俞募配穴针刺配合药物治疗咳嗽变异性哮喘的疗效观察及对巨噬细胞极化的影响  

Efficacy Observation of Acupuncture at Back-Shu and Front-Mu Acupoints Group Combined with Medication for Cough Variant Asthma and Its Impact on Macrophage Polarization

作　　者：魏巍 欧奇伟 林捷[1,2] WEI Wei;OU Qiwei;LIN Jie(Haikou People’s Hospital,Haikou 570208,China;Haikou Affiliated Hospital of Central South University Xiangya School of Medicine,Haikou 570208,China)

机构地区：[1]海口市人民医院,海口570208 [2]中南大学湘雅医学院附属海口医院,海口570208

出　　处：《上海针灸杂志》2022年第7期644-649,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：海南省自然科学基金面上项目(820MS162);海南省卫生健康行业科研项目(20A200082)。

摘　　要：目的观察俞募配穴针刺配合药物治疗肺脾气虚型咳嗽变异性哮喘(CVA)的临床疗效及外周血巨噬细胞极化的影响。方法将66例咳嗽变异性哮喘患者随机分为对照组和治疗组,每组33例。对照组以布地奈德福莫特罗吸入治疗,而治疗组则在布地奈德福莫特罗吸入治疗的基础上予以俞募配穴针刺治疗。观察两组治疗前后中医证候积分、呼出气一氧化氮(FeNO)水平、肺功能指标[1 s用力呼气容积(FEV1)、FEV1与用力肺活量的比值(FEV1/FVC)以及呼气峰流速(PEF)]、外周血嗜酸性粒细胞(EOS)比例、总IgE和M1/M2型巨噬细胞比例的变化,并比较两组临床疗效。结果治疗组总有效率明显优于对照组,差异具有统计学意义(P<0.05)。治疗组治疗后中医证候积分、FeNO水平、外周血EOS百分比、总IgE水平、M1型巨噬细胞的比例和M1/M2的比值较治疗前降低,FEV1、FEV1/FVC、PEF和M2型巨噬细胞的比例增加,差异均有统计学意义(P<0.01);治疗组上述指标优于对照组,差异有统计学意义(P<0.01)。治疗组随访复发率明显优于对照组,差异具有统计学意义(P<0.05)。结论俞募配穴针刺配合药物能够通过调节巨噬细胞的极化改善肺脾气虚证CVA患者的临床症状和肺功能,达到治疗CVA的作用,临床疗效显著。Objective To observe the clinical efficacy of acupuncture at back-Shu and front-Mu acupoints group plus medication in treating cough variant asthma(CVA)due to lung-spleen Qi deficiency and its impact on macrophage polarization in the peripheral blood.Method Sixty-six CVA patients were randomized into a control group and a treatment group,with 33 cases in each group.The control group received Budesonide and formoterol fumarate powder for inhalation,and the treatment group received acupuncture at back-Shu and front-Mu acupoints group in addition to Budesonide and formoterol fumarate powder for inhalation.Before and after the treatment,the symptoms score of traditional Chinese medicine(TCM),the level of fractional exhaled nitric oxide(FeNO),pulmonary function parameters[forced expiratory volume in one second(FEV1),the ratio of FEV1 to the forced vital capacity(FVC),peak expiratory flow(PEF)],peripheral blood eosinophil(EOS)percentage,total immunoglobulin(Ig)E,and the ratio of macrophage(M)1 to M2 were observed,and the clinical efficacy was compared between the two groups.Result The treatment group was superior to the control group comparing the total effective rate,and the difference was statistically significant(P<0.05).After the treatment,the TCM symptoms score,the level of FeNO,peripheral blood EOS percentage,total IgE level,percentage of M1,and M1/M2 decreased in the treatment group,and the FEV1,the ratio of FEV1 to the FVC,PEF,and the percentage of M2 increased,all showing statistical significance(P<0.01).The treatment group was superior to the control group comparing the indexes mentioned above,and the differences were statistically significant(P<0.01).The follow-up relapse rate was better in the treatment group than in the control group,and the difference was statistically significant(P<0.05).Conclusion Acupuncture at back-Shu and front-Mu acupoints group plus medication can improve the clinical symptoms and pulmonary function in patients with CVA due to lung-spleen Qi deficiency via regulating macrophage pol

关 键 词：俞募配穴 针刺疗法 针药并用 肺脾气虚 哮喘 咳嗽 巨噬细胞极化 

分 类 号：R246.1[医药卫生—针灸推拿学]