基于“冬病夏治”理念的中药穴位贴敷疗法对哮喘患儿肺功能、血清炎症因子及肺表面活性蛋白表达水平的影响  

Effect of acupoint application therapy of traditional chinese medicine based on the concept of"winter disease and summer treatment"on FVC,FEV1,serum inflammatory cytokines,and pulmonary surfactant protein expression in asthma children

作　　者：刘晓佳[1] 刘伟然 田中燕 董丽丽 黄光举[1] LIU Xiao-jia;LIU Wei-ran;TIAN Zhong-yan(Department of Pediatrics,Tangshan Maternal and Child Health Care Hospital,Tangshan Hebei 063000,China)

机构地区：[1]唐山市妇幼保健院儿内科,河北唐山063000

出　　处：《临床和实验医学杂志》2022年第15期1651-1655,共5页Journal of Clinical and Experimental Medicine

基　　金：河北省2020年度医学科学研究课题计划基金(编号:20201481)。

摘　　要：目的 探讨“冬病夏治”穴位贴敷对小儿哮喘患者肺功能、血清炎症因子及肺表面活性蛋白的影响。方法回顾性选取2018年7月至2020年至9月到唐山市妇幼保健院儿内科收治小儿哮喘患儿96例作为研究对象,按照治疗方法不同分为两组,每组48例。对照组采用常规雾化治疗法,观察组在对照组的治疗基础上采用“冬病夏治”穴位贴敷治疗。观察两组的临床疗效,并治疗前和治疗后1年测定两组患儿的肺功能指标[用力肺活量(FVC)、第一秒用力呼气容积(FEV1)]、炎症因子[肿瘤坏死因子α(TNF-α)、核转录因子κB(NF-κB)、白细胞介素(IL)-4、IL-8、IL-10]和肺表面活性蛋白[肺表面活性蛋白A(SP-A)、肺表面活性蛋白D(SP-D)]水平。结果 观察组患儿的总有效率为95.83%,高于对照组(79.17%),差异有统计学意义(P<0.05)。治疗前,两组FVC和FEV1水平比较,差异均无统计学意义(P> 0.05);治疗后,观察组FVC和FEV1为(90.13±2.24)%、(85.95±1.27)%,均高于对照组[(84.17±2.79)%、(81.17±1.63)%],差异均有统计学意义(P<0.05)。治疗前,两组TNF-α、NF-κB、IL-4、IL-8水平比较,差异均无统计学意义(P> 0.05);治疗后,观察组患者TNF-α、NF-κB、IL-4、IL-8水平为(10.33±1.82) pg/L、(88.39±13.18) ng/L、(124.41±20.38) ng/L、(118.32±15.68) ng/L,均低于对照组[(16.37±1.38) pg/L、(93.28±12.44) ng/L、(135.54±21.69) ng/L、(127.82±16.04) ng/L],IL-10水平为(88.29±8.95) ng/L,高于对照组[(84.45±5.42) ng/L],差异均有统计学意义(P<0.05)。治疗前,两组SP-A、SP-D水平比较,差异均无统计学意义(P>0.05);治疗后,观察组SP-A、SP-D水平为(48.31±14.12) mg/L、(49.29±13.05)μg/L,均低于对照组[(51.14±13.06) mg/L、(51.17±14.48)μg/L],差异均有统计学意义(P<0.05)。两组均未发生明显不良反应。结论 “冬病夏治”穴位贴敷疗法对改善支气管哮喘患儿肺功能疗效较佳,能调节儿童机体内TNF-α、NF-κB、IL-4、IL-8、IL-10等炎症Objective To investigate the effects of acupoint application for"winter disease and summer treatment"on inflammatory cytokines of lung function and serum lung surfactant protein in children with asthma.Methods A total of 96 children with asthma who were admitted to the Department of Pediatrics,Tangshan Maternal and Child Health Hospital from July 2018 to September 2020 were retrospectively selected as the research objects,and divided into two groups according to different treatment methods,with 48 cases in each group.The control group was treated with conventional atomization therapy,and the observation group was additionally treated with acupoint application for"winter disease and summer treatment"on the basis of the treatment of the control group.The clinical efficacy of the two groups was observed,and the levels of pulmonary function indexes[forced vital capacity(FVC),forced expiratory volume in one second(FEV1)],inflammatory factors[tumor necrosis factorα(TNF-α),interleukin(IL)-4,IL-8,IL-10 and nuclear transcription factor kappa B(NF-κB)],pulmonary surfactant protein[pulmonary surfactant protein A(SP-A)and pulmonary surfactant protein D(SP-D)]the two groups of children were measured before treatment and 1 year after treatment.Results The total effective rate of children in the observation group was 95.83%,which was higher than that in the control group(79.17%),the difference was statistically significant(P<0.05).There were no significant differences in the levels of FVC and FEV1 between the two groups before treatment(P>0.05),the levels of FVC and FEV1 in the observation group were(90.13±2.24)%,(85.95±1.27)%after treatment,which were higher than those in the control group[(84.17±2.79)%,(81.17±1.63)%],the differences were statistically significant(P<0.05).Before treatment,there was no significant difference in the levels of TNF-α,NF-κB,IL-4 and IL-8 between the two groups(P>0.05).The level of TNF-α,NF-κB,IL-4 and IL-8 were(10.33±1.82)pg/L,(88.39±13.18)ng/L,(124.41±20.38)ng/L,and(118.32±15.68)ng/

关 键 词：小儿哮喘 “冬病夏治”穴位贴敷 用力肺活量 第一秒用力呼气容积 细胞因子 

分 类 号：R272[医药卫生—中医儿科学]