Pathogenesis and treatment of glucocorticoid resistance in refractory allergic rhinitis from the perspective of "deficiency, stasis, and toxicity"

SUN Weixi; ZHANG Yeling; YAN Zhanfeng; GONG Zheng; LIU Lili; ZHAO Jiangpeng; LI Mengting

doi:10.16025/j.1674-1307.2025.11.019

您当前的位置：

首页 >

文章列表页 >

Pathogenesis and treatment of glucocorticoid resistance in refractory allergic rhinitis from the perspective of "deficiency, stasis, and toxicity"

更新时间：2026-01-29

- Pathogenesis and treatment of glucocorticoid resistance in refractory allergic rhinitis from the perspective of "deficiency, stasis, and toxicity"
- Beijing Journal of Traditional Chinese Medicine Vol. 44, Issue 11, Pages: 1468-1473(2025)
- 作者机构：
  
  1.北京中医药大学第一临床医学院，北京 100700
  2.北京中医药大学东直门医院中医耳鼻喉头颈研究所，北京 100700
- 作者简介：
- 基金信息：
- DOI：10.16025/j.1674-1307.2025.11.019
  CLC：
- Received：08 January 2025，
  
  Published：25 November 2025
- 稿件说明：
移动端阅览
孙未希，张烨铃，闫占峰，等.从“虚、瘀、毒”探讨难治性变应性鼻炎糖皮质激素抵抗的病机及治疗［J］.北京中医药，2025，44（11）：1468-1473.

SUN Weixi,ZHANG Yeling,YAN Zhanfeng,et al.Pathogenesis and treatment of glucocorticoid resistance in refractory allergic rhinitis from the perspective of "deficiency, stasis, and toxicity"[J]. Beijing Journal of Traditional Chinese Medicine,2025,44(11):1468-1473.
孙未希，张烨铃，闫占峰，等.从“虚、瘀、毒”探讨难治性变应性鼻炎糖皮质激素抵抗的病机及治疗［J］.北京中医药，2025，44（11）：1468-1473. DOI： 10.16025/j.1674-1307.2025.11.019.

SUN Weixi,ZHANG Yeling,YAN Zhanfeng,et al.Pathogenesis and treatment of glucocorticoid resistance in refractory allergic rhinitis from the perspective of "deficiency, stasis, and toxicity"[J]. Beijing Journal of Traditional Chinese Medicine,2025,44(11):1468-1473. DOI： 10.16025/j.1674-1307.2025.11.019.

摘要

糖皮质激素抵抗是导致难治性变应性鼻炎的关键因素，现代医学将其归咎于激素－受体结合异常及分子蛋白复合作用紊乱。从中医“虚、瘀、毒”角度出发，结合现代分子机制，解析难治性变应性鼻炎中糖皮质激素抵抗的中医病机：以肺脾肾虚损为病理基础，瘀血阻络为病情迁延的关键，内外毒邪互结（环境毒、内在瘀毒及药毒激素）为恶化因素。三者共同扰乱气血运行，致使药物失敏，形成激素抵抗。因此，遵循补虚培本、活血通络、清热解毒的治疗原则，为更有效地治疗难治性变应性鼻炎提供思路。

Abstract

Glucocorticoid resistance is a key factor leading to refractory allergic rhinitis. In modern medicine， it is mainly attributed to abnormalities in hormone-receptor binding and dysregulation of molecular protein interactions. From the perspective of traditional Chinese medicine （TCM） of "deficiency， stasis， and toxicity"， and integrating modern molecular mechanisms， the pathogenesis of glucocorticoid resistance in refractory allergic rhinitis can be understood as follows. Deficiency of the lung， spleen， and kidney forms the pathological basis； blood stasis and collateral obstruction are the key factors for disease persistence； and the interaction of internal and external toxic factors， including environmental toxins， endogenous stasis-toxicity， and hormone-induced drug toxicity， exacerbates the condition. These factors collectively disrupt the circulation of qi and blood， resulting in drug desensitization and glucocorticoid resistance. Therefore， adherence to the therapeutic principles of reinforcing deficiency to strengthen the root， promoting blood circulation to dredge collaterals， and clearing heat to resolve toxicity provides a theoretical basis for more effective treatment of refractory allergic rhinitis.

