| Objective:To observe the curative effect of various treatment methods on allergic rhinitis through the clinical data of the real world study,and to form a set of relatively optimized treatment plan for allergic rhinitis.By verifying the good clinical efficacy and safety of Yi Qi Wen Yang decoction in the real world study,further popularize the use of traditional Chinese medicine to prevent and treat allergic rhinitis,and provide a more reliable and true basis for the prevention and treatment of allergic rhinitis.At the same time,a set of complete and reliable technical route can be preliminarily formed for clinical reference.Methods:1.The origin of the cases:Retrospective study:200 patients with allergic rhinitis who met the diagnosis,inclusion criteria,and had relatively detailed information records from November 2017 to November 2019 were selected from the Donghua system database of Jiangsu Provincial Hospital of Traditional Chinese Medicine.Prospective study:A total of 100 outpatients with allergic rhinitis who came to Jiangsu Provincial Hospital of Traditional Chinese Medicine from December 2019 to December 2020 and met the diagnosis and inclusion criteria were selected.2.Research methods:No uniform treatment plans were made for Prospective studies.According to the patient’s wishes,the doctor formulated the treatment plan which is suitable for the patient and recorded the diagnosis and treatment process.Western medicine used for treatment mainly include glucocorticoids,antihistamines,leukotriene receptor antagonist and hypertrophic cell membrane stabilizers.Traditional Chinese medicine(TCM)used for treatment is mainly based on syndrome differentiation.For patients treated with Yi Qi Wen Yang decoction,the dose or the species of herbs can be added or subtracted according to the clinical reality.Retrospective studies grouped patients according to different treatment regimens.The relevant data were recorded to be analysied.3.Obvervational index:General information of the patient,such as age,gender,etc.Nasal symptom observation scale,Vasul Analogue Scale(VAS)and Rhinoconjunctivitis quality of life questionnaire(RQLQ)were used to evaluate the patients before and after treatment.4.Data analysis:SPSS 25.0 statistical analysis software was used for data analysis.Quantitative data are described as x±s if they conform to the normal distribution,while their mean value is described if they do not.Qualitative data were described by frequency and composition ratio.The t test was used to compare the mean values of the two groups of measurement data.Comparison of two or more sample rates is performed using the χ2 test;Rank sum test was used for grade data or data that did not conform to normal distribution.Logistic regression analysis was performed for the confounding factors that were difficult to control or uncontrolled at the time of initial diagnosis.Two-sided test was used uniformly,and P<0.05 was considered statistically significant.Result:1.The frequency of chief complaints of all patients was statistically analyzed,the following chief complaints was more than 50%:nasal itching,sneezing,runny nose and nasal obstruction,with the frequency reaching 77.8%,76.6%,65.2%and 57.9%,respectively.Statistics and analysis were conducted on the physical signs of all patients.The physical signs with a frequency of more than 50%were turbinate enlargement,clear and thin secretions and pale mucosa,with the frequency reaching 75.3%,66,2%,and 61.1%,respectively.2.The statistical analysis of the occurrence frequency of different herbs in the treatment showed that,in addition to the main composition of the Yi Qi Wen Yang decoction,the utilization rate of more than 50%in the treatment group of integrated traditional Chinese and western medicine was as follows:roasted rhizoma atractylodis,radix saposhnikoviae,myrobalan,parched white peony root,schizonepeta and periostracum cicada,the occurrence frequency reached 69.8%,66.0%,65.4%,64.8%,63.6%,57.4%,respectively;The utilization rate of more than 50%in the treatment group of Traditional Chinese medicine was as follows:dark plum,radix angelicae and schizonepeta,the occurrence frequency reached 75.3%,51.0%and 50.2%,respectively;3.The statistical analysis of the occurrence frequency of different Western medicine in the treatment showed that,the utilization rate of more than 50%in the treatment group of integrated traditional Chinese and western medicine was as follows:Desloratadine Citrate Disodium,Budesonide Nasal Spray,Mometasone Furoate Aqueous Nasal Spray,Desloratadine tablets,Montelukast Sodium tablet,Eucalyptol,Limonene and Pinene Enteric Soft Capsules,Physiological seawater nasal spray,Cetirizine Dihydrochloride Oral Drops and Desensitization anti-inflammatory nasal irrigator,the occurrence frequency reached 35.2%,33,3%,27.5%,24.7%,14.5%,9.3%,5.6%,5.2%and 5.2%,respectively;The utilization rate of more than 50%in the treatment group of western medicine was as follows:Budesonide Nasal Spray,Desloratadine Citrate Disodium,Mometasone Furoate Aqueous Nasal Spray,Montelukast Sodium tablet,Desloratadine tablets,Loratadine tablets,Montelukast Sodium chewable tablets,Desensitization anti-inflammatory nasal irrigator and Cetirizine Dihydrochloride Oral Drops,the occurrence frequency reached 4.1%,41.1%,39.0%,34.4%,26.2%,23.7%,16.1%,8.5%and 5.1%,respectively;4.VAS scores of each treatment group were statistically analyzed.The treatment group of integrated Chinese and Western medicine(5.01±2.406)<The treatment group of western medicine(5.24±2.057)<The treatment group of traditional chinese medicine(5.67 ±2.216).The difference was statistically significant(P<0.05).RQLQ scale scores of each treatment group were statistically analyzed.The treatment group of integrated Chinese and Western medicine(57.4±37.085)<The treatment group of traditional chinese medicine(57.58±27.765)<The treatment group of western medicine(69.64 ±24.926).The difference was statistically significant(P<0.05).The mean value of curative effect index of each treatment group was statistically analyzed.The treatment group of integrated Chinese and Western medicine(72%)>The treatment group of traditional chinese medicine(57%)>The treatment group of western medicine(54.8%).The difference was statistically significant(P<0.05).Conclusions:1.The real world study shows that the core symptoms of allergic rhinitis with lung and spleen deficiency-cold are nasal itching,sneezing,runny nose and nasal obstruction.The core signs were turbinate enlargement,clear and thin secretions,and pale mucosa.2.When using traditional Chinese medicine to treat allergic rhinitis with lung and spleen deficiency-cold,in addition to the main composition of the Yi Qi Wen Yang decoction,roasted rhizoma atractylodis,radix saposhnikoviae,myrobalan,parched white peony root,schizonepeta,periostracum cicada and dark plum were used with high frequency.These herbs can be added or subtracted according to clinical symptoms3.The real world study shows that the most commonly used western medicine in the treatment of allergic rhinitis are nasal hormone drugs,antihistamines,antileukotriene drugs and nasal cleaning agents.4.The treatment group of integrated Chinese and Western medicine had the best curative effect among the three treatment groups.the curative effect of Western medicine treatment group is fastest but easy to relapse.The curative effect of TCM treatment group was slower,but the improvement of systemic symptoms was significantly better than that of western medicine treatment group. |
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