The Clinical Research Of Combined Allergic Rhinitis And Asthma Syndrome Treated By The Method Of Tonifying Qi And Dispelling Wind, Warming Yang And Resolving Fluid Retention

Objective:To present etiology and pathogenesis, characteristics of syndrome differentiation and diagnosis and therapy plan by investigating causes, clinical manifestations and information of four diagnostic methods of patients with combined allergic rhinitis and asthma syndrome (CARAS). Taking "tonifying qi and dispelling wind, warming yang for resolving fluid retention" as the main way for treating CARAS, and through monitoring changes of clinical symptom scores and indexs observations before and after the treatment, which aimed to observe clinical effects of this treatment method and its formula composing and probe into its mechanism,in order to sum upproper therapeutic methods and safe and effectiveprescriptions and herbs with TCM characteristics and advantages that superiority inpreventing and curing CARAS and lay the foundation for clinical intervention.Methods:On the basis of previousclinical practice, this study was done as a randomized controlled trial, according to the principle of 1:2, and tookoutpatients with CARAS in the delayed period orgot partial remission astest subjects that met the syndrome differentiation standard of "deficiency of both lung and spleen, phlegm retentionin the body". All of the patients was divided into the control group (n=30) that taking Budesonide formoterol powder for inhalation and treatment group(n=60) that taking Budesonide formoterol powder for inhalation and decoctions with function of tonifying qi and dispelling wind and warming yang for resolving fluid retention. The basic prescription was composed ofradix codonopsis(15g), raw radix astragalis(25g), atractylodes macrocephala koidz(12g), saposhnicovia divaricata (6g), folium Perillae (6g), ephedra (5g), Sichuan cassia twig (6g), radix paeoniae alba (12g), rhizoma zingiberis(5g), fructus schisandrae (6g), prepared rehmannia root(12g), tussilago farfara (10g), semen cuscutae (10g),morinda officinalis how (10g). To vary the composition with syndromes: who has thick and greasy tongue coating and accompanying syndrome of dampness, can be given additional lOg roasted atractylodes,5g cortex magnoliae officinalis and lOg agastache rugosa; who got obviousnasal obstruction can be given 6g flos magnolia and lOg radix angelicae dahuricae; who got excessive phlegm can be given lOg perilla fruit, lOg rhizoma pinellinae praeparata and 15g coix seed. Clinical symptoms, indexes of pulmonary ventilation function and small airway function and eosinophilic granulocyte counts were recorded. One month as a treatment cycle. The trail have undergone for two cycles.Results:The treatment method of tonifying qi and dispelling wind and warming yang for resolving fluid retention and prescriptions based on this principle were capable of improving clinical symptoms of outpatients with CARAS belonging to syndrome of deficiency of both lung and spleen and phlegm retention in the body, such as gasp, cough, expectoration, thoracic discomfort, wheezing rale, sneeze, nasal discharge, nasal obstruction and rhinocnesmus, there were significant difference before and after treatment (P<0.05 or P<0.01), and these symptoms in the treatment group was superior to the control group (P<0.05 or P<0.01), so as the comprehensive therapeutic effect(P<0.05). The eosinophilic granulocyte (EOS) counts in the treatment group have reduced markedly after treatment and there was a statistical significance than before (P<0.05), but there was no significant difference in the control group (P>0.05). All indexes of pulmonary ventilation function such as FVC%、FEV1%、FEV1/FVC% in the treatment group were improved after treatment, and with significant difference (P<0.01), however, at these aspects, there was no obvious improvement in the control group and with no statistically significant difference(P>0.05). There are different degrees of improvement in the indexes of small airway function such as PEF%、FEF25%、FEF50%、FEF75%、MMEF75/25% of the treatment group, and with significant difference (P<0.05 or P<0.01). But only PEF% level in the control group was higher than before the treatment, and with statistical significance (P<0.05), while improvement of other indexes such as FEF25%、FEF50%、FEF75%、 MMEF75/25%were not obvious and with no statistical significance(P>0.05).Conclusion:Clinical symptoms of outpatients with CARAS belonging to syndrome of deficiency of both lung and spleen and phlegm retentionin the body can be improved by the treatment method of tonifying qi and dispelling wind and warming yang for resolving fluid retention and prescriptions based on this principle, by which simultaneously to improve pulmonary ventilation function and small airway function, suppressairway inflammatory and regulate immune function. The theoretical principle for curing the root cause of this disease is tonifying qi to benefit the lung and invigorating the spleen to nourish the kidney, and dispelling wind to disperse the lung and warming yang to resolve fluid retention for cuing incidental symptoms. The two kinds of principle should be used in combination and focusing on curing the root cause. It is important to adjust physical state of patients which make a lasting curative effect.