关键词

Keywords

references

陈海娟 , 侯艳鹏 . 鼻用糖皮质激素的常见不良反应 [J ] . 中国药物滥用防治杂志 , 2022 , 28 ( 1 ): 95 - 98 .

ISHIDA A , OHTA N , KOIKE S , et al . Overexpression of glucocorticoid receptor-beta in severe allergic rhinitis [J ] . Auris Nasus Larynx , 2010 , 37 ( 5 ): 584 - 588 .

薛建亭 , 陈文华 . 变应性鼻炎与糖皮质激素受体的表达及其意义 [J ] . 临床耳鼻咽喉头颈外科杂志 , 2010 , 24 ( 20 ): 956 - 960 .

段颖 , 屈静 , 高寅丽 , 等 . 变应性鼻炎的中西医结合诊疗方案 [J ] . 北京中医药 , 2024 , 43 ( 2 ): 128 - 132 .

OKANO M . Mechanisms and clinical implications of glucocorticosteroids in the treatment of allergic rhinitis [J ] . Clin Exp Immunol , 2009 , 158 ( 2 ): 164 - 173 .

YOO SH , KIM HY , KIM YA , et al . Radiofrequency ablation and microdebrider-assisted turbinoplasty: 5-year postoperative outcomes [J ] . J Rhinol , 2023 , 30 ( 3 ): 149 - 154 .

陈继鑫 , 董禹彤 , 袁卫玲 , 等 . 环境毒邪致过敏性鼻炎理论探讨 [J ] . 中国中医药信息杂志 , 2020 , 27 ( 2 ): 113 - 115 .

李军 , 李玉华 , 梁爱武 . 中医药对糖皮质激素受体调节作用研究进展 [J ] . 山东中医药大学学报 , 2019 , 43 ( 4 ): 417 - 420 .

薛建亭 . 糖皮质激素治疗变应性鼻炎的临床分析 [D ] . 大连 : 大连医科大学 , 2009 .

王雪 , 耿龙 , 季永智 , 等 . 糖皮质激素对其受体、热休克蛋白90和组蛋白去乙酰化酶6的影响及中药干预研究 [J ] . 中国医科大学学报 , 2010 , 39 ( 8 ): 607 - 609 .

田双双 . HMGB1/TLR4/NF-kB信号通路在变应性鼻炎大鼠发病中的作用及糖皮质激素的影响 [D ] . 青岛 : 青岛大学 , 2021 .

赵琳立 , 王昱茜 , 王珺 , 等 . 从糖皮质激素受体角度探讨激素抵抗型哮喘的危险因素、发病机制及对策 [J ] . 实用心脑肺血管病杂志 , 2024 , 32 ( 10 ): 1 - 6 .

王卫华 , 安云芳 , 赵长青 . 变应性鼻炎对小鼠鼻黏膜核因子-κB p65和糖皮质激素受体表达的影响 [J ] . 中国中西医结合耳鼻咽喉科杂志 , 2009 , 17 ( 1 ): 4 - 9 .

OHTA N , NOGUCHI N , TAKAHASHI T , et al . The expression of 11 beta hydroxysteroid dehydrogenase in severe allergic rhinitis [J ] . Otolaryngol Pol , 2018 , 73 ( 2 ): 18 - 22 .

LUO H , YAN NB , ZENG PF , et al . Relationship between alpha-and beta-isoform of corticosteroid receptors and corticosteroid resistant allergic rhinitis [J ] . Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi , 2007 , 42 ( 9 ): 650 - 653 .

李波 , 白祥军 , 王海平 . 地塞米松对人单核细胞糖皮质激素受体蛋白表达的影响 [J ] . 中华急诊医学杂志 , 2006 ,( 6 ): 525 - 528 .

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 .

冀晓俊 , 李昂 , 段美丽 , 等 . 黄芪甲苷对体外炎症状态下单核细胞NF-κB及糖皮质激素受体表达的影响 [J ] . 中国临床医学 , 2010 , 17 ( 4 ): 590 - 593 .

