改良无痛麦粒化脓灸配合药物治疗支气管哮喘慢性持续期疗效观察  

Therapeutic observation of modified painless wheat-grain sized suppurative moxibustion plus medication in treating chronic persistent bronchial asthma

作　　者：郭金依 邵智愚 陈怡文 高慧霞 韩琳 刘颖 苏秀贞[3] GUO Jinyi;SHAO Zhiyu;CHEN Yiwen;GAO Huixia;HAN Lin;LIU Ying;SU Xiuzhen(Weifang Medical University,Weifang 261053,China;Shandong University of Traditional Chinese Medicine,Jinan 250355,China;Weifang Hospital of Traditional Chinese Medicine,Weifang 261041,China)

机构地区：[1]潍坊医学院,潍坊261053 [2]山东中医药大学,济南250355 [3]潍坊市中医院,潍坊261041

出　　处：《上海针灸杂志》2024年第4期362-367,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：山东省中医药管理局齐鲁医派中医药特色技术推广项目[鲁卫函(2020)132号];潍坊市卫生健康委员会科研项目(WFZYY2022-4-015)。

摘　　要：目的观察改良无痛麦粒化脓灸配合药物治疗支气管哮喘慢性持续期的临床疗效及其对白细胞介素-6(interleukin-6,IL-6)、白细胞介素-10(interleukin-10,IL-10)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平的影响。方法将90例支气管哮喘慢性持续期患者随机分为治疗组和对照组,每组45例。对照组采用沙美特罗替卡松粉吸入剂治疗,治疗组在对照组基础上予以改良无痛麦粒化脓灸背俞穴治疗。观察两组治疗前后哮喘控制测试(asthma control test,ACT)评分、肺功能各项指标[第1秒用力呼气容积(forced expiratory volume in 1 second,FEV1)、用力肺活量(forced vital capacity,FVC)和最大呼气流量(peak expiratory flow,PEF)]、中医证候积分(气喘、咳嗽和哮鸣音)及各项血清炎性因子(IL-6、IL-10和TNF-α)水平的变化情况,比较两组临床疗效。结果两组治疗后ACT评分、肺功能各项指标及IL-10水平均较同组治疗前显著升高,各项临床症状评分及IL-6、TNF-α水平均显著下降,差异均具有统计学意义(P<0.05)。治疗组治疗后ACT评分、肺功能各项指标及IL-10水平均明显高于对照组,各项中医证候积分及IL-6、TNF-α水平均明显低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗组总有效率为92.9%,明显高于对照组的80.5%,两组比较差异具有统计学意义(P<0.05)。结论改良无痛麦粒化脓灸配合药物治疗支气管哮喘慢性持续期疗效确切,能提高患者肺功能,改善血清IL-6、IL-10、TNF-α水平及临床症状。Objective To observe the clinical efficacy of modified painless wheat-grain sized suppurative moxibustion plus medication in treating bronchial asthma(BA)in the chronic persistent stage and its effects on the levels of interleukin(IL)-6,IL-10,and tumor necrosis factor-α(TNF-α).Method Ninety patients with chronic persistent BA were randomized into a treatment group and a control group,with 45 cases in each group.The control group received Salmeterol xinafoate and Fluticasone propionate powder for inhalation,based on which the treatment group was given modified grain-sized suppurative moxibustion at back-Shu points.Before and after the treatment,the two groups were observed for changes in the asthma control test(ACT)score,pulmonary function indexes[forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC),and peak expiratory flow(PEF)],symptom scores of traditional Chinese medicine(panting,coughing,and wheezing sound),and serum inflammatory factor levels(IL-6,IL-10,and TNF-α).The clinical efficacy was compared between the two groups.Result After the treatment,the two groups showed an increase in the ACT score,pulmonary function indexes,and IL-10 level,and a decrease in the clinical symptom scores and the levels of IL-6 and TNF-α;the changes were all statistically significant(P<0.05).After the intervention,the ACT score,pulmonary function indexes,and IL-10 level were higher in the treatment group than in the control group,and the clinical symptom scores and the levels of IL-6 and TNF-αwere lower in the treatment group;the between-group differences were statistically significant(P<0.05).The total effective rate was 92.9% in the treatment group,notably higher than 80.5% in the control group,and the between-group difference was statistically significant(P<0.05).Conclusion The modified painless wheat-grain sized suppurative moxibustion plus medication is effective in treating BA in the chronic persistent stage.It can benefit the patient’s pulmonary function and improve the serum levels of IL-6,IL-10,a

关 键 词：灸法 哮喘 艾炷灸 直接灸 化脓灸 肺功能 炎性因子 

分 类 号：R246.1[医药卫生—针灸推拿学]