目的:探讨麻黄连翘赤小豆汤加减治疗变应性鼻炎(AR)的临床疗效和对患者血清γ-干扰素(IFN-γ),白细胞介素-2(IL-2),白细胞介素-4(IL-4),白细胞介素-5(IL-5),白细胞介素-17(IL-17),白细胞介素-10(IL-10)和血清总Ig E(TIg E)水平的影响。方法:125例AR肺经郁热型患者随机按数字表法分为对照组62例和观察组63例,并设20例健康。对照组采用布地奈德气雾剂,200~1 600μg·d~(-1),分成2~4次使用;观察组采用麻黄连翘赤小豆汤加减内服,10 g/次,2次/d。两组疗程均为7 d。检测治疗前后IFN-γ,IL-2,IL-4,IL-5,IL-17,IL-10和TIg E水平;采用视觉模拟量表(VAS)对治疗前后鼻塞、鼻痒、喷嚏、流涕4个症状和总体症状进行评分。结果:治疗后观察组临床愈显率为80.95%,对照组为61.29%,经卡方检验观察组高于对照组(P<0.05);观察组和对照组临床总有效率分别为95.24%和91.94%,经卡方检验差异无统计学意义;治疗后观察组鼻塞、鼻痒和喷嚏评分低于对照组(P<0.05);与健康对照组比较,治疗前两组血清IFN-γ,IL-2和IL-10水平均低于健康对照组(P<0.01),IL-4,IL-5,IL-17和TIg E水平则比健康对照组高(P<0.01);与治疗前比较,两组治疗后血清IL-2,IL-10均显著升高(P<0.01),IL-5,IL-17和TIg E水平均明显下降(P<0.01),两组IFN-γ变化无统计学意义;与对照组比较,治疗后观察组血清IL-2,IL-10水平均高于对照组,IL-5,IL-17和TIg E水平均低于对照组(P<0.01);治疗后两组间IFN-γ和IL-4水平差异无统计学意义;治疗后两组IFN-γ,IL-2和IL-10水平仍然低于健康对照组(P<0.01),而IL-4,IL-5,IL-17和TIg E水平仍然高于健康对照组(P<0.01)。结论:麻黄连翘赤小豆汤加减对AR患者的Th1/Th2,Th17,Treg细胞因子均有一定的调节作用,促使其恢复平衡,减轻炎症反应,治疗AR临床疗效优于布地奈德气雾剂。 Objective: To investigate the clinical curative effect of ephedra forsythia chidexuetang decoction on allergic rhinitis (AR) and its effect on serum levels of interferon-γ (IFN-γ), interleukin-2 (IL-2), interleukin-4 (IL-4), interleukin-5 (IL-5), interleukin 17 (IL-17), interleukin 10 (IL-10) and total serum IgE (TIg E) . Methods: One hundred and twenty-five AR patients were divided into control group (n = 62) and observation group (n = 63) according to the random number table. The control group was treated with budesonide aerosol, 200 ~ 1 600 μg · d ~ (-1), and divided into two or four times. The observation group was treated with ephedrine forsythia chidexuetang decoction orally, 10 g / time and twice daily. The two courses of treatment were 7 d. The levels of IFN-γ, IL-2, IL-4, IL-5, IL-17, IL-10 and TIgE were measured before and after treatment. The visual analog scale (VAS) Four symptoms and general symptoms of tears were scored. Results: After treatment, the clinical cure rate was 80.95% in the observation group and 61.29% in the control group, which was significantly higher in the observation group than in the control group (P <0.05). The total effective rates in the observation group and the control group were 95.24% 91.94%, there was no significant difference by chi-square test. After the treatment, nasal congestion, nasal itching and sneezing score in the observation group were lower than those in the control group (P <0.05); Compared with healthy control group, serum IFN- (P <0.01). The levels of IL-4, IL-5, IL-17 and TIg E were significantly higher than those in healthy controls (P <0.01). Compared with those before treatment The levels of IL-2, IL-10 and IL-5, IL-17 and TIg E were significantly decreased in both groups after treatment (P <0.01) Compared with the control group, the levels of IL-2 and IL-10 in the observation group were significantly higher than those in the control group, and the levels of IL-5, IL-17 and TIgE in the observation group were lower than those in the control group (P <0.01); The levels of IFN-γ, IL-2 and IL-10 in the two groups after treatment were still lower than those in healthy controls (P <0.01) 4, IL-5, IL-17 and TIg E levels were still higher than the healthy control group (P <0.01). Conclusion: The addition and subtraction of ephedra forsythiae Chuxiong Dou decoction can regulate the Th1 / Th2, Th17 and Treg cytokines in AR patients, promote its balance recovery and reduce the inflammatory reaction. The curative effect of AR is better than that of budesonide aerosol.