三伏天穴位貼敷對過敏性鼻炎之療效初探

THE THERAPEUTIC EFFECT OF APPLYING HERBAL PASTE ONTO ACUPOINTS FOR ALLERGIC RHINITIS DURING DOG DAYS - A PRELIMINARY STUDY

過敏性鼻炎是臨床常見疾病，早期反應有打噴嚏、鼻癢、流清鼻涕等症狀；晚期反應有疲倦、不適、易怒等症狀。為研究三伏天（夏季最熱的三個日子）穴位貼敷治療過敏性鼻炎的臨床療效，本研究使用鼻結膜炎生活品質調查問卷Rhinoconjunctivitis Quality of Life Questionnaire （RQLQ ），以評估患者因過敏性鼻炎，造成的生理、心理、以及社交困擾等問題。在2005 年三伏天（國曆7 月15 日、7 月25 日、8 月14 日）使用大椎、肺俞、膏肓、腎俞等穴位進行貼敷，治療前後由病人填寫RQLQ 問卷以評估療效，另並設計問卷評估貼敷治療後的皮膚反應，完成全部療程後5 個月，再以電話追蹤訪察後續療效。結果共有45 位患者完成穴位貼敷的治療。在三伏天期間，患者的RQLQ 分數有顯著改善；且年齡越小（< 30 歲）、皮膚反應越小（< 4 分）者，其療效越佳。療程結束5 個月後，於冬季好發季節時追蹤訪察，病人自覺症狀有所改善者達60.0% ，其餘則否。年齡、性別、是否合併氣喘、病程長短、貼敷時間、皮膚反應等因素，對於總有效率的高低皆無影響。初步觀察顯示：三伏天穴位貼敷治療過敏性鼻炎是一個安全、有效又方便的治療，其作用機制，值得進一步的研究。Allergic rhinitis is clinically a common ailment and frequently-occurring disease. Its etiology and pathogenesis are complicated and the recurrence rate is high. To investigate the clinical effect on allergic rhinitis of applying herbal paste onto acupoints during dog days (the 3 hottest summer days), the present study used the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) to measure the functional (physical, emotional and social) disturbance of the patients. The study subjects included 45 patients who completed treatment at Chang Gung Memorial Hospital in Keelung. The paste was placed on the selected acupoints during the dog days (15th July, 25th July, and 14th August 2005). The acupoints selected were Dazhui (GV14), Feishu (BL13), Gaohuang (BL43), and Shenshu (BL23). Changes of scores in the domains of the RQLQ, which were assessed by the patients before and after treatments, were recorded to evaluate the clinical efficacy. Another questionnaire was designed to record the patient’s skin reactions to the treatment. Five months after treatment, we conducted telephone interview with the patients to examine the perceived efficacy of this treatment during winter. The RQLQ scores indicated significant beneficial effects of treatment; the younger patient (< 30 years of age) and those who had minor skin reaction (< 4 score) had better effects. Five months after treatment, 60.0% of patients perceived the treatment as being effective, while others did not. And the perceived efficacy of treatment was not correlated to their age, sex, history of asthma, duration of allergic rhinitis and the skin reaction to the treatment. The results show that herbal paste onto acupoints during dog days is an effective, safe and convenient treatment for allergic rhinitis. The mechanism of its efficacy needs further study.