison in the test group(group A) between pre and post-treatment showed significant difference in aspects of symptoms(sneeze,running nose,stuffy nose,tickle on nose,being susceptible of wind.tickle on skin and eyes,rash,cough,sputum,fatigue, slumber,dyspepsia and tongue figure),except asthma.Meanwhile,the comparison in the control group(group B) between pre and post-treatment showed significant difference also in aspects of symptoms(sneeze,running nose,stuffy nose,tickle on nose,being susceptible of wind,tickle on skin and eyes,rash,cough,sputum and tongue figure),except asthma,fatigue,slumber and dyspepsia.The comparison between the two groups showed significant difference in aspects of symptoms(sneeze,stuffy nose,sputum,fatigue,slumber and dyspepsia),except running nose,tickle on nose,being susceptible of wind,tickle on skin and eyes,rash,cough,asthma and tongue figure,which was better in the test group(group A) than in the control group(group B).Both groups displayed signs of recovery and reduction of the frequency of rhinitis attacks without side effects.Conclusion:Qufeng-xuanqiao and Qingfei-huatan Decoction combined with child massage is an effective,safe,and practical method of improving allergic rhinitis symptoms and relieving the severity of rhinitis attacks.更多还原