| Theoretical,clinical studies on the treatment of Combined Allergic Rhinitis and Asthma Syndrome(CARAS)by TCM were made systematically in this paper.In theoretical study,this paper induced and arranged the principle-method-recipe-medicines opions of physicians through the ages about CARAS,and recent research rrogress of CARAS in Chinese and western medicine in recent ten years.The main method and essence of western medicine for the treatment of upper and lower respiratory tract which combine with anti-inflammatory and anti-allergic reactions is symptomatic treatment.It is deserved to be studied further to understand the corresponding principles of traditional Chinese medicine adequately,optimize the prescription,evaluate the efficacy and safety,and even expand the characteristic diagnosis of traditional Chinese medicine.As a result,further theoretical exploration leaded to the conclusion that the basic pathogenesis of non-remission CARAS is Qi of FengMu dwelling in lungs,including endogenous wind planted in eight extra-channel and exogenous wind-evil triggered off outside,which the foundation of scientific hypothesis and innovation points in this paper.So in clinical research,this study hopes to work on the basis of researches in the past according to ideology and treatment of Professor Hongsheng Cui,especially for his famous Chinese medicine formulae.Hence,the study changes Sangmeizhike Decoction into Cangersangmei Decoction.The formula above aimed at the treating syndrome of "wind and wood from Jueyin attacking lung ".This study regards the case control as the main body,so we can be committed to evaluate and improve the relevant mechanism,principle,formulae and medicine under the guidance of the thought we have mentioned.Besides,we can reveal syndrome characteristics,check against types and elements of syndrome and make a primary inquiry of nose and skin of thenar region’s inspection by standardized methods.A controlled study is conducted on the enrolled patients.The experimental group is given not only the standardized treatment of budesonide formoterol powder inhalation and montelukast sodium tablets,but also the "Cangersangmei Decoction " Chinese medicine granules for 14 days under the guidance of the viewpoint of "wind and wood from Jueyin attacking lung’’ pathogenesis.However,the control group is only given standardized Western medicine treatment.The clinical outcome evaluation is based on the TCM syndrome score,symptom scores relating to rhinitis,lung function,ACT score and other scales.This study chooses the outcome indicators and analyzes statistics to explore the effectiveness and safety of "Cangersangmei Decoction".Besides,the study establishes norms of CARAS syndrome types and related observation tables of TCM as standard and basis and identifies types and elements of syndrome in accordance with Chinese Medical Association’s Asthma Syndrome Pattern standards.For the above-mentioned syndrome information,statistical methods are used to analyze the distribution characteristics of types and elements of CARAS’s syndrome.For the case of nose and skin of thenar region’s inspection,the study collects information about types and elements of CARAS’s syndrome acquisition normalized by inspection to figure out the feasibility and room for improvement of those diagnostic methods.The results obtained are as follows:In terms of syndrome distribution study,the group of patients with "wind and phlegm obstructed in lung" syndrome account for 41.79%,patients with "phlegm and heat obstructed in lung" syndrome account for 5.22%,patients with "cold drink" syndrome account for 4.48%,patients with "phlegm turbid obstructed in lung" syndrome account for 2.24%,patients with "lung Qi deficiency" syndrome account for 38.81%,patients with "lung and kidney Yang deficiency" syndrome account for 5.22%,patients with "lung and spleen Qi deficiency" syndrome account for 0.75%,and patients with "lung and kidney Qi deficiency" syndrome account for 1.49%.patients with "phlegm turbid obstructed in lung" syndrome account for 2.24%.As for syndrome of nose inspection,there are exogenous wind syndrome(39.55%),internal wind syndrome(38.81%),lung heat syndrome(5.97%),yang deficiency syndrome(4.48%),and other cases(11.19%).In addition,syndromes of thenar region’s skin inspection conclude exogenous wind syndrome(47.01%),internal wind syndrome(38.81%)and other cases(14.18%).Both exogenous wind and internal wind syndrome predominate.Those syndromes of nasal inspection of exogenous wind syndrome,lung heat syndrome,internal wind syndrome,yang deficiency syndrome have no difference from the corresponding standard syndrome types.It is considered that the syndrome diagnosis of the nose is feasible.By comparing the standard "exogenous wind" syndrome with "wind and phlegm obstructed in lung" syndrome,the results of the syndromes of thenar region’s skin inspection are different to identify that "exogenous wind" syndrome of thenar inspection is not feasible.On the contrary,the results of those syndromes have no difference between internal wind syndrome with the standard one.It is considered feasible and the treatment group ’s efficacy is superior to the control group.In terms of efficacy evaluation,both the treatment group and the control group have a decrease in individual scores such as wheezing,coughing,sneezing,nasal itching,chest tightness,expectoration,nasal congestion,runny nose,itching throat,and itching eyes during the two period before and after treatment.After treatment,the treatment group is better than the control group in reducing wheezing,coughing,sneezing,nasal itching,chest tightness,nasal congestion,runny nose and itching throat.After treatment,there is no significant difference between the treatment group and the control group in reducing the individual scores of coughing and itching eyes(P>0.05).The reduction of total scores of TCM syndromes and the overall efficacy is more obvious in the treatment group than in the control group.The treatment group has the better curative effect than the control group.The ACT score improvement and control level were improved,and the treatment group is superior to the control group on ACT score’s improvement.As for the improvement of lung function index,the FEV1(%)and PEF(%)of the treatment group is better than the control group,but there is no significant difference in FVC(%).The results of the above theoretical and clinical studies show that:CARAS’s syndrome performance is based on exogenous wind syndrome and internal wind syndrome.In this study,the nasal observation method can be applied to the syndrome diagnosis of CARAS.The syndromes of thenar region’s skin inspection is feasible for the syndrome differentiation of the internal wind syndrome,while which is still not feasible for the syndrome differentiation of the exogenous wind syndrome and needs further research and improvement."wind and wood from Jueyin attacking lung" The applications of Cangersangmei Decoction,directed by ideology of "wind and wood from Jueyin attacking lung" can effectively alleviate rhinitis and asthma symptoms of the CARAS,enhance the overall efficacy,promote ACT scores and improve lung function related indicators.The safety indicators before and after treatment are stable.Besides,there are no adverse reaction events in the process,which can be widely used in clinical practice. |
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