穴位贴敷联合中西药治疗老年复治肺结核阴虚火旺证的临床观察  

Clinical Observation of Acupoint Sticking Combined with Chinese and Western Medications for Senile Retreatment Pulmonary Tuberculosis Cases of Yin-deficiency-caused Fire Hyperactivity Pattern

作　　者：蔡剑飞[1] 刘忠达[1] 徐磊 章晓伟 CAI Jianfei;LIU Zhongda;XU Lei;ZHANG Xiaowei(Zhejiang Lishui Hospital of Traditional Chinese Medicine,Lishui 323000,China)

机构地区：[1]浙江省丽水市中医院,丽水323000

出　　处：《上海针灸杂志》2022年第3期231-237,共7页Shanghai Journal of Acupuncture and Moxibustion

基　　金：丽水市公益性技术应用研究项目(2019GYX25)。

摘　　要：目的观察穴位贴敷联合当归六黄汤合玉女煎及西医方案治疗老年复治肺结核阴虚火旺证的临床疗效。方法将81例老年复治肺结核阴虚火旺证患者,随机分为A组、B组和C组,每组27例。A组给予西医3HRZE/6HRE方案治疗,B组在西医方案基础上加用穴位贴敷治疗,C组在西医方案及穴位贴敷基础上加用当归六黄汤合玉女煎治疗。比较3组治疗前后中医证候积分、病灶吸收率、痰检阴转率、免疫指标(CD^(3﹢)、CD^(4﹢)、CD^(4﹢)/CD^(8﹢))、生活质量(SF-36评分)及安全性。结果治疗后,3组主症、次症积分较治疗前降低;且C组主症、次症积分低于B组,B组低于A组;差异有统计学意义(P<0.05)。C组病灶吸收率、痰检阴转率高于A组,差异有统计学意义(P<0.05)。治疗后,3组CD^(3﹢)、CD^(4﹢)、CD^(4﹢)/CD^(8﹢)提高;且C组CD^(3﹢)、CD^(4﹢)、CD^(4﹢)/CD^(8﹢)高于B组,B组高于A组;差异有统计学意义(P<0.05)。重复测量方差分析显示,治疗1个月、3个月,3组SF-36评分均依次提高(P<0.05);治疗1个月时SF-36评分C组评分高于A组(P<0.05),治疗3个月时C组高于B组,B组高于A组,差异有统计学意义(P<0.05)。3组不良反应发生率比较,差异无统计学意义(P>0.05)。结论穴位贴敷联合当归六黄汤合玉女煎及西医方案治疗老年复治肺结核阴虚火旺证,可明显缓解症状,提高免疫水平,改善生活质量,同时安全可靠。Objective To observe the clinical efficacy of combining acupoint sticking therapy,Dang Gui Liu Huang Tang,Yu NüJian,and Western medicine treatment regiment for elderly retreatment pulmonary tuberculosis(TB)cases of yin-deficiency-caused fire hyperactivity pattern.Method Eighty-one elderly pulmonary TB retreatment cases of yin-deficiency-caused fire hyperactivity pattern were randomized into group A,group B,and group C,with 27 cases in each group.Group A was treated with the 3HRZE/6HRE regiment of Western medicine.Based on the Western medicine treatment regiment,group B was given additional acupoint sticking therapy,and group C was given acupoint sticking therapy plus Dang Gui Liu Huang Tang and Yu NüJian.Before and after the treatment,the symptom score of traditional Chinese medicine(TCM),lesion absorption rate,sputum negative-conversion rate,immune indicators(CD^(3﹢),CD^(4﹢),and CD^(4﹢)/CD^(8﹢)),quality of life[36-item short-form health survey(SF-36)score],and safety rating were compared for the three groups.Result After the treatment,the primary and secondary symptom scores dropped in all three groups and were lower in group C than in group B and lower in group B than in group A,and the differences were statistically significant(P<0.05).The lesion absorption rate and sputum negative-conversion rate were significantly higher in group C than in group A(P<0.05).After the intervention,the levels of CD^(3﹢),CD^(4﹢),and CD^(4﹢)/CD^(8﹢)increased in all three groups and were higher in group C than in group B and higher in group B than in group A,and the differences were statistically significant(P<0.05).The repeated measurement analysis showed that after 1-month and 3-month treatments,the SF-36 score increased over time in the three groups(P<0.05).After 1-month treatment,the score was higher in group C than in group A(P<0.05),and the score was higher in group C than in group B and higher in group B than in group A after 3-month treatment with statistical significance(P<0.05).There were no significant

关 键 词：结核 肺 复治 阴虚火旺 当归六黄汤 玉女煎 穴位贴敷法 

分 类 号：R246.1[医药卫生—针灸推拿学]