穴位贴敷联合常规西药治疗慢性阻塞性肺疾病急性加重期的疗效观察及对肺功能、气道重塑的影响  

Efficacy of Acupoint Sticking Therapy Combined with Conventional Western Medication for Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Its Effects on Pulmonary Function and Airway Remodeling

作　　者：卢军仪 赵丹 孙义田[1] 李亚 LU Junyi;ZHAO Dan;SUN Yitian;LI Ya(Cangzhou Hospital of Integrated TCM-WM,Hebei,Cangzhou 061000,China)

机构地区：[1]河北省沧州中西医结合医院,沧州061000

出　　处：《上海针灸杂志》2022年第9期862-867,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：河北省中医药管理局科研计划项目(2020467)。

摘　　要：目的观察穴位贴敷联合常规西药治疗痰热郁肺型慢性阻塞性肺疾病急性加重期(AECOPD)的临床疗效及对其肺功能、气道重塑的影响。方法将84例痰热郁肺型AECOPD随机分为对照组和试验组,每组42例。对照组实施常规西药治疗,试验组实施穴位贴敷联合常规西药治疗。观察两组治疗前后中医证候积分(主症、次症评分和总分)、肺功能指标[1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)和FEV_(1)/FVC]和气道重塑指标[基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶-9(MMP-9)、基质金属蛋白酶抑制剂-2(TIMP-2)和转化生长因子-β1(TGF-β1)]变化,并观察两组的临床疗效及不良反应发生率。结果两组治疗前主症、次症评分及总分和血清MMP-2、MMP-9、TIMP-2、TGF-β1水平比较,差异无统计学意义(P>0.05);两组治疗后主症、次症评分和总分及气道重塑指标低于治疗前,试验组低于对照组,差异有统计学意义(P<0.05)。两组治疗前FEV1、FVC和FEV_(1)/FVC比较,差异无统计学意义(P>0.05);两组治疗后上述肺功能指标均升高,试验组高于对照组,差异有统计学意义(P<0.05)。两组临床疗效及总有效率比较,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论穴位贴敷联合常规西药治疗痰热郁肺型AECOPD可显著减轻症状,改善肺功能,抑制气道重塑。Objective To observe the clinical efficacy of acupoint sticking therapy plus conventional Western medication in treating acute exacerbation of chronic obstructive pulmonary disease(AECOPD)due to phlegm-heat blocking the lung and its effects on pulmonary function and airway remodeling.Method Eighty-four patients with AECOPD due to phlegm-heat blocking the lung were randomized into a control group and an experimental group,with 42 cases in each group.The control group received conventional Western medication treatment,and the experimental group received acupoint sticking therapy plus the conventional Western medication treatment.Before and after the treatment,the symptom score of traditional Chinese medicine(primary and secondary symptoms scores and total score),pulmonary function indexes[forced expiratory volume in one second(FEV_(1)),forced vital capacity(FVC),and FEV_(1)/FVC],and airway remodeling indicators[matrix metalloproteinase-2(MMP-2),matrix metalloproteinase-9(MMP-9),tissue inhibitor of metalloproteinase-2(TIMP-2),and transforming growth factor-β1(TGF-β1)]were observed,as well as the clinical efficacy and adverse reaction rate in the two groups.Result Before the treatment,there were no significant differences in the primary and secondary symptoms scores and total score or the levels of serum MMP-2,MMP-9,TIMP-2,and TGF-β1(P>0.05)between the two groups.After the treatment,the primary and secondary symptoms scores,total score,and airway remodeling indicators dropped in both groups and were lower in the experimental group than in the control group(P<0.05).Before the treatment,there were no significant differences in the FEV1,FVC,or FEV_(1)/FVC between the two groups(P>0.05);after the treatment,the pulmonary function parameters mentioned above ascended in both groups and were higher in the experimental group than in the control group(P<0.05).The between-group differences in the clinical efficacy and total effective rate were also statistically significant(P<0.05).The between-group difference in the adverse

关 键 词：穴位贴敷法 肺疾病 慢性阻塞性 痰热郁肺 肺功能 气道重塑 

分 类 号：R246.1[医药卫生—针灸推拿学]