王笑雨 , 王召 , 曹利华 , 等 . 基于数据挖掘、网络药理学及实验验证探讨中药治疗变应性鼻炎的用药规律及相关药理分析 [J ] . 天然产物研究与开发 , 2024 , 36 ( 1 ): 137 - 154 .

姚敬心 , 卢威 , 郑家旺 , 等 . 参苓白术散加减对脾虚湿困型鼻鼽豚鼠模型的调节机制研究 [J ] . 湖南中医杂志 , 2024 , 40 ( 7 ): 147 - 152 .

徐宁聪 , 画奕惟 , 谭希 , 等 . 鼻敏方对变应性鼻炎肺脾气虚证模型大鼠鼻黏膜TMEM16A/NF-κB/MUC5AC信号通路的影响 [J ] . 中医杂志 , 2024 , 65 ( 8 ): 842 - 848 .

万楷杨 . 金匮肾气丸加减治疗过敏性鼻炎的疗效及机制研究 [J ] . 光明中医 , 2020 , 35 ( 5 ): 643 - 645 .

年宏蕾 , 杨燕 , 罗良涛 , 等 . 淫羊藿及女贞子协同布地奈德对哮喘大鼠糖皮质激素受体及抗炎作用的影响 [J ] . 北京中医药 , 2016 , 35 ( 2 ): 118 - 121 .

张丽艳 , 孙海波 . 补气助阳汤对变应性鼻炎模型大鼠TNF-α、NF-kB影响随机平行对照研究 [J ] . 实用中医内科杂志 , 2016 , 30 ( 12 ): 95 - 98 .

李鑫 . 益气活血外治法对气虚血瘀型鼻鼽的临床疗效及鼻阻力的影响 [D ] . 成都 : 成都中医药大学 , 2017 .

黄铄 , 李双 , 陈哲 , 等 . 丹参酮ⅡA通过调节NF-κB通路对肥大细胞介导的过敏性鼻炎的影响 [J ] . 武汉大学学报(医学版) , 2018 , 39 ( 2 ): 223 - 227 .

徐畅 , 宋艺兰 , 姜京植 , 等 . 川芎嗪通过AMPK/NF-κB和Nrf-2/HO-1途径减轻过敏性气道炎症和氧化应激的实验研究 [J ] . 免疫学杂志 , 2021 , 37 ( 2 ): 100 - 106 .

张红金 , 刘娇 , 吴相伟 , 等 . 大黄对烫伤后脓毒症大鼠糖皮质激素受体表达和外周血淋巴细胞的影响 [J ] . 中国中西医结合急救杂志 , 2014 ( 3 ): 186 - 189 .

刘书芹 , 李桂华 , 赵娜 , 等 . 黄连解毒汤对变应性鼻炎大鼠TLR4/NF-κB信号通路及黏膜杯状细胞的影响 [J ] . 中国病理生理杂志 , 2021 , 37 ( 1 ): 140 - 145 .

巩政 , 闫占峰 , 刘巧平 , 等 . 鼻内针刺治疗持续性中重度变应性鼻炎的临床研究 [J ] . 中国中西医结合杂志 , 2020 , 40 ( 12 ): 1458 - 1463 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Microscopic syndrome differentiation and treatment of precancerous lesions of chronic atrophic gastritis based on the pathogenesis theory of “deficiency, stagnation, depression, and stasis”

Mechanisms of local superficial puncture for the treatment of pathological scars

Expert consensus on the treatment of allergic rhinitis by acupuncture of sphenopalatine ganglion

Research progress of clinical application of nasal irrigation with Chinese medicine preparations

WANG Junge differentiates and treats two cases of allergic rhinitis based on Taiyin Disease with wind affection

Related Author

WEI Wei

YANG Yang

BAI Wei

QING Xiangli

WANG Lin

FANG Shuangshuang

BAN Yanran

LIU Qingquan

Related Institution

Graduate School， Beijing University of Chinese Medicine

Department of Spleen and Stomach Diseases （Digestion）， Wangjing Hospital， China Academy of Chinese Medical Sciences

Beijing Institute of Traditional Chinese Medicine

Colinical Medical College of Beijing Hospital of Traditional Chinese Medicine，Beijing University of Chinese Medicine

Beijing Tongren Hospital，Capital Medical University

⁰