補中益氣湯對緩解期過敏性鼻炎患者免疫機轉影響之研究

楊賢鴻
財團法人長
「過敏性疾病」（過敏性鼻炎、氣喘、異位性皮膚炎）在台灣小學學齡族群中佔有相當高的比例，尤以「過敏性疾病」，約占1/3的比例，臨床上本疾病的最大困擾為不斷的反覆再發，導致治療上的困難，同時該疾病也會影響到孩童的學習，中醫認為「過敏性疾病」的發生原因可分為「肺氣虛」、「肺脾氣虛」及「腎氣虛」，基本上本病的發生原因皆因為「氣虛」所致，所以臨床上針對疾病緩解期適度給予中藥「補氣藥」可有效改善體質，以減少「過敏性疾病」的再發率。在先前的計畫我們評估了「過敏性疾病」的中醫臨床療效，現在我們希望進一步探討「補氣藥」對「過敏性疾病」患者的臨床症狀影響，及體內免疫機轉的調節，做為未來中醫臨床上對「過敏性疾病」患者治療及預防的指標。

實驗中將選擇臨床上出現打噴嚏、流鼻水、鼻塞的患者，血清中過敏抗體IgE呈陽性反應經中藥治療一個月後，有臨床症狀改善；IgE值下，疾病降進入緩解期的患者80例，分兩組治療，一組給予「補中益氣湯」做為治療組，一組給予「平胃散」做為對照組，治療期間為二個月，治療前後及治療中將分別評估兩組患者：一、臨床症狀指數，二、單核球在IL-4及IL13刺激下IgE產生量的多寡，三、嗜中性白血球在IL-4及IL13刺激下，PGE2, LTC4, LTD4的產生量及環氧脢(cyclooxygenase)；COX1；COX2的mRNA表現強弱，來評估服用「補中益氣湯」的患者體內致敏機轉是否受到調節，並了解中藥「補中益氣湯」是否能藉著體內免疫機能的調節作用，來達到改善體質減少過敏的再發情況，做為未來中藥「補中益氣湯」臨床上治療的依據，及進一步了解中藥補藥對過敏性疾病的重要性。

關鍵字：過敏性鼻炎、補中益氣湯、細胞激素

Immunolgic studies on allergic rhinitis treated by Chinese medicine, Bu-zhong-yi-qi-tang

Jun-Hong Yang
Chang Gung Memorial Hospital
The prevalence of hypersensitivity disorders, including allergic rhinitis, bronchial asthma and ectopic dermatitis, is as high as one-third in pupils of elementary schools. Hypersensitivity disorders are chartered by the relapsing despite the clinical therapy. The mechanism of hypersensitivity has been suggested to be caused by the deficiency of “Lung-Chi”, “Lung-Spleen-Chi”, and “Renal-Chi” by Chinese medicine. All these mechanisms suggest the deficiency of “Chi”.

Chinese medicine has been shown to relieve and to decrease the relapse of the hypersensitivity disorders by the supplement of “Chi”. Our prior study confirmed the clinical role of supplement of “Chi” in the treatment of hypersensitivity disorders. We, therefore, study the role of the supplement of “Chi” on the immunological modulation in hypersensitivity disorders.

We plan to study 80 patients of hypersensitivity disorders with the clinical symptoms of rhinorrhea, sneezing and nasal stiffness. For
關鍵字：allergic rhinitis, Bu-zhong-yi-qi-tang, cytokine