鼻用皮质类固醇联合中药鼻腔冲洗治疗肺脾气虚型药物性鼻炎的疗效观察

王晓瑞; 夏睿琪; 刘怡陶; 吴莹莹; 陈慧; 冯炜

doi:10.16025/j.1674-1307.2026.01.004

您当前的位置：

首页 >

文章列表页 >

鼻用皮质类固醇联合中药鼻腔冲洗治疗肺脾气虚型药物性鼻炎的疗效观察

临床研究 | 更新时间：2026-04-01

- 鼻用皮质类固醇联合中药鼻腔冲洗治疗肺脾气虚型药物性鼻炎的疗效观察
- Efficacy evaluation study on the treatment of rhinitis medicamentosa with nasal corticosteroids combined with traditional Chinese medicine nasal irrigation
- 北京中医药 2026年45卷第1期页码：16-21
- 作者机构：
  
  中国中医科学院望京医院耳鼻喉科，北京 100102
- 作者简介：
  
  王晓瑞，男，26岁，硕士研究生。研究方向：中西医结合治疗耳鼻咽喉疾病。
  冯炜，E-mail：13611147987@163.com
- 基金信息：
  
  中国中医科学院科技创新工程重大攻关项目(CI2021A02704)
- DOI：10.16025/j.1674-1307.2026.01.004
  中图分类号：
- 收稿：2025-05-09，
  
  纸质出版：2026-01-25
- 稿件说明：
移动端阅览
王晓瑞，夏睿琪，刘怡陶，等.鼻用皮质类固醇联合中药鼻腔冲洗治疗肺脾气虚型药物性鼻炎的疗效观察［J］.北京中医药，2026，45（1）：16-21.

WANG Xiaorui,XIA Ruiqi,LIU Yitao,et al.Efficacy evaluation study on the treatment of rhinitis medicamentosa with nasal corticosteroids combined with traditional Chinese medicine nasal irrigation[J]. Beijing Journal of Traditional Chinese Medicine,2026,45(01):16-21.
王晓瑞，夏睿琪，刘怡陶，等.鼻用皮质类固醇联合中药鼻腔冲洗治疗肺脾气虚型药物性鼻炎的疗效观察［J］.北京中医药，2026，45（1）：16-21. DOI： 10.16025/j.1674-1307.2026.01.004.

WANG Xiaorui,XIA Ruiqi,LIU Yitao,et al.Efficacy evaluation study on the treatment of rhinitis medicamentosa with nasal corticosteroids combined with traditional Chinese medicine nasal irrigation[J]. Beijing Journal of Traditional Chinese Medicine,2026,45(01):16-21. DOI： 10.16025/j.1674-1307.2026.01.004.

摘要

目的

观察鼻用皮质类固醇联合中药鼻腔冲洗治疗肺脾气虚型药物性鼻炎的疗效。

方法

纳入2023年9月1日—2024年12月31日在中国中医科学院望京医院耳鼻喉科确诊的RM肺脾气虚证患者84例，依据随机数字表法分为对照组和观察组各42例。对照组采用盐水鼻腔冲洗联合鼻用皮质类固醇治疗，观察组采用加味玉屏风散鼻腔冲洗联合鼻用皮质类固醇治疗，连续治疗2周，随访3个月。治疗前后采用VAS评分评价鼻塞严重程度，用鼻阻力仪和鼻声反射仪测量双侧鼻腔有效阻力（R

