针刺蝶腭神经节治疗变应性鼻炎的多中心病例系列研究

doi:10.3969/j.issn.1006-7795.2019.06.019

首都医科大学学报 ›› 2019, Vol. 40 ›› Issue (6): 916-920.doi: 10.3969/j.issn.1006-7795.2019.06.019

针刺蝶腭神经节治疗变应性鼻炎的多中心病例系列研究

张鹏¹, 杨威¹, 王奎吉¹, 谭翊¹, 商晓娟¹, 舒凝², 汪芗³, 许世闻⁴, 孙三峰⁵, 赵新雨⁶, 於堃⁷, 陈陆泉¹

1. 首都医科大学附属北京同仁医院针灸科, 北京 100010;
2. 北京汇安中西医结合医院针灸科, 北京 100071;
3. 北京市通州区中西医结合医院针灸科, 北京 101149;
4. 北京市平谷区中医医院针灸科, 北京 101200;
5. 北京市怀柔区中医医院针灸科, 北京 101400;
6. 北京市朝阳区中医医院针灸科, 北京 100020;
7. 首都医科大学附属复兴医院月坛社区卫生服务中心, 北京 100032

收稿日期:2019-03-25 出版日期:2019-11-21 发布日期:2019-12-18
通讯作者: 陈陆泉 E-mail:chenluquan@hotmail.com
基金资助:
北京市优秀人才资助（青年骨干）项目（2014000021469G263），鼻病研究北京市重点实验室开放课题（2014BBYJ01）。

A multi-center prospective case series study on the treatment of allergic rhinitis by acupuncture of sphenopalatine ganglion

Zhang Peng¹, Yang Wei¹, Wang Kuiji¹, Tan Yi¹, Shang Xiaojuan¹, Shu Ning², Wang Xiang³, Xu Shiwen⁴, Sun Sanfeng⁵, Zhao Xinyu⁶, Yu Kun⁷, Chen Luquan¹

1. Department of Acupuncture-Moxibustion, Beijing Tongren Hospital, Capital Medical University, Beijing 100010, China;
2. Department of Acupuncture-Moxibustion, Beijing Hui'an Integrated Hospital of Traditional Chinese and Western Medicine, Beijing 100071, China;
3. Department of Acupuncture-Moxibustion, Beijing Tongzhou District Integrated Hospital of Traditional Chinese and Western Medicine, Beijing 101149, China;
4. Department of Acupuncture-Moxibustion, Beijing Pinggu District Hospital of Traditional Chinese Medicine, Beijing 101200, China;
5. Department of Acupuncture-Moxibustion, Beijing Huairou District Hospital of Traditional Chinese Medicine, Beijing 101400, China;
6. Department of Acupuncture-Moxibustion, Beijing Chaoyang District Hospital of Traditional Chinese Medicine, Beijing 100020, China;
7. Yuetan Community Health Service Center, Fuxing Hospital, Capital Medical University, Beijing 100032, China

Received:2019-03-25 Online:2019-11-21 Published:2019-12-18
Supported by:
This study was supported by Beijing Talents of Youth Backbone(2014000021469G263),The Open Project of Beijing Key Laboratory of Management Research(2014BBYJ01).

摘要/Abstract

摘要： 目的初步评价针刺蝶腭神经节治疗变应性鼻炎（allergic rhinitis，AR）的临床疗效。方法采用病例系列研究设计，自2017年4月至2018年6月分别于7个分中心纳入222例过敏性鼻炎患者予针刺蝶腭神经节治疗，各分中心之间纳入患者的基线一致，每周1次，共4次。分别于治疗前、治疗第2、3、4、8周进行鼻炎症状量表（total nasal symptom score，TNSS）和鼻炎伴随症状量表（total nonnasal symptom score，TNNSS）评价，于治疗前、治疗第4、8周进行鼻结膜炎生活质量调查问卷标准版（rhinconjunctivitis quality of life questionnaire，RQLQ）评价。结果 222例患者中有1例失访，纳入统计的有效量表分别为221份TNSS、218份TNNSS、213份RQLQ。患者TNSS量表和TNNSS量表评分自针刺第2周开始持续下降至第8周（治疗结束后4周，观察结束时点），RQLQ量表评分在第4周或此前即明显降低，并于第8周进一步下降，差异均具有统计学意义。1例患者出现面颊肿胀的轻微不良反应。在8周的观察期内，AR患者的控制率超过80%。结论初步证明针刺蝶腭神经节治疗AR有效、安全、具备推广的可行性。进一步研究将增加客观指标评价、补充针刺即刻效应观察，细化可能的不良反应种类，延长随访时间，明确不同刺激方式对AR治疗效果的影响，规范针刺方案，优化患者就诊体验。

