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儿童过敏性鼻炎的中医治疗临床实践指南

Clinical practice guidelines for the treatment of allergic rhinitis in children with traditional Chinese medicine.

作者信息

Feng Lu, Lin Lili, Wang Shouchuan, Zhao Xia, Dai Qigang, Wang Lei, Yang Yan, Xu Ling, Liu Yuling, An Li, Shen Cunsi

机构信息

Jiangsu Key Laboratory of Pediatric Respiratory Disease, Institute of Pediatrics, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.

Medical Metabolomics Center, Nanjing University of Chinese Medicine, Nanjing, China.

出版信息

Anat Rec (Hoboken). 2021 Nov;304(11):2592-2604. doi: 10.1002/ar.24718. Epub 2021 Jul 29.

Abstract

Allergic rhinitis (AR) is one of the most common allergic diseases in children and it can lead to physical and mental health problems. Traditional Chinese medicine (TCM) plays an important role in understanding the phenotypes and treatment of AR. However, there are currently no normative clinical practice guidelines (CPGs) for the treatment of AR in children. The study aimed to develop an evidence-based CPG for the treatment of AR in children with TCM. Systematic literature research, expert questionnaire, and clinical evaluation after three rounds of surveys were adopted to form recommendations for treating children with AR using the Delphi method. Depending on the clinical manifestations, we finally recommended two decoctions with two Chinese patent medicines for an acute attack of AR and two decoctions for a chronic period of AR. For the acute attack of AR in children, Xinyi Qingfei decoction, Wenfei Zhiliu decoction, Xinqin granules, and Xinyi Biyan pills were suggested, whereas for the chronic period of AR, Buzhong Yiqi and Jingui Shenqi decoctions were recommended. The four external treatment methods suggested for the prevention and care of AR were body acupuncture, moxibustion, auricular point pressing, and acupoint application. The recommended levels of the suggested TCM strategies ranged from Grade B to D, indicating the weakness of the recommendations. TCM has the potential to offer new insights into phenotypes and the management of AR worldwide; however, more high-quality clinical studies are needed to improve the quality of evidence.

摘要

变应性鼻炎(AR)是儿童最常见的过敏性疾病之一,可导致身心健康问题。中医在认识AR的表型和治疗方面发挥着重要作用。然而,目前尚无针对儿童AR治疗的规范性临床实践指南(CPG)。本研究旨在制定基于证据的儿童AR中医治疗CPG。采用系统文献研究、专家问卷和三轮调查后的临床评估,运用德尔菲法形成儿童AR治疗建议。根据临床表现,我们最终推荐了两种汤剂加两种中成药用于AR急性发作期,以及两种汤剂用于AR慢性期。对于儿童AR急性发作期,建议使用辛夷清肺汤、温肺止流汤、辛芩颗粒和辛夷鼻炎丸,而对于AR慢性期,推荐使用补中益气汤和金匮肾气汤。推荐的预防和护理AR的四种外治疗法为体针、艾灸、耳穴按压和穴位贴敷。所建议的中医策略推荐级别从B级到D级,表明这些建议的力度较弱。中医有可能为全球范围内AR的表型和管理提供新的见解;然而,需要更多高质量的临床研究来提高证据质量。

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