中医杂志

目的 观察隔蒜药物铺灸治疗对肺经伏热型变应性鼻炎（AR）患者的疗效并探讨可能的作用机制。方法 将70名肺经伏热型AR患者随机分为氯雷他定组（35例）和铺灸组（35例）。氯雷他定组采用氯雷他定片口服治疗，每次10 mg，每日1次，1周为1个疗程，连续治疗4个疗程。铺灸组进行隔蒜药物铺灸治疗，每天1次，7次为1个疗程，连续治疗4个疗程。主要结局指标为鼻部症状总评分（TNSS），分别于治疗前后及治疗结束1个月随访时进行评价；次要结局指标包括中医证候积分、免疫球蛋白E (IgE)水平及嗜酸性粒细胞（EOS）水平，分别于治疗前后评价；并根据TNSS治疗前后的变化情况评定疗效。观察并记录患者治疗过程中的不良反应及不良事件，并进行安全性评价。结果 最终两组各33例纳入结果分析。两组患者临床疗效比较，铺灸组总有效率93.94%(31例/33例)优于氯雷他定组的75.76%(25例/33例)，差异有统计学意义（P<0.05）。两组治疗后TNSS、中医证候积分、IgE、EOS均较治疗前降低（P<0.05或P<0.01），且铺灸组均低于氯雷他定组（P<0.05）。随访时铺灸组TNSS亦低于氯雷他定组患者（P<0.05）。治疗过程中，铺灸组有1例患者出现气短，氯雷他定组有1例出现头痛，均症状轻微，对症处理后均继续治疗。结论 隔蒜药物铺灸治疗能够减轻患者鼻腔炎性症状，缓解AR患者过敏反应，有效控制AR发作及相关炎症反应，疗效优于单纯氯雷他定片口服治疗，且安全性较好。

Objective To observe the clinical effect of garlic moxibustion with herbal medicinals in treating allergic rhinitis(AR) with latent heat in lung meridian and explore the potential mechanisms. Methods A total of 70 AR patients with the latent heat in lung meridian were randomly divided into loratadine group(35 cases) and moxibustion group(35 cases). The loratadine group was treated with loratadine tablets orally, 10mg each time, once a day, one week as a course for 4 courses. The moxibustion group received garlic moxibustion with herbal medicinals once a day, 7 times as one course, for a total of 4 courses. The primary outcome was total nasal symptom score(TNSS), measured before and after treatment, and at the 1-month follow-up. Secondary outcomes included traditional Chinese medicine(TCM) syndrome score, immunoglobulin E(IgE) level and eosinophils(EOS) level before and after 4weeks of treatment. Efficacy was evaluated based on the changes in TNSS after treatment. Adverse reactions and events during treatment were observed, and safety evaluation was performed. Results A total of 33 patients from each group were included in the final analysis. The moxibustion group had a total effective rate of 93. 94%(31/33), significantly higher than the 75. 76%(25/33) of the loratadine group(P<0. 05). After treatment, both groups showed a significant reduction in TNSS, TCM syndrome score, IgE and EOS levels(P<0. 05 or P<0. 01), and more reductions were seen in the moxibustion group(P<0. 05). During follow-up, the moxibustion group also had a lower TNSS than the loratadine group(P<0. 05). During treatment, one patient in the moxibustion group experienced shortness of breath, and one patient in the loratadine group experienced headache. Both symptoms were mild and improved after symptomatic treatment, allowing them to continue the treatment. Conclusion Garlic moxibustion with herbal medicinals can alleviate nasal inflammatory symptoms, reduce allergic reactions in AR patients, and effectively control AR flare-ups and related inflammatory responses, superior to oral loratadine alone and of good safety.