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目的探讨在中-重度持续性变应性鼻炎(PAR)患者中应用玉屏风颗粒联合布地奈德鼻喷剂治疗的临床疗效及作用机制。方法 86例症属气虚不固的中-重度持续性变应性鼻炎患者,随机分成治疗组和对照组,每组43例。治疗组采用玉屏风颗粒口服+布地奈德鼻喷剂治疗,对照组单纯使用布地奈德鼻喷剂治疗。在治疗前、治疗4周及治疗12周后分别进行病情及相关指标的评估。结果两组患者治疗4周后,症状和体征总分均较治疗前显著下降,差异具有统计学意义(P<0.05),但两组间比较,差异无统计学意义(P>0.05)。治疗12周后,治疗组中-重度症状发作患者7例(16.28%),对照组中-重度症状发作患者18例(41.86%),治疗组少于对照组,差异具有统计学意义(χ2=6.824,P<0.05)。两组患者治疗4周后,鼻腔分泌物中白细胞介素(IL)-4、IL-5含量较治疗前显著降低,差异具有统计学意义(P<0.05),但组间比较差异无统计学意义(P>0.05)。治疗12周后,治疗组显著低于对照组,差异具有统计学意义(P<0.05)。结论玉屏风颗粒联合布地奈德鼻喷剂治疗症属气虚不固的中-重度持续性变应性鼻炎患者临床疗效显著,可获得更加稳定而持久的症状控制期,提高药物远期治疗效果。
Objective To investigate the clinical efficacy and mechanism of Yupingfeng granule combined with budesonide nasal spray in patients with moderate-severe persistent allergic rhinitis (PAR). Methods A total of 86 patients with moderate-severe persistent allergic rhinitis with deficiency of Qi were randomly divided into treatment group and control group, with 43 cases in each group. The treatment group was treated with Yupingfeng granule oral budesonide nasal spray and the control group with budesonide nasal spray alone. Before treatment, after 4 weeks of treatment and after 12 weeks of treatment, respectively, the assessment of the disease and related indicators. Results After 4 weeks of treatment, the total score of symptoms and signs in both groups decreased significantly compared with that before treatment (P <0.05), but there was no significant difference between the two groups (P> 0.05). After 12 weeks of treatment, there were 7 cases (16.28%) in the treatment group and 18 cases (41.86%) in the control group with moderate-severe symptoms, the treatment group was less than the control group, the difference was statistically significant (χ2 = 6.824, P <0.05). After 4 weeks of treatment, the levels of IL-4 and IL-5 in nasal secretions were significantly lower than those before treatment (P <0.05), but there was no significant difference between the two groups Significance (P> 0.05). After 12 weeks of treatment, the treatment group was significantly lower than the control group, the difference was statistically significant (P <0.05). Conclusion Yupingfeng granule combined with budesonide nasal spray treatment of patients with moderate-to-severe persistent allergic rhinitis is significant clinical efficacy, access to more stable and lasting control of symptoms, improve long-term drug treatment.