拔罐发泡疗法联合雷火灸治疗支气管哮喘冷哮证及对气道重塑的影响  

Effects of blistering cupping combined with thunder-fire moxibustion on the efficacy and airway remodeling of cold-wheezing syndrome in bronchial asthma

作　　者：陶继恩[1] 邹卓成[1] TAO Ji-en;ZOU Zhuo-cheng(Department of Acupuncture and Moxibustion,First Affiliated Hospital of Guangxi University of CM,Nanning 530001,China)

机构地区：[1]广西中医药大学第一附属医院针灸科,南宁530001

出　　处：《中国针灸》2023年第9期1023-1027,共5页Chinese Acupuncture & Moxibustion

基　　金：国家自然科学基金资助项目:81960895;广西壮族自治区中医药管理局自筹经费科研课题项目:GZZC2020056。

摘　　要：目的:观察在常规西药治疗基础上,加用拔罐发泡疗法联合雷火灸治疗支气管哮喘冷哮证的临床疗效,以及对气道重塑、炎性因子、肺功能与生存质量的影响。方法:将76例支气管哮喘冷哮证患者随机分为观察组和对照组,每组38例。对照组采用布地奈德福莫特罗粉吸入剂吸入等基础治疗,观察组在对照组基础上加用拔罐发泡疗法联合雷火灸进行治疗,穴取大椎、膻中及双侧肺俞、膏肓、中府,拔罐发泡疗法每日1次,雷火灸每日2次。两组均治疗7 d为一疗程,共治疗2个疗程。治疗前后,采用放射免疫法检测两组患者气道重塑指标[基质金属蛋白酶9(MMP-9)、基质金属蛋白酶组织抑制剂-1(TIMP-1)、转化生长因子-β1(TGF-β1)]与炎性指标[白细胞介素(IL)-1β、IL-25],观察两组患者肺功能、中医症状评分、哮喘生存质量问卷(AQLQ)评分。结果:治疗后,两组患者血清MMP-9、TIMP-1、TGF-β1、IL-1β、IL-25含量,呼气高峰流量(PEFR)及中医症状评分、AQLQ评分均较治疗前降低(P<0.05),观察组均低于对照组(P<0.05)。治疗后,两组患者第1秒用力呼气容积(FEV1)、呼气峰值流速(PEF)较治疗前升高(P<0.05),观察组均高于对照组(P<0.05)。结论:在常规西药治疗基础上,加用拔罐发泡疗法联合雷火灸能有效减轻支气管哮喘患者的临床症状,降低炎性因子水平,抑制气道重塑,改善患者肺功能及生存质量。Objective To investigate the clinical efficacy of the combined application of blistering cupping with thunder-fire moxibustion in treating bronchial asthma of cold-wheezing syndrome,and its influences on airway remodeling,inflammatory factors,lung function,and quality of life on the base of conventional western medicine treatment.Methods A total of 76 patients with bronchial asthma of cold-wheezing syndrome were randomly divided into an observation group and a control group,38 cases in each group.In the control group,the basic treatment was used,i.e.budesonide formoterol powder inhalation.In the observation group,on the basis of the treatment as the control group,blistering cupping combined with thunder-fire moxibustion was supplemented,Dazhui(GV 14),Danzhong(CV 17)and bilateral Feishu(BL 13),Gaohuang(BL 43),and Zhongfu(LU 1)were selected;blistering cupping was administered once a day and thunder-fire moxibustion was given twice a day.One course of treatment was composed of 7 days in both groups,and 2 courses of treatment were required.Before and after treatment,the airway remodeling indexes(matrix metalloproteinase-9[MMP-9],tissue inhibitor of matrix metalloproteinase-1[TIMP-1],and transforming growth factor-β1[TGF-β1])and inflammatory indexes(interleukin[IL]-1β、IL-25)were detected by using radioimmunoassay in the patients of the two groups.The lung function,traditional Chinese medicine symptom score,and asthma quality of life questionnaire(AQLQ)score were observed in the patients of the two groups.Results After treatment,the serum levels of MMP-9,TIMP-1,TGF-β1,IL-1β,IL-25,peak expiratory flow(PEFR),traditional Chinese medicine symptom scores,and AQLQ scores were decreased compared with those before treatment in the patients of the two groups(P<0.05),and the results in the observation group were lower than those in the control group(P<0.05).After treatment,the first second forced expiratory volume(FEV1)and peak expiratory flow rate(PEF)were increased compared with those before treatment in the two groups(

关 键 词：支气管哮喘 冷哮证 拔罐发泡疗法 雷火灸 气道重塑 炎性因子 随机对照试验 

分 类 号：R246.1[医药卫生—针灸推拿学]