针刺联合中药穴位贴敷治疗小儿支气管哮喘的临床研究  

Clinical Study of Acupuncture Combined with Chinese Medicinal Acupoint Sticking for Bronchial Asthma in Children

作　　者：汪蕾[1] 赵静[1] 赵因[1] WANG Lei;ZHAO Jing;ZHAO Yin(Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010,China)

机构地区：[1]首都医科大学附属北京中医医院,北京100010

出　　处：《上海针灸杂志》2022年第2期174-179,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：北京市医院管理局培育计划(PZ2021022)。

摘　　要：目的观察针刺联合中药贴敷治疗小儿支气管哮喘的临床疗效并探讨其可能的机制。方法将70例哮喘慢性持续期患者按照随机数字表法分为观察组与对照组,每组35例。两组均予沙美特罗替卡松粉经口吸入治疗,观察组在此基础上加用针刺联合中药贴敷治疗。比较两组治疗前后症状评分、小气道功能检测指标及血常规、血清免疫球蛋白E(IgE)、淋巴细胞亚群(CD3^(﹢)、CD4^(﹢)、CD8^(﹢)、CD19^(﹢))和CD4^(﹢)T细胞亚群(Th1、Th2、Th17、Treg)检测结果。比较两组临床疗效。结果观察组总有效率91.4%,优于对照组的77.1%(P<0.05)。观察组治疗后症状积分明显低于对照组(P<0.05)。观察组治疗后小气道功能指标均明显高于对照组(P<0.05)。观察组治疗后血清IgE、CD3^(﹢)、CD4^(﹢)、CD19^(﹢)、CD4^(﹢)/CD8^(﹢)均明显低于对照组(P<0.05),CD8^(﹢)明显高于对照组(P<0.05)。观察组治疗后CD4^(﹢)T细胞亚群中Th2、Th17、Treg、Th17/Treg均明显低于对照组(P<0.05),Th1、Th1/Th2则明显高于对照组(P<0.05)。结论在西药治疗基础上,针刺联合中药贴敷可明显缓解小儿支气管哮喘的临床症状,改善小气道功能,其作用机制可能与调节免疫细胞及免疫因子相关。Objective To observe the clinical efficacy of acupuncture plus Chinese medicinal sticking in treating bronchial asthma in kids and discuss its possible mechanism.Method Seventy patients with asthma in chronic persistent stage were randomized into an observation group and a control group using the random number table method,with 35 cases in each group.Both groups were offered Salmeterol xinafoate and Fluticasone propionate powder via oral inhalation.In addition,the observation group received acupuncture and Chinese medicinal sticking therapies.Before and after the treatment,the symptom score,small airway function test,blood routine test,and the serum immunoglobulin E(IgE),lymphocyte subsets(CD3^(﹢),CD4^(﹢),CD8^(﹢),and CD19^(﹢)),and CD4^(﹢)T cell subsets(Th1,Th2,Th17,and Treg)were compared for the two groups.The clinical efficacy was also compared.Result The total effective rate was 91.4%in the observation group,higher than 77.1%in the control group(P<0.05).After the intervention,the symptom score was significantly lower in the observation group than in the control group(P<0.05);the small airway function indicator levels were notably higher in the observation group than in the control group(P<0.05);the serum levels of IgE,CD3^(﹢),CD4^(﹢),CD19^(﹢),and CD4^(﹢)/CD8^(﹢)were significantly lower in the observation group than in the control group(P<0.05),and the level of CD8^(﹢)was higher in the observation group(P<0.05);the levels of Th2,Th17,Treg,and Th17/Treg in the CD4^(﹢)T cell subsets were markedly lower in the observation group than in the control group(P<0.05),and the levels of Th1 and Th1/Th2 were significantly higher in the observation group(P<0.05).Conclusion Based on the Western medication,acupuncture plus Chinese medicinal sticking therapy can alleviate the clinical symptoms and improve the small airway function in treating bronchial asthma in kids;its treatment mechanism may be associated with the regulation of immunocytes and immune factors.

关 键 词：针刺疗法 穴位贴敷法 哮喘 儿童 气道功能 免疫因子 免疫细胞 

分 类 号：R246.1[医药卫生—针灸推拿学]