【摘要】 目的 观察曲安奈德注射液足三里穴位注射治疗非过敏性鼻炎的临床疗效并探讨其作用机制。方法 随机选取非过敏性鼻炎（non-allergic rhinitis, NAR）与过敏性鼻炎（allergic rhinitis, AR）门诊患者各50例，均予以双侧足三里穴位注射曲安奈德注射液治疗，每周1次，连续注射4周。治疗前后检测患者Th1、Th2相关因子水平；观察两组治疗4周时、3月后以及1年后随访期间的鼻部症状总评分(TNSS)变化，比较分析两组近期疗效和远期疗效。结果 NAR组与AR组在治疗4周结束时、疗后3月及1年随访期间的TNSS均比治疗前明显下降（P<0.05）。NAR组与AR组患者治疗4周后的血清白介素-2(IL-2)、干扰素-γ(INF-γ)、肿瘤坏死因子（TNF）水平均比治疗前上升（P<0.05），白介素-4 (IL-4)则较治疗前显著下降（P<0.05）。治疗4周后NAR组有效率84.0%,AR组有效率92.0%。随访期间，疗后3月NAR组有效率72.0%,AR组有效率64.0%，两组疗效差异无统计学意义（P>0.05）;1年后，NAR组总有效率54.0%,AR组总有效率30.0%,NAR组总有效率显著高于AR组（P<0.05）。结论 足三里穴位注射治疗NAR远期疗效更佳，对脾气虚弱和肺气虚寒型的治疗有效率更高。其机制可能与提升Th1细胞因子的分泌并抑制IL-4的产生，从而调节Th1/Th2的稳定状态相关。更多还原

【Abstract】 Objective To investigate the therapeutic effect of acupoint injection into Zusanli(ST36) with triamcinolone acetonide on patients with non-allergic rhinitis(NAR) and its effect mechanism. Methods A total of 100 cases with NAR or AR were randomly selected from outpatient cases, with 50 in each group. Triamcinolone acetonide injection was injected into acupoint Zusanli(ST36) on both sides of all cases in both groups, once a week and lasted for 4 weeks. The levels of Th1 and Th2 cytokines were determined before and after treatment among them respectively. At the same time, the total score of nasal symptoms(TNSS) was recorded at these time points as by the ends of the 4thweek during the therapeutic course, the 3rd months after the treatment and 1 year during the following up period to evaluate their differences in the short-term and long-term efficacies between the two groups in a comparative way. Results There were significant improvement in TNSS among cases in both groups following the treatment lasted for 4 weeks, by the ends of the3rd month and 1 year after treatment(P<0.05), significantly decreased when compared with that measured before treatment. The serum levels of interleukin-2(IL-2), interferon-γ(INF-γ) and tumor necrosis factor(TNF) were significantly increased in 2 groups following treatment(P<0.05), while that of interleukin-4(IL-4) was significantly decreased after treatment, when compared with that determined before treatment(P<0.05). By the end of the 4th week of therapeutic course, the effective rate evaluated was 84.0% in the NAR group and 92.0% in the AR group, while it was 72.0% in NAR group and 64.0% in AR group respectively during the follow-up period by the end of the 3rd month, with no statistically significant difference between these two groups(P>0.05). However, the total effective rate of 54.0% in NAR group was significantly higher than that of 30.0% in AR group, with a statistically significant difference between them(P<0.05) by the end of the following up period lasted for one year. Conclusion Zusanli acupoint injection holds better long-term efficacy in the treatment of NAR, especially for those cases with the patterns of Spleen Qi weakness or Lung Qi deficiency and cold.The mechanism may be associated with the regulatory effect of it on Th1/Th2 balance by increasing the serum levels of Th1 cytokines and decreasing that of IL-4.更多还原