有效

）、距前鼻孔0~7 cm的鼻腔容积（V

），用鼻腔鼻窦结局测试-20（SNOT-20）评分评估症状，治疗结束后3个月内定期随访统计减充血剂复用率，统计治疗期间2组发生的不良反应，比较疗效。

结果

观察组总有效率为92.9%，高于对照组的76.2%（

0.05）。与治疗前比较，治疗后2组鼻塞VAS评分均降低（

0.05），且观察组鼻塞VAS评分低于对照组（

0.05）。与治疗前比较，治疗后2组R

有效

均降低（

0.05），且观察组R

有效

低于对照组（

0.05）；治疗后2组V

均升高（

0.05），且观察组V

高于对照组（

0.05）。与治疗前比较，治疗后2组SNOT-20评分均降低（

0.05），且观察组SNOT-20评分低于对照组（

0.01）。观察组减充血剂复用3例（7.7%），对照组为9例（28.1%），2组比较差异有统计学意义（

0.05）。治疗期间，2组均未发生不良反应。

结论

加味玉屏风散鼻腔冲洗联合鼻用皮质类固醇治疗药物性鼻炎疗效优于盐水鼻腔冲洗联合鼻用皮质类固醇，能够显著降低患者对减充血剂的依赖并改善其生活质量。

Abstract

Objective

To evaluate and compare the efficacy of nasal irrigation with

Jiawei Yupingfeng

and saline combined with nasal corticosteroids in the treatment of rhinitis medicamentosa.

Methods

A prospective controlled study was conducted at Wangjing Hospital of China Academy of Traditional Chinese Medicine from September 2023 to December 2024. The study included 84 patients diagnosed with Rhinitis medicamentosa and treated during this period. Patients were randomly divided into two groups： a saline rinse group and a traditional Chinese medicine rinse group. The randomization method used was a numerical table method. The saline rinse group was treated with saline nasal irrigation combined with nasal corticosteroids， while the traditional Chinese medicine rinse group was treated with

Jiawei Yupingfeng

nasal irrigation combined with nasal corticosteroids. The patients were followed up for a period of one month. The patients in the Chinese medicine rinsing group underwent a 2-week course of nasal irrigation with Jiawei yupingfeng in conjunction with nasal corticosteroids， followed by a 3-month follow-up period. The Visual Analog Scale of Nasal Congestion （VAS）， the Nasal Resistive Index （NRI）， the Nasal Acoustic Reflex （NAR）， and the sinuses outcome test-20（SNOT-20） were compared and analyzed before and after treatment for the two groups.

Results

The total effective rate of treatment in the Chinese medicine flushing group （92.7%） was higher than that in the saline flushing group （76.2%）， and the difference was statistically significant （

0.05）； the rate of decongestant reuse in the Chinese medicine flushing group （7.7%） was lower than that of decongestant reus

e in the saline flushing group （28.1%） and the difference was statistically significant （

0.05）； Compared with before treatment， VAS score， SNOT-20 score and effective resistance of nasal cavity decreased （

0.05）， and nasal cavity volume increased significantly （

0.05）. The VAS score of nasal obstruction ，nasal effective resistance and nasal volume 0-7cm from nostril were not significantly different between the two groups before treatment （

0.05）. After treatment， the VAS score of nasal obstruction，the SNOT-20 score， nasal effective resistance in the Chinese medicine irrigation group were significantly lower than those in the saline irrigation group （

0.05）， and nasal volume 0-7cm from nostril in the Chinese medicine irrigation group was significantly higher than that in the saline irrigation group （

0.05）.

Conclusion

Jiawei Yupingfeng

nasal irrigation combined with nasal corticosteroids therapy is better than saline nasal irrigation combined with Nasal corticosteroids therapy， which significantly reduced the patients' dependence on decongestants and significantly improved their quality of life.

关键词

Keywords

references

SCHEIRE S , GERMONPRÉ S , VAN TONGELEN I , et al . The Indispensable Nasal Decongestant: Patients' Views and Perspectives on Nasal Decongestant Overuse [J ] . J Allergy Clin Immunol Pract , 2023 , 11 ( 2 ): 602 - 609.e1 .

孙瑶 , 孙书臣 , 杨丽 . 中医特色疗法治疗药物性鼻炎临床经验 [J ] . 中医药学报 , 2021 , 49 ( 10 ): 60 - 63 .

DI PONIO AP , SAMAD MN , PELLIZZARI R , et al . Outcomes after Functional Nasal Surgery in Patients with Versus without Rhinitis Medicamentosa [J ] . Laryngoscope , 2025 , 135 ( 3 ): 1015 - 1020 .

YANG X , EREMEEVA K , SVISTUSHKIN V , et al . Variants of rhinitis medicamentosa treatment: a systematic review [J ] . Eur Arch Otorhinolaryngol , 2025 , 282 ( 9 ): 4407 - 4416 .

DE CORSO E , MASTRAPASQUA RF , TRICARICO L , et al . Predisposing factors of rhinitis medicamentosa: what can influence drug discontinuation [J ] . Rhinology , 2020 , 58 ( 3 ): 233 - 240 .

