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目的:对比应用酪酸梭菌二联活菌胶囊(常乐康)等药物前后变应性鼻炎(AR)患者血清中IL-10、转化生长因子-β1(TGF-β1)、视觉模拟量表(VAS)评分及鼻结膜炎生活质量调查问卷(RQLQ)评分的变化,观察常乐康辅助治疗AR的疗效。方法:招募到符合条件的季节性中-重度AR患者,研究组20例,对照组20例;另取10例健康者为正常组。研究组给予常乐康加枸地氯雷他定片加糠酸莫米松鼻喷剂治疗(疗程2周),然后继续给予常乐康维持治疗6周,而停用其他2种药物。对照组给予枸地氯雷他定片加糠酸莫米松鼻喷剂治疗2周后退出临床实验。统计分析在治疗过程中患者症状评分、RQLQ评分及血清IL-10、TGF-β1的变化。结果:(1)治疗前正常组、研究组、对照组血清TGF-β1和IL-10水平总体差异有统计学意义(P<0.001),且研究组、对照组均显著低于正常组;(2)随着治疗时间的增加,研究组血清IL-10、TGF-β1水平逐渐升高,四分法眼部症状评分、VAS眼部症状评分、RQLQ总分逐渐降低;(3)对照组患者治疗2周后血清IL-10、TGF-β1均高于治疗前(P<0.001),症状评分、RQLQ总评分均低于治疗前(P<0.001);(4)治疗2周后研究组患者血清IL-10高于对照组(P<0.001);(5)治疗前AR患者血清IL-10、TGF-β1与各项症状评分、RQLQ总分之间无线性相关关系(P>0.05)。结论:(1)IL-10、TGF-β1可能参与了AR的发病;(2)常乐康可能对AR患者血清IL-10、TGF-β1的产生起促进作用;(3)AR患者在枸地氯雷他定和糠酸莫米松鼻喷剂治疗的基础上加用常乐康可能比常规的二者联合治疗更能促进血清IL-10的产生,但在症状及患者生活质量方面没有更明显的改善;(4)常乐康可能对AR患者眼部症状、总生活质量的改善有一定作用;(5)AR患者治疗前血清IL-10、TGF-β1水平可能与其症状、生活质量关联性较小,暂不能用血清IL-10、TGF-β1水平的高低来评估AR患者病情的严重程度。
OBJECTIVE: To compare the changes of serum levels of IL-10, TGF-β1, visual analogue scale before and after allergic rhinitis (AR) VAS score and quality of life questionnaire of rhinoconjunctivitis (RQLQ) were observed. The therapeutic effect of Changlekang adjuvant AR was observed. Methods: To meet the requirements of seasonal moderate-severe AR patients, the study group of 20 patients, the control group of 20 patients; the other 10 healthy subjects were normal. The study group was given Changle Kanga citrate loratadine tablets plus mometasone furoate nasal spray treatment (for 2 weeks), and then continue to Chang Lekang maintenance treatment for 6 weeks, while the other two drugs discontinued. Control group was given loratadine tablets plus mometasone furoate nasal spray treatment after 2 weeks out of clinical trials. Statistical analysis of patient symptom scores, RQLQ score and changes of serum IL-10, TGF-β1 in the course of treatment. Results: (1) The levels of TGF-β1 and IL-10 in the normal group, the study group and the control group before treatment were significantly different (P <0.001), and were significantly lower in the study group and the control group than in the normal group 2) With the increase of treatment time, serum levels of IL-10 and TGF-β1 in the study group gradually increased, and the scores of ocular symptom score, VAS ocular symptom score and RQLQ score gradually decreased in the study group; (3) After 2 weeks of treatment, the levels of IL-10 and TGF-β1 were significantly higher than those before treatment (P <0.001), symptom scores and total RQLQ scores were lower than those before treatment (P <0.001); (4) Serum IL-10 was higher than that of the control group (P <0.001). (5) There was no linear correlation between serum IL-10, TGF-β1 and symptom score and RQLQ score before treatment in AR patients (P> 0.05). Conclusion: (1) IL-10 and TGF-β1 may be involved in the pathogenesis of AR; (2) Changlekang may promote the production of IL-10 and TGF-β1 in AR patients; (3) Desloratadine and mometasone furoate nasal spray treatment based on the use of Changle Kang may be more than the conventional combination of the two more to promote the production of serum IL-10, but in terms of symptoms and quality of life of patients no more (4) Changlekang may play an important role in the improvement of ocular symptoms and total quality of life in patients with AR; (5) The levels of serum IL-10 and TGF-β1 before treatment in AR patients may be related to their symptoms and quality of life Sex is small, can not use the level of serum IL-10, TGF-β1 to assess the severity of AR patients.