关键词: 蝶腭神经节, 针刺疗法, 变应性鼻炎, 病例系列研究, 中西医结合

Abstract: Objective To evaluate the clinical efficacy of acupuncture on sphenopalatine ganglion in the treatment of allergic rhinitis (AR). Methods Totally 222 patients with allergic rhinitis were enrolled in 7 sub-centers from April 2017 to June 2018. The baseline of the patients was the same among the sub-centers, once a week for 4 times. Total nasal symptom score (TNSS) and total nonnasal symptom score (TNNSS) were evaluated before treatment, 2, 3, 4 and 8 weeks, respectively. Rhinconjunctivitis quality of life questionnaire (RQLQ) was evaluated before treatment, 4 and 8 weeks. Results One of 222 patients was lost to follow-up. Totally 221 TNSS, 218 TNNSS and 213 RQLQ were included in the effective scale. The scores of patients' TNSS scale and TNNSS scale decreased continuously from the 2^nd week of acupuncture to the 8^th week (4 weeks after the end of treatment, the end point of observation). The scores of RQLQ scale decreased significantly at the 4^th week and continued to decrease to the 8^th week. The differences were statistically significant. One patient had mild adverse reaction of cheek swelling. During the 8-week observation period, the control rate of AR patients exceeded 80%. Conclusion Acupuncture of sphenopalatine ganglion is effective, safe and can be popularized in the treatment of AR. Further research will increase objective index evaluation, supplement observation of immediate effect of acupuncture, refine the types of possible adverse reactions, prolong the follow-up time, clarify the effect of different stimulation methods on AR treatment effect, standardize the acupuncture program, and optimize the patient's treatment experience.

Key words: sphenopalatine ganglion, acupuncture therapy, allergic rhinitis, case series study, integrated traditional Chinese and Western Medicine

中图分类号:

R765.21

张鹏, 杨威, 王奎吉, 谭翊, 商晓娟, 舒凝, 汪芗, 许世闻, 孙三峰, 赵新雨, 於堃, 陈陆泉. 针刺蝶腭神经节治疗变应性鼻炎的多中心病例系列研究[J]. 首都医科大学学报, 2019, 40(6): 916-920.

Zhang Peng, Yang Wei, Wang Kuiji, Tan Yi, Shang Xiaojuan, Shu Ning, Wang Xiang, Xu Shiwen, Sun Sanfeng, Zhao Xinyu, Yu Kun, Chen Luquan. A multi-center prospective case series study on the treatment of allergic rhinitis by acupuncture of sphenopalatine ganglion[J]. Journal of Capital Medical University, 2019, 40(6): 916-920.

参考文献

[1] 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组,中华医学会耳鼻咽喉头颈外科学分会鼻科学组.变应性鼻炎诊断和治疗指南(2015年,天津)[J].中华耳鼻咽喉头颈外科杂志,2016,51(1):6-24.
[2] 李新吾.针刺蝶腭神经节——"治鼻3"穴位治疗鼻部疾病的机制分析及有关针刺方法的介绍[J].临床耳鼻咽喉头颈外科杂志,2011,25(5):193-196.
[3] 张路,杨威,王克键.针刺蝶腭神经节治疗慢性单纯性鼻炎71例[J].中国针灸,2013,33(6):495-496.
[4] 张燕超. 针刺治疗过敏性鼻炎的临床疗效观察[D].北京:北京中医药大学,2013.
[5] 陈陆泉,杨宇洋,杨威.通过蝶腭神经节治疗变应性鼻炎的临床研究进展[J].北京中医药,2012,31(8):631-633.
[6] 李新吾,田平忠.治疗鼻炎新法"针刺蝶腭神经节"的初步总结[J].北京中医,1990(4):36-38.
[7] Undem B J,Taylor-Clark T. Mechanisms underlying the neuronal-based symptoms of allergy[J].J Allergy ClinImmunol,2014,133(6):1521-1534.
[8] Zhao C, Ji Y, An Y, Xue J, et al. An alternative method of endoscopic intrasphenoidal vidian neurectomy[J].OTO Open, 2018,2(1):2473974X1876-4862.
[9] Ikeda K, Yokoi H, Saito T, et al. Effect of resection of theposterior nasal nerve on functional and morphological changes in the inferior turbinate mucosa[J].Acta Otolaryngol,2008,128(12):1337-1341.
[10] 王奎吉,陈陆泉,王阳,等.针刺蝶腭神经节对正常人鼻腔神经功能的影响[J].中国耳鼻咽喉头颈外科,2016,23(8):483-486.
[11] 王奎吉,陈陆泉,王阳,等.针刺蝶腭神经节对正常青年人鼻腔通气功能影响的研究[J].临床军医杂志,2016,44(8):801-804.
[12] 许庆庆,段甦,王向东,等.鼻中隔偏曲矫正对变应性鼻炎患者治疗效果的Meta分析[J].首都医科大学学报,2018,39(6):928-932.
[13] 袁媛,姜长青,陈玥,等.神经调控技术的发展与展望[J].生命科学仪器,2018,16(Z1):20-28,70.
[14] 王奎吉,陈陆泉,王阳. 针刺蝶腭神经节对正常青年人鼻腔通气功能影响的研究[J].临床军医杂志,2016,44(8):801-804.
[15] Wang K, Chen L, Wang Y, et al. Sphenopalatine ganglion acupuncture improves nasal ventilation and modulates autonomic nervous activity in healthy volunteers:a randomized controlled study[J]. Sci Rep,2016,6:29947.
[16] Chen L, Chen J, Fu Q, et al. Chinese Society of Allergy Guidelines for diagnosis and treatment of allergic rhinitis[J]. Allergy, Asthma Immunol Res,2018,10(4):300-353.

针刺蝶腭神经节治疗变应性鼻炎的多中心病例系列研究

A multi-center prospective case series study on the treatment of allergic rhinitis by acupuncture of sphenopalatine ganglion

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