Study On The Mechanism Of IL-4 In Allergic Rhinitis (The Type Of Lung Qi Deficiency And Blood Stasis) Patients Treated By Keminqidan Nasal Spray

BACKGROUND:Allergic rhinitis(AR)is a common disease and Intractable disease in upper respiratory tract diseases.There are 20% to 38% of patients with allergic rhinitis have bronchial asthma,and the US spends about $2-3 billion on medical expenses for this disease.Traditional Chinese medicine has obvious advantages in disease prevention and control,and it seeks more effective AR prevention and control methods in combination with the characteristics of traditional Chinese medicine.The AR belongs to the category of "Bi Qiu" of traditional Chinese medicine.From the Western Zhou Dynasty,the theory of epistaxis was gradually enriched and perfected.Prof.Tian Li,a tutor,combined ancient and modern medical experts and their own clinical experience,believes that the key to the treatment of allergic rhinitis is “spontaneous treatment of lung and heart”.Through previous animal experiments and clinical studies,it has been proved that "Keminqidan nasal spray" has definite curative effect on allergic rhinitis of lung deficiency and blood stasis,and can control its recurrence.At present,the clinical mechanism of Keminqidan treatment of AR remains to be further studied.OBJECTIVE:Based on the role of IL-4 in the pathological mechanism of AR(which can induce Th0 to differentiate to Th2,and also to differentiate and proliferate B cells),the changes of serum IL-4 in patients with AR patients with lung deficiency and blood stasis treated by Keminqidan nasal spray are analyzed to discuss the mechanism of the action of Keminqidan nasal spray on AR,and provide reference for the clinical study of the external treatment of traditional Chinese medicine.METHODS:In this study,a randomized,double-blind,parallel control method was used to divide 40 outpatients to the standard allergic rhinitis into the experimental group and the placebo group: the experimental group was given the nasal spray of Keminqidan,3 times on the 1 day,each side of the nasal cavity with 2 spray,and the placebo group was given the saline nasal spray,1 days 3 times,and each side of the nasal cavity 2,each time,and used continuously for four weeks.The scores of symptoms and signs,RQLQ scale,and IL-4 serum levels before and after treatment,third weeks and fourth weeks after treatment were recorded.Finally,the statistical data SPSS21.0 was used to analyze the data.RESULTS:1.Comparison of IL-4 before and after treatment,P<0.001 in group A and P>0.05 in group B.2.The correlation between the rate of IL-4 change and body tiredness and fatigue and ocular symptoms in group A were P<0.05;3.The P value of spleen deficiency symptoms in group A was less than 0.05,and the P value of spleen deficiency symptoms in group B was more than 0.05.4.Compared with before and after treatment,the total P value of RQLQ in group A and group B were less than 0.05;The all P value in group A were less than 0.05,and the P value of nasal symptoms was <0.05;Compared with group A and B,the P values of sleep,actual problems,nasal symptoms,eye symptoms,emotions,activities,and quality were all <0.05.5.Symptoms and signs of group A had p value<0.05,and group P had symptoms P<0.05.There were 6 cases of nasal mucosal irritation in group A.In group B,there were 2 cases of nasal mucous membrane irritation and 1 case of nasal dry discomfort.CONCLUSIONS:1.Changes in IL-4 before and after treatment,Keminqidan has an effect on IL-4,can reduce IL-4,placebo has no effect on IL-4.It can be speculated that Keminqidan can induce Th0 to Th1 differentiation,inhibit Th0 to Th2 differentiation,balance Th1 and Th2,reduce IL-4.2.The change of IL-4 in the Keminqidan group was positively linear with the body fatigue and ocular symptoms.It is suggested that Keminqidan can reduce IL-4 by supplementing Qi.3.Keminqidan has the function of tonifying the spleen,but placebo does not help the spleen.4.Keminqdan and placebo all have RQLQ alleviation effect on AR patients;4.Keminqidan can improve AR patients’ RQLQ from 7 dimensions,and placebo can improve RQLQ from nasal symptoms;In improving RQLQ,especially sleep,actual problems,nasal symptoms,eye symptoms,emotions,and activities,Keminqidan has advantages over placebo nasal spray.5.Keminqidan can improve the symptoms and signs of AR,and placebo can improve the symptoms of AR.6.In group of Keminqidan,there were 6 cases of nasal mucosal irritation.In group of placebo,there were 2 cases of nasal mucous membrane irritation and 1 case of nasal dry discomfort.