季节因素及辨证分型对穴位贴敷辅助治疗尘肺病疗效影响的研究  

Study on the effect of season factor and syndrome differentiation and typing on acupoint application adjuvant therapy on pneumoconiosis

作　　者：李琪 曹殿凤[2] 郑艳艳[1] 靳毅[1] 贾学敏 韩萍[1] LI Qi;CAO Dianfeng;ZHENG Yanyan;JIN Yi;JIA Xuemin;HAN Ping(Department of Traditional Chinese Medicine,Zibo Institute for Occupational Disease Prevention and Control,Zibo Shandong,255000,China;Department of Occupational Diseases,Zibo Institute for Occupational Disease Prevention and Control,Zibo Shandong,255000,China)

机构地区：[1]淄博市职业病防治院中医科,山东淄博255000 [2]淄博市职业病防治院职业病一科,山东淄博255000

出　　处：《职业与健康》2024年第3期325-329,336,共6页Occupation and Health

基　　金：山东省中医药科技项目(2020Q079)。

摘　　要：目的探究季节因素及辨证分型对穴位贴敷辅助治疗尘肺病疗效影响。方法将2021年6月—2022年5月在淄博市职业病防治院职一科住院治疗的尘肺病患者360例随机分为对照组和观察组各180例,对照组常规口服止咳、化痰、平喘药物以及静脉滴注改善肺循环等药物予以对症支持治疗,试验组则在对照组治疗的基础上增加穴位贴敷治疗并进行中医辨证,每10天1次,每次4 h,连续治疗30天为1疗程,共治疗3个疗程,随访并记录观察2组患者治疗前后慢性阻塞性肺疾病多因素分级系统评分(body mass index,airflow obstruction,dyspnea,and exercise capacity index,BODE index)、慢性阻塞性肺疾病评估测试(COPD assesment test,CAT)评分、临床症状积分、呼吸道急性发作次数、血清学指标的变化。结果实验数据分析显示,穴位贴敷辅助治疗尘肺病疗效显著,试验组BODE指数评分、CAT评分、临床症状积分、呼吸道感染急性期发作次数、干扰素-α(interferon-α,INF-α)、白细胞介素8(interleukin-8,IL-8)水平变化的改善与对照组比较,差异均有统计学意义(均P<0.05)。其中,夏季组在CAT评分、临床症状如咳痰难易程度、呼吸困难、痰性状积分、INF-α改善方面与其他季节比较,差异均有统计学意义(均P<0.05);中医辨证分型中,痰湿阻肺证组在咳痰难易程度、呼吸道感染急性期发作次数方面改善较其他证型组比较,差异有统计学意义(P<0.05);肺气虚证组INF-α水平变化的改善方面比较,差异有统计学意义(P<0.05)。结论穴位贴敷治疗在夏季疗效最佳,但其他季节疗效亦显著优于对照组(P<0.05)。穴位贴敷作为常规治疗给予尘肺病患者使用能取得较好的治疗效果,且不必拘泥于时间节气;痰湿阻肺证组在减轻临床发作症状,减少发作次数上作用显著;肺气虚证组在降低INF-α上作用显著;穴位贴敷治疗尘肺病患者可不拘节气长期应用对于改善临床症�Objective To explore the influence of season factor and syndrome differentiation on the therapeutic effect of acupoint application on pneumoconiosis.Methods From June 2021 to May 2022,a total of 360 pneumoconiosis patients hospitalized in the Department of Occupational Diseases of Zibo Institute for Occupational Disease Prevention and Control were randomly divided into the control group(n=180)and the observation group(n=180).Symptomatic and supportive treatment such as taking oral drugs to relieve a cough,reducing phlegm and preventing asthma and intravenous drip to improve pulmonary circulation was performed on the control group.In addition to the regular treatment performed on the control group,point application theropy and dialectical classify treatments of traditional chinese medicine were performed once every 10 days for 4 h and 3 courses of treatment were performed on the observation group(continuous treatment for 30 days as 1 course).The body mass index,airflow obstruction,dyspnea,and exercise capacity index(BODE index)score,COPD assesment test(CAT)score,clinical symptom score,the frequency of respiratory acute attack and serological index score before and after treatments of patients in both groups were followed and recorded.Results Results showed that pneumoconiosis theropy with point application theropy as the adjuvant therapy had significant effect.The improvement of BODE index score,CAT score,clinical symptom score,the frequency of respiratory acute attack and levels of INF-αand IL-8 of the observation group were significantly different from those of the control group(all P<0.05).The summer group showed significant differences in improvement of CAT score,clinical symptom score(expectoration,breathing difficulty,character of sputum),and INF-αfrom other seasons(all P<0.05).Among syndrome differentiation of traditional Chinese medicine,the phlegm dampness impeding lung syndrome group showed significant difference in expectoration and the frequency of respiratory acute attack(all P<0.05).The pulmonary q

关 键 词：尘肺 穴位贴敷 季节因素 辨证分型 

分 类 号：R135.2[医药卫生—劳动卫生]