经皮穴位电刺激对慢性阻塞性肺疾病患者急性加重风险的影响  

Effect of transcutaneous electrical acupoint stimulation on lung function and risks of exacerbation for patients with chronic obstructive pulmonary disease

作　　者：肖雄[1] 李姝 王燕[1] 雷冬梅 张霞[2] 赵奉茹 黄伟[1] XIAO Xiong;LI Shu;WANG Yan;LEI Dong-mei;ZHANG Xia;ZHAO Feng-ru;HUANG Wei(Department of Tra ditional Chinese Medicine,Chengdu Fifth People’s Hospital,Chengdu 611130,China;Department of Traditional Chinese Medicine,Chengdu Wenjiang People’s Hospital,Chengdu 611130)

机构地区：[1]成都市第五人民医院,成都中医药大学附属第五人民医院中医科,成都611130 [2]成都市温江区人民医院中医科,成都611130

出　　处：《针刺研究》2021年第7期598-604,共7页Acupuncture Research

基　　金：成都市卫生健康委员会科研项目(No.2018098)。

摘　　要：目的:评估经皮穴位电刺激(TEAS)对慢性阻塞性肺疾病(COPD)稳定期患者肺功能、临床症状、活动耐量和急性加重风险的影响。方法:COPD患者随机分为TEAS组25例及对照组24例。TEAS组患者于双侧肺俞、定喘、足三里、脾俞实施TEAS治疗,每次40 min,隔天1次,4周为1个疗程,每3个月治疗1个疗程,共4个疗程。对照组患者在相同穴位上安置TENS电极但不通电,其余治疗措施与TEAS组相同。分别在治疗前、治疗1个月后及治疗1年后记录患者肺功能(FEV1%、FVC%)、临床症状CAT评分、6 min步行距离(6MWD)和急性加重风险(中重度急性加重次数、住院次数)的变化,并对患者急性加重风险因素进行相关性分析。结果:相关性分析显示,急性加重风险与FEV1%、FVC%呈负相关(P<0.01),与CAT评分呈正相关(P<0.01)。与治疗前比较,对照组治疗1个月后及治疗1年后的FEV1%、FVC%、6MWD均下降(P<0.001,P<0.01),CAT评分升高(P<0.05);TEAS组患者治疗1个月后FEV1%升高(P<0.001),治疗1个月后及治疗1年后的CAT评分降低(P<0.001,P<0.05),治疗1个月后及治疗1年后的6MWD明显升高(P<0.001),治疗1年后中重度急性加重次数、住院次数显著减少(P<0.001)。与同时点对照组比较,TEAS组患者治疗1个月后的FEV1%升高(P<0.05),治疗1个月后及治疗1年后的FVC%升高、6MWD升高(P<0.05),治疗1个月后及治疗1年后的CAT评分降低(P<0.05),治疗1年后中重度急性加重次数、住院次数均减少(P<0.001,P<0.01)。结论:TEAS可以改善COPD患者肺功能、临床症状、活动耐量,并降低急性加重风险。Objective To evaluate the effect of transcutaneous electrical acupoint stimulation(TEAS)on lung function,clinical symptoms,exercise tolerance and risk of acute exacerbation in patients with chronic obstructive pulmonary disease(COPD).Methods A total of 49 outpatients with COPD were randomly divided into TEAS group and control group by using a digital table.The clinical trials were conducted by using randomized,single-blinded and placebo-controlled method.Patients in the TEAS group were treated by TEAS of Feishu(BL13),Dingchuan(EX-B1),Zusanli(ST36)and Pishu(BL20)for 40 min,once every other day for 4 weeks,while patients in the control group were treated with placebo TEAS which the electrode plates were adhered to the same acupoints but without electrical current outputs.The treatment was conducted every 3 months in one year.In addition,patients of the two groups had no restriction on their original treatment with conventional western medicines and Chinese Materia medica.The lung function(forced expiratory volume in 1 second predicted,FEV1%,forced vital capacity predicted,FVC%)was detected using a spirometer),clinical symptom scores(CAT)for coughing,phlegm,chest tightness,climbing,family activities,out-door activities,sleeping and energy status were given.The patient’s exercise tolerance was assessed using walking distance in 6 min,and the risks of acute exacerbation(times of exacerbation and hospitalization in 1 year)were recorded.Results Correlative analysis showed a negative correlation between the risks of acute exacerbation and the levels of FEV1%and FVC%(P<0.01)and a positive correlation between the risks of acute exacerbation and CAT score(P<0.01).Self-comparison showed that 1 month after the treatment,the FEV1%and FVC%levels,6 MWD in the control group were significantly decreased(P<0.001,P<0.01),while the CAT score in the control group,and FEV1%and 6 MWD in the TEAS group were obviously increased in comparison with their own pretreatment(P<0.05,P<0.001),but FVC%in the TEAS group and the times of exacerbat

关 键 词：经皮穴位电刺激 慢性阻塞性肺疾病 急性加重风险 肺功能 

分 类 号：R245.97[医药卫生—针灸推拿学]