微创埋线联合扶正化瘀方治疗肺肾气虚型慢性阻塞性肺疾病疗效及对免疫功能的影响  

Efficacy of micro-invasion catgut embedding combined with Fuzheng Huayu Decoction on COPD with lung-kidney Qi deficiency syndrome and its effect on immune function

作　　者：王虹[1,2] 王余民[1,2] 孙文善[3] 沈丽萍 WANG Hong;WANG Yumin;SUN Wenshan;SHEN Liping(Shanghai Fifth People’s Hospital Affiliated to Fudan University,Shanghai 200240,China;Community Health Research Center of Fudan University(in preparation),Shanghai 200240,China;Shanghai Tenth People’s Hospital,Shanghai 200072,China;Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)

机构地区：[1]复旦大学附属上海市第五人民医院,上海200240 [2]复旦大学社区健康研究中心(筹),上海200240 [3]上海市第十人民医院,上海200072 [4]上海中医药大学附属龙华医院,上海200032

出　　处：《现代中西医结合杂志》2021年第20期2188-2193,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：上海市闵行区自然科学研究课题(2018MHZ013)。

摘　　要：目的观察微创埋线联合扶正化瘀方治疗肺肾气虚型慢性阻塞性肺疾病疗效及对免疫功能的影响。方法将2018年9月-2020年1月上海市第五人民医院中医科收治的90例肺肾气虚型慢性阻塞性肺疾病患者随机分为对照组和治疗组,每组各45例。对照组给予常规西医治疗和扶正化瘀方内服治疗,治疗组在对照组治疗基础上联合微创埋线治疗(每周1次),疗程均为3个月。比较2组治疗疗效,治疗前后的肺功能、体质指数(BMI)、6 min步行距离(6MWD)、呼吸困难指数(mMRC)评分及血清IgM、IgA、IgG、降钙素原、白细胞介素17(IL-17)、转化生长因子-β_(1)(TGF-β_(1))水平。结果治疗组总有效率为91.1%(41/45),对照组总有效率为75.6%(34/45),治疗组疗效优于对照组(P<0.05);2组治疗后第1秒用力呼气容积占预计值百分比(FEV_(1)%)、用力肺活量(FVC)、FEV_(1)/FVC均较本组治疗前明显升高(P均<0.05),且治疗组各指标均明显高于对照组(P均<0.05)。治疗后,2组BMI与治疗前比较差异均无统计学意义(P均>0.05),2组间比较差异无统计学意义(P>0.05);治疗后对照组6MWD、mMRC评分与治疗前比较差异均无统计学意义(P均>0.05),治疗后治疗组6MWD较治疗前及对照组明显增加(P均<0.05),mMRC评分较治疗前及对照组明显下降(P均<0.05)。治疗后,对照组IgM、IgA、IgG水平与治疗前比较差异均无统计学意义(P均>0.05),治疗组IgM、IgA、IgG水平均较治疗前显著升高(P均<0.05),且显著高于对照组(P均<0.05)。治疗后,2组PCT与治疗前比较差异均无统计学意义(P均>0.05),2组IL-17、TGF-β_(1)水平均较治疗前明显降低(P均<0.05),且治疗组明显低于对照组(P均<0.05)。结论微创埋线联合扶正化瘀方治疗肺肾气虚型慢性阻塞性肺疾病疗效确切,可明显改善肺功能,增加患者运动耐量,且可明显抑制气道炎症反应,提高机体免疫功能。Objective It is to observe the clinical efficacy of micro-invasion catgut embedding combined with Fuzheng Huayu Decoction in the treatment of chronic obstructive pulmonary disease(COPD)with lung-kidney Qi deficiency syndrome and its effect on immune function.Methods A total of 90 COPD patients with lung-kidney Qi deficiency syndrome treated in Department of Traditional Chinese Medicine,Shanghai Fifth People's Hospital were randomly divided into the control group and treatment group,with 45 cases in each group.The control group was given routine western medicine combined with Fuzheng Huayu Decoction,the treatment group was added with micro-invasion catgut embedding(once a week)on the basis of the control group,both groups were treated for 3 months.The therapeutic effects of the two groups,lung function,body mass index(BMI),6-min walking distance(6MWD),dyspnea index(mMRC scores),levels of serum IgM,IgA,IgG,procalcitonin,and interleukin 17(IL-17),transforming growth factor-β_(1)(TGF-β_(1))before and after treatment in the two groups were compared.Result The total effective rate in the treatment group was 91.1%(41/45),and that in the control group was 75.6%(34/45),the curative effect of the treatment group was better than that of the control group(P<0.05);the percentage of forced expiratory volume in 1 second to the predicted value(FEV 1%),forced vital capacity(FVC),FEV_(1)/FVC were all significantly higher than those before treatment in the two groups(all P<0.05),and the indicators of the treatment group were significantly higher than those of the control group(all P<0.05).There was no significant difference in BMI between before and after treatment in the two groups and between the two groups after treatment(all P>0.05).There was no significant difference in 6MWD and mMRC score between before and after treatment in the control group(both P>0.05),but 6MWD was significantly higher and mMRC score was lower after treatment in the treatment group than that before treatment and in the control group(all P<0.05).After tr

关 键 词：穴位埋线 扶正化瘀方 慢性阻塞性肺疾病 肺肾气虚 免疫功能 

分 类 号：R563[医药卫生—呼吸系统]