穴位敷贴联合抗结核药物治疗肺阴亏虚型肺结核的临床观察  

Clinical Observation of Acupoint Application Combined with Antituberculosis Drugs for the Treatment of Pulmonary Tuberculosis with Lung-Yin Deficiency Syndrome

作　　者：黄晋 范春[2] 潘静洁[3] HUANG Jin;FAN Chun;PAN Jing-Jie(Clinical Medical School of Acupuncture,Moxibustion and Rehabilitation,Guangzhou University of Chinese Medicine,Guangzhou 510006 Guangdong,China;Guangzhou University of Chinese Medicine,Guangzhou 510006 Guangdong,China;Guangzhou Chest Hospital,Guangzhou 510095 Guangdong,China)

机构地区：[1]广州中医药大学针灸康复临床医学院,广东广州510006 [2]广州中医药大学,广东广州510006 [3]广州市胸科医院,广东广州510095

出　　处：《广州中医药大学学报》2023年第2期386-392,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(编号:20211304);广州市中医药和中西医结合科技项目(编号:20212A011016)。

摘　　要：【目的】观察穴位敷贴(浙贝母、瓜蒌、青黛、蛤蚧)联合抗结核药物治疗肺阴亏虚型肺结核的临床疗效。【方法】将88例肺阴亏虚型肺结核患者随机分为观察组和对照组,每组各44例。对照组给予常规西医抗痨治疗,观察组在对照组治疗的基础上,给予穴位贴敷治疗,连续治疗2个月。治疗2个月后,评价2组临床疗效,观察2组患者治疗前后白细胞介素6(IL-6)、单核细胞趋化蛋白1(MCP-1)水平的变化情况,以及用力肺活量(FVC)、1秒用力呼气容积(FEV1)、1秒率(FEV1/FVC)的情况。比较2组患者治疗前后中医证候积分的变化情况,并结合影像学比较2组患者的病灶吸收率,评价2组的安全性。【结果】(1)治疗后,2组患者的血清IL-6、MCP-1水平均明显改善(P<0.05),且观察组在改善血清IL-6、MCP-1方面明显优于对照组,差异均有统计学意义(P<0.01)。(2)治疗后,2组患者的FEV1、FVC、FEV1/FVC明显改善(P<0.05),且观察组在改善FEV1、FVC、FEV1/FVC方面明显优于对照组,差异均有统计学意义(P<0.01)。(3)治疗后,观察组肺部病灶总吸收率为93.18%(41/44),对照组为77.27%(34/44)。观察组肺部病灶总吸收率明显优于对照组,差异有统计学意义(P<0.05)。(4)治疗后,2组患者的中医证候积分均明显改善(P<0.05),且观察组在改善中医证候积分方面明显优于对照组,差异均有统计学意义(P<0.05)。(5)观察组总有效率为90.91%(40/44),对照组为77.27%(34/44)。观察组疗效优于对照组,差异有统计学意义(P<0.05)。(6)观察组与对照组均无明显不良反应情况发生。观察组不良反应发生率为11.36%(5/44);对照组为13.63%(6/44);观察组与对照组的不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】穴位敷贴联合抗结核药物治疗肺阴亏虚型肺结核,能明显改善患者的临床症状,有效降低患者血清IL-6、MCP-1水平,提高病灶吸收率,改善患者肺功能,疗效显著。Objective To observe the clinical efficacy of acupoint application(Fritillariae Thunbergii Bulbus,Trichosanthis Fructus, Indigo Naturalis, Gecko)combined with antituberculosis drugs for the treatment of pulmonary tuberculosis with lung-yin deficiency syndrome. Methods Eighty-eight cases of pulmonary tuberculosis with lung-yin deficiency syndrome were randomly divided into the observation group and the control group,with44 cases in each group. The control group was given conventional western medicine antituberculous therapy,while the observation group was given acupoint application treatment on the basis of the treatment of the control groups.The treatment in the two groups lasted for 2 months. After 2 months of treatment,the clinical efficacy of the two groups was evaluated, and the changes in interleukin 6(IL-6)and monocyte chemotactic protein 1(MCP-1)levels,as well as the forced vital capacity(FVC),forced expiratory volume in one second(FEV1)and onesecond rate of FEV1/FVC were observed before and after treatment in the two groups. The changes in the traditional Chinese medicine(TCM)syndrome scores were compared before and after treatment,the rate of lesion absorption in the two groups was compared by imageology,and the safety in the two groups was evaluated. Results (1)After treatment,the serum IL-6 and MCP-1 levels of patients in both groups were significantly improved(P<0.05),and the observation group was significantly superior to the control group in improving serum IL-6 and MCP-1,the differences being statistically significant(P<0.01).(2)After treatment,the FEV1,FVC and FEV1/FVC of the two groups were significantly improved(P<0.05), and the observation group was significantly superior to the control group in improving FEV1,FVC and FEV1/FVC,the difference being statistically significant(P<0.01).(3)After treatment, the total absorption rate of lung lesions was 93.18%(41/44)in the observation group and77.27%(34/44) in the control group. The total absorption rate of lung lesions in the observation group was sig

关 键 词：穴位敷贴 肺阴亏虚型 肺结核 白细胞介素6 单核细胞趋化蛋白1 临床观察 

分 类 号：R246.9[医药卫生—针灸推拿学]