目的:评价针刺联合艾灸治疗过敏性鼻炎(AR)的临床疗效及安全性。方法:选取AR患者80例，采用随机数字表法分为药物组与针刺联合艾灸组，每组40例。药物组给予氯雷他定片口服，每日1片，10 d为1个疗程，治疗3个疗程；针刺联合艾灸组以迎香(双)、印堂、合谷(双)、肾俞(双)为主穴进行针刺和艾灸，并随证加减穴位，每日治疗1次，每次30 min

10次为1个疗程，治疗3个疗程。治疗前后分别评定临床症状评分、临床体征评分及鼻-结膜相关生活量表评分；刮取部分下鼻甲黏膜组织表面的分泌物，采用HE染色法及Sheldeny评价法进行嗜酸性粒细胞(EOS)分布程度评分；采用酶联免疫吸附法测定血清免疫球蛋白E(IgE)、维甲酸孤儿受体γt(RORγt)、叉头盒蛋白P3(Foxp3)、白细胞介素-17(IL-17)、IL-27、IL-33含量。评价两组AR患者的临床疗效，并记录治疗期间出现的所有不良反应。结果:两组患者临床症状评分、临床体征评分及鼻-结膜相关生活量表评分、EOS分布评分及血清IgE、RORγt、IL-17、IL-33含量均较本组治疗前降低(P

<

0.05)

血清Foxp3、IL-27含量较本组治疗前升高(P

<

0.05)。治疗后针刺联合艾灸组临床症状评分、临床体征评分及鼻-结膜相关生活量表评分及血清IgE、RORγt、IL-33含量低于药物组(P

<

0.05)

血清Foxp3、IL-27含量高于药物组(P

<

0.05)。针刺联合艾灸组总有效率为100.0%(40/40)

显著高于药物组的82.5%(33/40

P

<

0.05)。治疗期间及治疗后，两组患者均未出现明显不良反应。结论:针刺联合艾灸治疗AR疗效显著，安全性好，其治疗机制可能与调控幼稚CD4

+

T细胞介导的辅助性T细胞(Th)1/Th2、Th17/调节性T细胞平衡有关。Objective To evaluate the clinical efficacy and safety of acupuncture combined with moxibustion on allergic rhinitis. Methods Using the random number table

80 patients with allergic rhinitis were divided into a medication group and an acupuncture combined with moxibustion(acu-mox) group

40 cases in each one. In the medication group

ioratadine tables were prescribed for oral administration

one tablet daily for 10 days as 1 session

3 sessions of treatment were required. In the acupuncture combined with moxibustion group

bilateral Yingxiang(LI20)

Yintang(EX-HN3)

bilateral Hegu(LI4) and bilateral Shenshu(BL23) were selected as the main points and stimulated with acupuncture and moxibustion; and the acupoint prescription was modified according to symptoms. This combined treatment was given once every day

stimulating for 30 min each time

and 10 treatments made 1 course

for 3 courses of treatment totally. Before and after treatment

the scores for symptoms and physical signs

as well as the score of rhino-conjunctivitis related quality of life scale(R-QOL) were evaluated separately. The sample of the inferior turbinate mucosa tissue was collected and the distribution of eosinophil(EOS) was scored using HE staining and Sheldeny evaluation. Using enzyme-linked immunosorbent assay(ELISA)

the contents of serum immunoglobulin E(IgE)

retinoic-acid-receptor-related orphan nuclear receptor γt(RORγt)

forkhead box protein P3(Foxp3)

interleukin-17(IL-17)

IL-27 and IL-33 were determined. The clinical efficacy was evaluated in the patients with allergic rhinitis of two groups and all the adverse reactions were recorded during treatment. Results The scores of symptoms and physical signs as well as the score of R-QOL

and EOS distribution score and the contents of serum IgE

RORγt

IL-17 and IL-33 were all reduced as compared with those before treatment in each group(P

<

0.05)

and the contents of serum Foxp3 and IL-27 were increased as compared with those before treatment in each group(P

<

0.05). After treatment

the scores of symptoms and physical signs as well as the score of R-QOL

and the contents of serum IgE

RORγt and IL-33 in the acu-mox group were lower than those in the medication group(P

<

0.05)

and the contents of serum Foxp3 and IL-27 were higher than those of the medication group(P

<

0.05). The total effective rate of the acu-mox group was 100.0%(40/40)

significantly higher than 82.5%(33/40) in the medication group(P

<

0.05). No ob-vious adverse reaction was found in either group during and after treatment. Conclusion Acupuncture combined with moxibustion is significantly effective and safe in treatment of allergic rhinitis. Its effect mechanism may be related to the balance modulation of Th1/Th2 and Th17/Treg cells mediated by naive CD4+T细胞介导的辅助性T细胞(Th)1/Th2、Th17/调节性T细胞平衡有关。