鼻针联合调神针法治疗中重度持续性变应性鼻炎的临床疗效

Dong Bo-Yang, Li Bing-Quan, Li Yan

Heilongjiang University of Chinese Medicine, Harbin 150040, China.

Department of Otorhinolaryngology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin 150040.

Zhen Ci Yan Jiu. 2024;49(9):964-971. doi: 10.13702/j.1000-0607.20230959.

OBJECTIVES

To observe the therapeutic effect of intranasal acupuncture combined with Tiaoshen (spirit-regulation) acupuncture for patients with moderate-to-severe persistent allergic rhinitis (AR), and to explore its mechanism of anti-inflammation.

METHODS

135 patients with persistent AR were randomly divided into western medicine group, intranasal acupuncture group, and combination group, with 45 cases in each group. The western medicine group was treated with budesonide nasal spray, 1 press (32 μg/press) in each nostril, once a day. Patients in the intranasal acupuncture group were treated with intranasal acupuncture at the Neiyingxiang (EX-HN9) and Biqiu (nasal hillock) for 20 min. Patients in the combination group were treated with intranasal acupuncture combined with spirit-regulation acupuncture at Baihui (GV20), Sishencong (EX-HN1), Daling (PC7), Shenmen (HT7), Yintang (GV24), Shenting (GV24), Anmian, and Yingxiang (LI20) for 20 min. Each group was treated once daily for 2 weeks. Total nasal symptom score (TNSS), total non-nasal symptom score (TNNSS), rhinoconjunctivitis quality of life questionnaire (RQLQ), self-assessment scale of anxiety (SAS), and self-assessment scale of depression (SDS) were observed before and after treatment respectively. Serum total immunoglobulin E (IgE), substance P (SP), neuropeptide Y (NPY), and vasoactive intestinal peptide (VIP) levels were detected before and after treatment using ELISA. The number of eosinophil (EOS) in peripheral venous blood was detected using a blood analyzer. The clincial efficacy of the 3 groups was evaluated.

RESULTS

Compared with those before treatment, TNSS, TNNSS, RQLQ, SAS, SDS scores, EOS number and serum IgE, SP and VIP contents were decreased (<0.05), and serum NPY content was increased (<0.05) after treatment in the 3 groups. After treatment, the observation indexes in the intranasal acupuncture group were significantly improved (<0.05) than those in the western medication group. The observation indexes of the combination group were better (<0.05) than those of the other 2 groups. The total effective rate of the combination group (40/45, 88.89%) was higher (<0.05) than that of the intranasal acupuncture group (35/45, 77.78%) and higher (<0.05) than that of the western medication group (33/45, 73.33%).

CONCLUSIONS

Intranasal acupuncture combined with spirit-regulation acupuncture can improve the nasal clinical symptoms and accompanying symptoms of AR patients, reduce EOS and IgE, as well as regulate the secretion of neuropeptide and relieve the negative emotions of anxiety and depression.

目的

观察鼻针联合调神针法治疗中重度持续性变应性鼻炎（AR）患者的疗效，并探讨其抗炎机制。

方法

将135例持续性AR患者随机分为西药组、鼻针组和联合组，每组45例。西药组采用布地奈德鼻喷雾剂治疗，每侧鼻孔1揿（32μg/揿），每日1次。鼻针组采用鼻针针刺内迎香（EX-HN9）、鼻丘治疗20分钟。联合组采用鼻针联合调神针法针刺百会（GV20）、四神聪（EX-HN1）、大陵（PC7）、神门（HT7）、印堂（GV24）、神庭（GV24）、安眠、迎香（LI20）治疗20分钟。每组每日治疗1次，共2周。分别观察治疗前后的总鼻症状评分（TNSS）、总非鼻症状评分（TNNSS）、鼻结膜炎生活质量问卷（RQLQ）、焦虑自评量表（SAS）和抑郁自评量表（SDS）。采用酶联免疫吸附测定法检测治疗前后血清总免疫球蛋白E（IgE）、P物质（SP）、神经肽Y（NPY）和血管活性肠肽（VIP）水平。采用血液分析仪检测外周静脉血嗜酸性粒细胞（EOS）数量。评价3组的临床疗效。

结果

与治疗前比较，3组治疗后TNSS、TNNSS、RQLQ、SAS、SDS评分、EOS数量及血清IgE、SP和VIP含量均降低（<0.05），血清NPY含量升高（<0.05）。治疗后，鼻针组的观察指标较西药组明显改善（<0.05）。联合组的观察指标优于其他2组（<0.05）。联合组的总有效率（40/45，88.89%）高于鼻针组（35/45，77.78%），且高于西药组（33/45，73.33%）（<0.05）。