LI W , MISRA S , HARVEY RJ , et al . Long-term treatment outcomes in refractory rhinitis medicamentosa managed with nasal surgery [J ] . Int Forum Allergy Rhinol , 2024 , 14 ( 3 ): 630 - 638 .

FOWLER J , CHIN CJ , MASSOUD E . Rhinitis medicamentosa: a nationwide survey of Canadian otolaryngologists [J ] . J Otolaryngol Head Neck Surg , 2019 , 48 ( 1 ): 70 .

VAIDYANATHAN S , WILLIAMSON P , CLEARIE K , et al . Fluticasone reverses oxymetazoline-induced tachyphylaxis of response and rebound congestion [J ] . Am J Respir Crit Care Med , 2010 , 182 ( 1 ): 19 - 24 .

FERGUSON BJ , PARAMAESVARAN S , RUBINSTEIN E . A study of the effect of nasal steroid sprays in perennial allergic rhinitis patients with rhinitis medicamentosa [J ] . Otolaryngol Head Neck Surg , 2001 , 125 ( 3 ): 253 - 260 .

GRAF P . Rhinitis medicamentosa: a review of causes and treatment [J ] . Treat Respir Med , 2005 , 4 ( 1 ): 21 - 29 .

万霞 , 李赞华 , 刘建平 . 临床研究中的样本量估算:(1)临床试验 [J ] . 中医杂志 , 2007 ， 48 ( 6 ): 504 - 507 .

王雨农 , 栾兆磊 , 王洪田 . 药物性鼻炎的研究进展 [J ] . 中华耳鼻咽喉头颈外科杂志 , 2017 , 52 ( 11 ): 872 - 875 .

王洪田 , 杨钦泰 , 安云芳 , 等 . 鼻用减充血剂的临床应用暨药物性鼻炎的诊治专家共识(2022,北京) [J ] . 中国耳鼻咽喉颅底外科杂志 , 2022 , 28 ( 4 ): 1 - 7 .

刘蓬 . 中医耳鼻咽喉科学 [M ] . 北京 : 中国中医药出版社 , 2016 : 105 - 107 .

LIM M , LEW-GOR S , DARBY Y , et al . The relationship between subjective assessment instruments in chronic rhinosinusitis [J ] . Rhinology , 2007 , 45 ( 2 ): 144 - 147 .

杨军玲 , 罗志强 . 鼻阻力测定及其临床应用研究进展 [J ] . 医学综述 , 2016 , 22 ( 18 ): 3640 - 3643 .

左可军 , 方积乾 , PICCIRILLO JF , 等 . 鼻腔鼻窦结局测试-20(SNOT-20)量表中文版的研制 [J ] . 中华耳鼻咽喉头颈外科杂志 , 2008 , 43 ( 10 ): 751 - 756 .

徐英 , 高萌 , 宋咏霞 , 等 . 清热解毒方联合莫西沙星治疗急性鼻窦炎临床疗效及对血清炎性因子hs-CRP、IL-6、TNF-α影响 [J ] . 中华中医药学刊 , 2024 , 42 ( 09 ): 232 - 235 .

GRAF P . Adverse effects of benzalkonium chloride on the nasal mucosa: allergic rhinitis and rhinitis medicamentosa [J ] . Clin Ther , 1999 , 21 ( 10 ): 1749 - 1755 .

MORTUAIRE G , DE GABORY L , FRANÇOIS M , et al . Rebound congestion and rhinitis medicamentosa: nasal decongestants in clinical practice. Critical review of the literature by a medical panel [J ] . Eur Ann Otorhinolaryngol Head Neck Dis , 2013 , 130 ( 3 ): 137 - 144 .

PASSÀLI D , SALERNI L , PASSÀLI GC , et al . Nasal decongestants in the treatment of chronic nasal obstruction: efficacy and safety of use [J ] . Expert Opin Drug Saf , 2006 , 5 ( 6 ): 783 - 790 .

RAMEY JT , BAILEN E , LOCKEY RF . Rhinitis medicamentosa [J ] . J Investig Allergol Clin Immunol , 2006 , 16 ( 3 ): 148 - 155 .

