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 (P<0.05), and serum NPY content was increased (P<0.05) after treatment in the 3 groups. After treatment, the observation indexes in the intranasal acupuncture group were significantly improved (P<0.05) than those in the western medication group. The observation indexes of the combination group were better (P<0.05) than those of the other 2 groups. The total effective rate of the combination group (40/45, 88.89%) was higher (P<0.05) than that of the intranasal acupuncture group (35/45, 77.78%) and higher (P<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: 观察鼻内针刺联合调神针对中重度持续性变应性鼻炎（AR）患者的治疗效果，同时探讨其调控炎性反应的机制。方法: 将135例持续性AR患者随机分为西药组45例、鼻内针刺组45例、联合组45例。西药组采用布地奈德鼻喷雾剂治疗；鼻内针刺组采用鼻内针刺治疗，取穴内迎香、鼻丘，每次20 min；联合组采用鼻内针刺联合调神针治疗，调神针取穴百会、四神聪、大陵、神门、印堂、神庭、安眠、迎香，每次20 min。各组均每日治疗1次，连续2周。分别观察各组治疗前后鼻部症状总积分（TNSS）、鼻部伴随症状总分量表（TNNSS）、鼻结膜炎生存质量量表（RQLQ）、焦虑自评量表（SAS）、抑郁自评量表（SDS）评分。用ELISA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）、血管活性肠肽（VIP）含量。用体液血液分析仪检测外周静脉血中的嗜酸性粒细胞（EOS）数量。评价3组的临床疗效。结果: 与本组治疗前比较，3组患者治疗后TNSS、TNNSS、RQLQ、SAS、SDS评分及EOS数量、IgE、SP、VIP含量均降低（P<0.05），血清NPY含量升高（P<0.05）。治疗后，鼻内针刺组患者TNSS、TNNSS、RQLQ、SAS、SDS评分及EOS数量、IgE、SP、VIP含量较西药组降低（P<0.05），血清NPY含量较西药组升高（P<0.05）；联合组患者TNSS、TNNSS、RQLQ、SAS、SDS评分及EOS数量、IgE、SP、VIP含量较其他两组降低（P<0.05），血清NPY含量较其他两组升高（P<0.05）。联合组总有效率（40/45，88.89%）高于（P<0.05）鼻内针刺组（35/45，77.78%）和西药组（33/45，73.33%）。结论: 鼻内针刺联合调神针可改善AR患者鼻部临床症状及伴随症状，降低EOS、IgE，抑制超敏反应的形成，同时调控神经肽分泌，缓解焦虑抑郁负性情绪。.
Keywords: Allergic rhinitis; Clinical efficacy; Intranasal acupuncture; Tiaoshen (spirit-regulation) acupuncture.