A Series Of Reports On The Treatment Of Adult Allergic Rhinitis-asthma Syndrome By The Method Of Yiwenwenyang And Tongqiao To Relieve Asthma

Objectives:The World Allergy Organization(WAO)had formally proposed the new medical diagnostic terms of Combined Allergic Rhinitis and Asthma Syndrome(CARAS),which is mainly manifested aschronic inflammation existed simultaneously of upper and lower respiratory tract and high reactivity symptoms,including nasal itching frequently,flow nose,nasal congestion,sneezing,coughing and wheezing.Studies show that 60%～78%of asthma patients with allergic rhinitis,20%～38%of allergic rhinitis with bronchial asthma.Western medicine has recommended upper and lower respiratory tract with anti-inflammatory therapy,giving priority to with inhaled corticosteroids.But the low awareness of CARAS,non-standard diagnosis and treatment,poor compliance with hormone,and other side effects of western medicine influence the effect of diagnosis and therapy.therefore,looking for a safe and effective treatment of TCM has becoming the top priority.During the long-term clinical practice,supervisor Tang Xuechun has found adult some characteristics of CRARS with" insufficiency of lung and spleen,phlegm damages lung,lung fails to perfuse and downbearing",and putted forward the principle of "reinforcing qi and worming yang,diffusing the lung to calm panting",and used "shenge canglong plus(minus)decoction "as the treatment,which shows can obviously improve the symptom of the patients with upper and lower respiratory tract,reducing frequency of acute episodes.On the basis of joint diagnosis model,using accepted observational studies both at home and abroad and report specification,the research carrys out a observational study of"reinforcing qi and worming yang,diffusing the lung to calm panting" treatment,and chooses internationally recognized effect evaluation,to objective evaluation the clinical curative effect of TCM treatment of the disease and the possible mechanism of action.That is expected to provide a safe and effective for clinical treatment of TCM,as well as evidence-based basis for the next step of research on TCM treatment of CRARS affirmsMethods:Adopted Prospective observational(Case series report),the research chooses CARAS patients with mild and moderate asthma syndrome(TCM syndrome:insufficiency of lung and spleen,phlegm damages lung)as the research object,during June 2015 to March 2016 in dongzhimen hospital respiratory outpatient and otolaryngology outpatient clinic and by recruiting.Researchers use the TCM treatment of "shenge canglong plus(minus)decoction" for two consecutive period of treatment(3 months as a period of treatment)and observe rhinitis and asthma symptom scores and related laboratory test results(including the efficacy index and safety index)before and after treatment as well as the variations of all the points.Results:1.General situation analysis:17 cases had been screened,including 12 subjects included in the standard,3 subjects shedding.12 subjects had been completed 3 months course,and 9 subjects had been completed 6 months course.There are 1 man and 11 women of 12 subjects,their ages distribution from 29 to 68 years old,mean age 45.8±12.21(years old);duration from 4 months to 10 years;the average duration of 56.25 + 13.03(month).In 12 subjects,there are 2 subjects belong toseasonal allergic rhinitis,10 subjects of sustainability,and 2 subjects of mild,10 subjects of severe;All subjects belong to stage of chronic asthma,including 1 of level 1,5 of level 2,4 of level 3.2.Curative effect analysis:2.1 Allergic rhinitis symptom scores:The visual analogue scale scores(VAS),rhinitis main symptoms scores at each time point after treatment compared with before showed a gradual downward trend,a statistically significant difference compared(P<0.05),tipping that the treatment can improve the patient’s clinical rhinitis symptoms,and curative effect is proportional to the time.2.2 Asthma score:asthma symptom scores,asthma control test score(ACT)and Asthma Quality of Life Questionnaire(AQLQ)at each time point after treatment compared with before,a statistically significant difference compared(P<0.05),asthma symptom scores at each time point after treatment showed a gradual downward trend and ACT and AQLQ showed a gradual uptrend,tipping that the treatment can improve the patient’s clinical symptoms with asthma,reducing frequency of attacks,control the onset of asthma symptoms,and improve patient’s quality of life,and curative effect is proportional to the time.2.3 TCM symptom score:at each time point after treatment compared with before,a statistically significant difference compared(P<0.05),tipping that the treatment can improve the patient’s clinical symptoms,and curative effect is proportional to the time.2.4 Experimental indexes:because there are subjects who live or work in the field,by the end of the case at the end of the collection,only 5 cases of the subjects completed laboratory tests.because of too little sample cases,statistical analysis have been made.To continue to expand this study sample cases before the relevant analysis.2.5 Security analysis:In the treatment of patients with 12 cases in the process,no drug related adverse events occurred,5 patients completed laboratory tests,before and after treatment the patient’s safety indicators,including the three conventional,livers and kidney function and ECG all found no obvious abnormalities.Conclusion:According to the results of case series report("reinforcing qi and worming yang,diffusing the lung to calm panting" treatment for the treatment of patients with adult CARAS):"shenge canglong plus(minus)decoction " can improve patients with mild and moderate clinical symptoms of allergic rhinitis and asthma,better control of asthma attacks,improving patient’s quality of life,prompting the TCM to treat the patients with mild and moderate CARAS is safe and feasible.Due to the limitation of study time,there are less sample cases.This study for the next step is to expand the sample size,and provide the basis for the confimatory studies of TCM treatment on CARAS.