足三里穴位注射胸腺肽治疗慢性阻塞性肺疾病稳定期随机对照研究  

Therapeutic Effects on Stable Chronic Obstructive Pulmonary Disease by Acupoints Injection of Thymosin at Zusanli(ST 36):a Randomized Controlled Trial

作　　者：贡丽娅 王娅 李鹤[1] 祁宏[1] 张海蒙[3] 沈雪勇[3] GONG Li-ya;WANG Ya;LI He;QI Hong;ZHANG Hai-meng;SHEN Xue-yong(Department of Chinese Medicine,Renji Hospital,School of Medicine,Shanghai Jiaotong University,Shanghai(200127);Department of Respiratory Medicine,Shanghai Tianshan Hospital of Traditional Chinese Medicine,Shanghai(200051);School of Acupuncture-Moxibustion and Tuina,Shanghai University of Traditional Chinese Medicine,Shanghai(201203))

机构地区：[1]上海交通大学医学院附属仁济医院中医科,上海200127 [2]上海市长宁区天山中医医院呼吸内科,上海200051 [3]上海中医药大学针灸推拿学院,上海201203

出　　处：《中国中西医结合杂志》2022年第1期34-39,共6页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：上海市科学技术委员会基金项目(No.18401902600,No.18401970800)。

摘　　要：目的观察足三里穴位注射胸腺肽治疗慢性阻塞肺疾病(COPD)稳定期的临床疗效,探讨注射方式与不同药物之间"穴-药"关系,分析主效应、交互效应和协同作用。方法将144例COPD稳定期患者随机分为穴位治疗组、肌肉治疗组、穴位对照组和肌肉对照组,每组36例。穴位治疗组:给予注射用胸腺肽(每支5 mg),溶于2 mL注射用水,双侧足三里穴位注射。肌肉治疗组:药物同穴位治疗组,臀部肌肉注射。穴位对照组:给予维生素B1注射液(每支0.1 g:2 mL),双侧足三里穴位注射。肌肉对照组:药物同穴位对照组,肌肉注射操作同肌肉对照组。各组均每周注射1次,1支/次,连续8周。治疗前、治疗8周后、治疗结束后8周进行2次随访,采用COPD自我评估测试问卷(CAT)、改良版英国医学研究委员会呼吸问卷(mMRC)、第一秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、FEV_(1)/FVC和淋巴细胞亚群CD系列作为评价指标。结果127例完成研究,其中穴位治疗组34例,肌肉治疗组31例,穴位对照组32例,肌肉对照组30例。治疗8周后、治疗结束后8周与治疗前比较,治疗结束后8周与治疗8周后比较,穴位治疗组CAT评分降低(P<0.05)、FEV_(1)、FVC、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)升高(均P<0.05)。4组FVC治疗8周后、治疗结束后8周,组间比较差异均有统计学意义(均P<0.05),均肌肉对照组最低。治疗8周后,4组CD4^(+)、CD4^(+)/CD8^(+),组间比较差异有统计学意义(均P<0.05);治疗结束后8周,4组CAT评分、FEV_(1)、CD4^(+)、CD4^(+)/CD8^(+),组间比较差异有统计学意义(均P<0.05),均穴位治疗组最优,肌肉对照组最差。mMRC等级和COPD综合评估等级治疗结束后8周,穴位治疗组和肌肉治疗组比较,差异无统计学意义(均P>0.05);穴位治疗组mMRC等级、COPD综合评估等级均低于肌肉对照组(均P<0.05)。结论足三里穴位注射胸腺肽治疗COPD,能够提高COPD稳定期患者的FVC预计值和改善CD4^(+)分子�Objective To observe the therapeutic effects of acupoint injection of thymosin at Zusanli(ST 36)in the treatment of stable chronic obstructive pulmonary disease(COPD),and to study mutual effects,interaction effects and synergistic effects as well.Methods Totally 144 subjects with stable COPD were randomly assigned to four groups by block randomization,i.e.,acupoints treatment group,muscle treatment group,acupoints control group,muscle control group,36 in each group.Patients in acupoints treatment group were injected with Thymosin[5 mg each ampoule,dissolved in 2 mL injecting water,injected from bilateral foot Zusanli(ST 36)].Those in muscle treatment group received the same acupoints treatment as those in acupoints treatment group but from ectogluteus.Those in acupoints control group were injected with vitamin B1 injection[0.1 g each ampoule,dissolved in 2 mL injecting water,injected from bilateral foot Zusanli(ST 36)].Those in muscle treatment group received the same acupoints treatment as those in acupoints treatment group but from ectogluteus.All the injection was performed one ampoule each time,once per week for 8 successive weeks.The COPD assessment test(CAT)score,breathlessness measurement using the modified British Medical Research Council(mMRC)scale,forced expiratory volume in one second(FEV_(1)),forced vital capacity(FVC),FEV_(1)/FVC,and the lymphocyte subpopulations CD were taken as evaluation indices.Results Totally 127 subjects completed the trial,including 34 in acupoints treatment group,31 in muscle treatment group,32 in acupoints control group,30 in muscle control group.Compared with before treatment,the CAT score decreased(P<0.05);FEV_(1),FVC,CD3^(+),CD4^(+),CD4^(+)/CD8^(+) increased(all P<0.05)in acupoints treatment group after 8 weeks treatment/by the end of 8 weeks treatment.Compared with after 8 weeks treatment,the CAT score decreased(P<0.05);FEV_(1),FVC,CD3^(+),CD4^(+),CD4^(+)/CD8^(+) increased(all P<0.05)in acupoints treatment group by the end of 8 weeks treatment.There were statistical diff

关 键 词：慢性阻塞性肺疾病 穴位注射 足三里 胸腺肽 中西医结合 随机对照试验 

分 类 号：R246.1[医药卫生—针灸推拿学]