针灸疗法对慢性阻塞性肺疾病急性加重期患者呼吸肌疲劳的改善作用分析  

Analysis of the role of acupuncture therapy on the improvement of respiratory muscle fatigue in patients with acute exacerbation of chronic obstructive pulmonary disease

作　　者：陈斌 刘海英 孙琳林 赵志轩 CHEN Bin;LIU Hai-ying;SUN Lin-lin(Department of Rehabilitation,Fuqing Hospital of Traditional Chinese Medicine,Fuzhou 350300,China)

机构地区：[1]福清市中医院康复科,350300 [2]牡丹江医学院附属红旗医院中西医结合科,157100

出　　处：《中国现代药物应用》2023年第15期152-155,共4页Chinese Journal of Modern Drug Application

基　　金：牡丹江市应用技术研究与开发计划项目(项目编号:HT2020NS076),项目名称:自拟中药方剂联合呼吸肌松解对COPD血清suPAR及肺功能的影响研究。

摘　　要：目的探讨针灸疗法对慢性阻塞性肺疾病急性加重期(AECOPD)患者呼吸肌疲劳的改善作用。方法84例AECOPD患者为研究对象,随机分为观察组与对照组,各42例。对照组采用常规西医治疗,观察组在对照组基础上采用针灸疗法。比较两组中医证候积分、改良英国MRC呼吸困难指数(mMRC)评分、辅助呼吸肌动用评分、6 min步行试验(6MWT)、临床疗效、肺功能及呼吸肌疲劳指标。结果观察组治疗总有效率为95.24%,明显高于对照组的71.43%,差异有统计学意义(P<0.05)。治疗后,观察组咳嗽、喘息、咳痰、自汗气短、神疲乏力等中医证候积分分别为(0.96±0.15)、(0.91±0.17)、(0.92±0.14)、(0.89±0.13)、(0.95±0.18)分,均明显低于对照组的(1.53±0.21)、(1.48±0.22)、(1.53±0.24)、(1.46±0.25)、(1.57±0.24)分,差异均有统计学意义(P<0.05)。治疗后,观察组mMRC评分(0.91±0.24)分、辅助呼吸肌动用评分(1.37±0.50)分明显低于对照组的(1.58±0.33)、(1.83±0.56)分,6MWT(339.41±53.67)m明显长于对照组的(303.29±51.26)m,差异均有统计学意义(P<0.05)。治疗后,观察组用力肺活量(FVC)(2.63±0.54)L、第1秒用力呼气容积占预计值百分比(FEV1%pred)(60.32±11.26)%、第1秒用力呼气容积与用力肺活量的比值(FEV1/FVC)(57.96±11.84)%、最大通气量(MVV)(36.20±10.04)L、最大吸气压(MIP)(3.84±1.35)kPa均高于对照组的(2.01±0.56)L、(54.15±11.64)%、(53.02±10.39)%、(31.45±9.26)L、(3.18±1.26)kPa,差异均有统计学意义(P<0.05)。结论针灸疗法对改善AECOPD患者呼吸肌疲劳的作用显著,能明显缓解症状,改善肺功能,提高呼吸肌运动能力。Objective To discuss the role of acupuncture therapy on the improvement of respiratory muscle fatigue in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 84 patients with AECOPD were randomly divided into observation group and control group,with 42 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with acupuncture on the basis of the control group.Both groups were compared in terms of traditional Chinese medicine syndrome score,modified British medical research council(mMRC)score,score of activity of accessory respiratory muscles,6-min walking test(6MWT),clinical efficacy,lung function and respiratory muscle fatigue indexes.Results The total effective rate of the observation group was 95.24%,which was significantly higher than that of 71.43%in the control group,and the difference was statistically significant(P<0.05).After treatment,the scores of traditional Chinese medicine symptoms such as cough,wheezing,expectoration,spontaneous sweating and shortness of breath,and fatigue were(0.96±0.15),(0.91±0.17),(0.92±0.14),(0.89±0.13),and(0.95±0.18)points in the observation group,which were significantly lower than those of(1.53±0.21),(1.48±0.22),(1.53±0.24),(1.46±0.25),and(1.57±0.24)points in the control group,and the differences were statistically significant(P<0.05).After treatment,mMRC score of(0.91±0.24)points and score of activity of accessory respiratory muscles of(1.37±0.50)points in the observation group were significantly lower than those of(1.58±0.33)and(1.83±0.56)points in the control group;6MWT of(339.41±53.67)m in the observation group was significantly longer than that of(303.29±51.26)m in the control group;the differences were statistically significant(P<0.05).After treatment,the observation group had forced vital capacity(FVC)of(2.63±0.54)L,forced expiratory volume in one second as a percentage of the predicted value(FEV1%pred)of(60.32±11.26)%,the ratio of FEV1 to

关 键 词：慢性阻塞性肺疾病 急性加重期 针灸疗法 疗效 呼吸肌疲劳 

分 类 号：R563.9[医药卫生—呼吸系统]