抗敏合方對過敏性鼻炎臨床療效之研究(2/2)

戴志展
中國醫藥大學
過敏性鼻炎是一種非常常見的疾病，據估計，在美國影響近1/10的美國人。台灣處於亞熱帶地區，因氣候潮濕，罹患過敏性疾病甚多，其中以過敏性鼻炎與氣喘最為常見。近年來，環境污染日益嚴重，過敏性疾病如支氣管氣喘、過敏性鼻炎、濕疹，呈現增加的趨勢，根據調查，20年間(民國63年至83年)台北地區學童過敏性鼻炎之罹患率顯著增加，民國83年達33.53%，由此可見對過敏性鼻炎治療與預防的重要性。從細胞激素之調控來看，過敏性鼻炎呈現Th2細胞增多的趨勢，Th2所分泌的細胞激素中IL-4能抑制Th1活性，刺激B細胞產生IgE，刺激肥大細胞生長、發育、誘導血管內皮細胞VCAM-1表現及嗜酸性白血球過多症，相對的，Th1細胞-細胞激素INF-γ對Th2細胞具負迴饋反應。調節Th1/Th2細胞的平衡以使Th2比例減少而Th1比例增加，被認為是治療Th2細胞產生的過敏疾病，因而Th1/Th2免疫調節劑之發展乃為近年來研究對過敏性鼻炎預防與治療之重點之一，免疫療法即是將Th2反應轉向Th1反應，經由其他途徑之免疫療法曾被研究過，經由口腔途徑投與者並沒有成功，因此尋找Th1/Th2細胞平衡的口服藥物是值得開發的方向，抗敏合方（小柴胡湯、逍遙散、六味地黃丸加減），是中醫臨床治療過敏性鼻炎具明顯療效方劑之一，尤其適合台灣地區過敏性鼻炎證型，但對其詳細之臨床療效評估，與其免疫調節機轉探討一直闕如，本研究團隊曾探討養陰克敏方對過敏性氣喘患者之免疫調節作用及小青龍湯對過敏性鼻炎之臨床療效評估。本研究擬探討抗敏合方對過敏性鼻炎患者臨床症狀、鼻氣流阻力、鼻腔內空間血清中IgE、過敏原特異性IgE，過敏原特異性IgG4及細胞激素(IL-4、IL-5、IL-12、INF-γ) 之影響，尋找更好的治療方劑。
關鍵字：過敏性鼻炎；抗敏合方；過敏原特異性IgE；細胞激素

Clinical Evaluation of Kang-Min-He-Fang in the Treatment of Allergic Rhinitis(2/2)

Tai Chih Jaan
China Medical University
Allergic rhinitis is a common disease that is estimated to affect nearly one tenth of the U.S. population. It is caused by cascade of inflammatory mediators, initiated after contact of the nasopharynx with allergens such as grass, tree pollen, and animal dander. The disease is characterized by chronic nasal symptoms of obstruction, rhinorrhea, sneezing, and itching. Components of inhaled dust, such as mites and molds, or animal dander cause an imtranasal IgE-mediated response in atopic individuals. These perennial allergens active mast cells induce the release of potent chemical medicators that attract inflammatory cells such as eosinophils and basophils, and ultimately produce the signs and symptoms of allergic rhinitis.There are detailed descriptions of the clinical experiences and prescriptions of allergic rhinitis in traditional Chinese medicine. Kang-Min-He-Fang (KMHF) is one of the Chinese herbal medicines used to treat allergic rhinitis . In this study we will evaluate the effect of KMHF on clinical symptoms, serum total IgE, allergen specific IgE, allergen specific IgG4 and cytokines (IL-4 IL-5 IL-12 INF-r) in the treatment of allergic rhinitis.
關鍵字：allergic rhinitis；Kang-Min-He-Fang