ZUCKER SM , BARTON BM , MCCOUL ED . Management of Rhinitis Medicamentosa: A Systematic Review [J ] . Otolaryngol Head Neck Surg , 2019 , 160 ( 3 ): 429 - 438 .

TAIT S , KALLOGJERI D , SUKO J , et al . Effect of Budesonide Added to Large-Volume, Low-pressure Saline Sinus Irrigation for Chronic Rhinosinusitis: A Randomized Clinical Trial [J ] . JAMA Otolaryngol Head Neck Surg , 2018 , 144 ( 7 ): 605 - 612 .

王东坡 , 李卫红 , 丁雷 , 等 . 玉屏风散释名、类方及其出处考证 [J ] . 安徽中医药大学学报 , 2015 , 34 ( 3 ): 6 - 8 .

李鹏飞 , 丘琴 , 覃春萍 , 等 . 玉屏风散的研究进展及质量标志物预测分析 [J ] . 中华中医药学刊 , 2024 , 42 ( 4 ): 101 - 107 .

林甦 , 黄敬之 . 玉屏风散对变应性鼻炎模型大鼠TLR4/NF-κB信号通路的影响 [J ] . 中国中医药信息杂志 , 2018 , 25 ( 12 ): 48 - 52 .

CHEN H , FENG W , LU Y , et al . Effects and mechanism of Chinese medicine Jiawei Yupingfeng in a mouse model of allergic rhinitis [J ] . J Integr Med , 2021 , 19 ( 4 ): 354 - 361 .

李霞 , 王丽萍 , 王婷 , 等 . 盐水鼻腔冲洗联合多种药物治疗变应性鼻炎的网状Meta分析 [J ] . 中华现代护理杂志 , 2022 , 28 ( 21 ): 2858 - 2865 .

肖全 , 刘婷 , 田理 . 指南解析鼻腔冲洗在变应性鼻炎及慢性鼻-鼻窦炎中的治疗地位 [J ] . 国际耳鼻咽喉头颈外科杂志 , 2017 , 41 ( 1 ): 52 - 54 .

WANG JJ , CHIANG YF , JIANG RS . Influence of Age and Gender on Nasal Airway Patency as Measured by Active Anterior Rhinomanometry and Acoustic Rhinometry [J ] . Diagnostics (Basel) , 2023 , 13 ( 7 ): 1235 .

MORRIS S , ECCLES R , MARTEZ SJ , et al . An evaluation of nasal response following different treatment regimes of oxymetazoline with reference to rebound congestion [J ] . Am J Rhinol , 1997 , 11 ( 2 ): 109 - 115 .

GRAF P , ENERDAL J , HALLÉN H . Ten days' use of oxymetazoline nasal spray with or without benzalkonium chloride in patients with vasomotor rhinitis [J ] . Arch Otolaryngol Head Neck Surg , 1999 , 125 ( 10 ): 1128 - 1132 .

BAROODY FM , BROWN D , GAVANESCU L , et al . Oxymetazoline adds to the effectiveness of fluticasone furoate in the treatment of perennial allergic rhinitis [J ] . J Allergy Clin Immunol , 2011 , 127 ( 4 ): 927 - 934 .

NEIGHBORS CL , SALVADOR CF , ZHU B , et al . Intranasal corticosteroid and oxymetazoline for chronic rhinitis: a systematic review [J ] . J Laryngol Otol , 2022 , 136 ( 1 ): 8 - 16 .

ZHANG K , PIPALIYA RM , MIGLANI A , et al . Systematic Review of Surgical Interventions for Inferior Turbinate Hypertrophy [J ] . Am J Rhinol Allergy , 2023 , 37 ( 1 ): 110 - 122 .

CUI X , WANG S , WANG L . Letter to the editor regarding "Long-term treatment outcomes in refractory rhinitis medicamentosa managed with nasal surgery" [J ] . Int Forum Allergy Rhinol , 2023 , 13 ( 12 ): 2262 - 2263 .

LIU DT , PHILLIPS KM , SPETH MM , et al . Exploring possibilities for shortening the 22-item Sino-Nasal Outcome Test (SNOT-22) using item response theory [J ] . Int Forum Allergy Rhinol , 2022 , 12 ( 2 ): 191 - 199 .

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

中药制剂鼻腔冲洗临床应用的研究进展