针刺疗法对稳定期慢性阻塞性肺疾病患者呼吸功能的影响  

Effect of Acupuncture on Respiratory Function of Stable Chronic Obstructive Pulmonary Disease

作　　者：郭泳梅[1] 童娟[2] 姚红[2] 

机构地区：[1]南方医科大学附属小榄医院呼吸科,广东中山528415 [2]广州医科大学第一附属医院,广东广州510120

出　　处：《广州中医药大学学报》2013年第5期658-663,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省科技厅课题(编号:20100308);广东省中医药管理局课题(编号:20111258)

摘　　要：【目的】观察针刺疗法对稳定期慢性阻塞性肺疾病(COPD)患者呼吸功能的影响。【方法】将33例稳定期COPD患者随机分为治疗组18例和安慰组15例,其中2组各有1例退出。2组均在稳定期慢性阻塞性肺疾病规范用药和有氧运动训练的前提下,治疗组采用治疗针,安慰组采用安慰针,选取膻中、乳根(双)、膺窗(双)、天枢(双)、中脘、关元进行针刺治疗,隔日1次,共治疗14次。观察2组治疗前后中医临床症状、COPD生存质量、6 min步行距离(6-MWD)、肺功能检查相关指标[一秒钟用力呼气容积占预计值百分比(FEV1%)、用力肺活量占预计值百分比(FVC%)、FEV1与FVC的比值(FEV1/FVC)、最大分钟通气量(MVV)]等指标的变化情况。【结果】治疗组治疗前后6-MWD、FEV1%、FEV1/FVC、MVV差值均较安慰组显著改善,差异有统计学意义(P<0.05或P<0.01);2组治疗后中医临床症状总分和主要症状、整体症状评分均显著改善,差异有统计学意义(P<0.05或P<0.01),但治疗后两组间比较差异均无统计学意义(P>0.05)。生存质量方面,治疗组治疗后的生存质量总分、日常生活情况、抑郁症状均显著改善,差异有统计学意义(P<0.05或P<0.01);安慰组治疗前后生存质量总分和各组评分比较差异均无统计学意义(P>0.05)。肺功能方面,治疗组治疗后FEV1%、FEV1/FVC、MVV显著改善,差异有统计学意义(P<0.05或P<0.01),安慰组治疗后MVV显著改善,差异有统计学意义(P<0.01),但其余指标差异无统计学意义(P>0.05)。6-MWD方面,治疗组治疗后显著改善,与治疗前比较差异有统计学意义(P<0.01),安慰组治疗后改善不明显,与治疗前比较差异无统计学意义(P>0.05)。相关性分析结果表明:6-MWD与COPD生存质量总分呈负相关;6-MWD与FVC%、FEV1%、MVV呈正相关。【结论】针刺疗法能改善稳定期COPD患者的呼吸功能。Objective To observe the efficacy of acupuncture therapy on the respiratory function of chronic obstructive pulmonary disease （COPD） patients at stable phase. Methods Thirty-three stable COPD patients were randomly divided into acupuncture group （N=18） and placebo-acupuncture group （N=15）. During the treatment, one case in acupuncture group and one case in placebo-acupuncture group dropped out. The illness state of both groups was controlled by pulmonary rehabilitation treatment with conventional drugs and aerobic exercise training. And additionally, the treatment group was given acupuncture on acupoints of Shtmzhong, Rugen （bilateral）, Yingchuang （bilateral）, Tianshu （bilateral）, Zhongwan and Guanyuan, and the placebo- acupuncture group was given placebo acupuncture on the same acupoints as those of the treatment group. The acupuncture was performed once every other day, and treatment lasted 14 times for six weeks. Before and after intervention, we investigated the changes of clinical symptoms scores, COPD quality of life （QOL） scores, 6- mininute walking distance（6-MWD）, pulmonary function indexes such as the percentage of forced expiratory volume in one second （FEV1%）, the percentage of forced vital capacity （FVC%）, the ratio of FEV1 to FVC （FEV1 /FVC）, and maximum voluntary ventilation （MVV） in COPD patients at stable phase. Results Significant differences were showed between the two groups in the difference of pre-intervention and post- intervention 6-MWD, FEV1/FVC, FEV1% and MVV （P〈0.05 or P〈0.01） The total scores of clinical symptoms, and scores of main clinical symptoms, and overall symptoms after intervention in the acupuncture group were similar to those in the placebo-acupuncture group （P〉0.05）, but the total scores in both groups after intervention differed from those before intervention （P〈0.05 or P〈0.01）. The total COPD-QOL scores, and the dimension scores of daily life and depression in the acupuncture group after intervention di

关 键 词：肺疾病 慢性阻塞性 针刺疗法 呼吸功能 

分 类 号：R2-031[医药卫生—中西医结合]