目的 评价在糠酸莫米松鼻喷雾剂基础上联合中药熏蒸（小青龙汤）及锋钩针对肺气虚寒型变应性鼻炎的临床疗效。 方法 采用随机对照试验的方法，纳入2025年1—7月于广州中医药大学附属北碚中医院就诊的肺气虚寒型变应性鼻炎患者144例。对照组（糠酸莫米松鼻喷雾剂）、熏蒸组（糠酸莫米松鼻喷雾剂 + 中药熏蒸）、钩针组（糠酸莫米松鼻喷雾剂 + 锋钩针）、联合组（糠酸莫米松鼻喷雾剂 +中药熏蒸 + 锋钩针）：糠酸莫米松鼻喷雾剂每日2次，每次每鼻孔2揿，疗程14 d；中药熏蒸6 d后休息2 d，再熏蒸6 d，总疗程14 d；锋钩针于入组当天及第8天各操作1次，共2次。其余3组相应操作方法同联合组。治疗前后采用酶联免疫吸附法（enzyme-linked immunosorbent assay，ELISA）检测血清白细胞介素?4（interleukin-4，IL-4）、IL-5、IL-13、免疫球蛋白E（immunoglobulin E，IgE）、胸腺基质淋巴细胞生成素（thymic stromal lymphopoietin，TSLP）、γ干扰素（interferon-gamma，IFN-γ）水平，对鼻腔分泌物嗜酸性粒细胞（nasal secretion eosinophils， EOS）分布程度及主观症状进行评分统计。 结果 治疗后4组患者血清IL-4、IL-5、IL-13、IgE、TSLP水平、EOS分布程度评分、主观症状评分均较治疗前下降（P < 0.05），且联合组在改善血清炎性因子水平及鼻部伴随症状评分（Total Nasal Non-symptom Score，TNNSS）、视觉模拟评分（Visual Analogue Scale，VAS）评分上较其余3组显著降低（P < 0.01），在改善EOS分布程度评分及鼻部症状总分分级标准（severity grading criteria for Total Nasal Symptom Score，TNSS）、鼻眼结膜相关生活质量问卷调查量表（Rhinoconjunctivitis Quality of Life Questionnaire，RQLQ）评分上优于对照组（P < 0.05）。联合组、熏蒸组、钩针组治疗后血清IFN-γ水平较治疗前上升（P < 0.05），对照组治疗前后对IFN-γ的疗效无统计学意义（P > 0.05）。 结论 在糠酸莫米松鼻喷雾剂基础上联合中药熏蒸（小青龙汤）及锋钩针安全性好，可有效调控肺气虚寒型变应性鼻炎的炎症因子水平并缓解主观症状。

Objective To evaluate the clinical efficacy of combining herbal fumigation （Xiaoqinglong Decoction） and sharp hook needle therapy on the basis of mometasone furoate nasal spray in treating allergic rhinitis with lung?qi deficiency and cold syndrome. Methods A randomized controlled trial was conducted. A total of 144 patients with allergic rhinitis of lung?qi deficiency and cold syndrome， treated at the Beibei Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine from January to July 2025， were enrolled. Patients were divided into： Control group （mometasone furoate nasal spray）， Fumigation group （mometasone furoate nasal spray + herbal fumigation）， Hook needle group （mometasone furoate nasal spray + sharp hook needle）， and Combination group （mometasone furoate nasal spray + herbal fumigation + sharp hook needle）. Mometasone furoate nasal spray was administered twice daily， 2 sprays per nostril each time， for 14 days. Herbal fumigation was applied for 6 days， followed by a 2-day break， then another 6 days， totaling 14 days. Sharp hook needle therapy was performed once on the day of enrollment and again on day 8， totaling 2 sessions. The corresponding procedures in the other three groups followed the same schedule as the Combination group. Serum levels of interleukin-4 （IL-4）， interleukin-5 （IL-5）， interleukin-13 （IL-13）， immunoglobulin E （IgE）， thymic stromal lymphopoietin （TSLP）， and interferon-gamma （IFN-γ） were measured by enzyme-linked immunosorbent assay （ELISA） before and after treatment. The distribution degree of eosinophils （EOS） in nasal secretions and subjective symptom scores were also assessed. Results After treatment， serum levels of IL-4， IL-5， IL-13， IgE， TSLP， EOS distribution scores， and subjective symptom scores decreased significantly in all four groups compared to before treatment （P < 0.05）. The Combination group showed significantly greater reductions in serum inflammatory factor levels， TNNSS， and VAS scores compared to the other three groups （P < 0.01）， and greater reductions in EOS distribution scores， TNSS， and RQLQ scores compared to the Control group （P < 0.05）. Serum IFN-γ levels increased after treatment in the Combination， Fumigation， and Hook needle groups （P < 0.05）， while no statistically significant change in IFN-γ was observed in the Control group before and after treatment （P > 0.05）. Conclusion The combination of herbal fumigation （Xiaoqinglong Decoction） and sharp hook needle therapy on the basis of mometasone furoate nasal spray is safe and effective in regulating inflammatory cytokine levels and alleviating subjective symptoms in patients with allergic rhinitis of lung?qi deficiency and cold syndrome.