加味生脉散联合铺灸法治疗慢性持续期肥胖型哮喘临床研究  

Clinical Study on Modified Shengmai San Combined with Long-Snake Moxibustion for Chronic Persistent Asthma with Obesity

作　　者：李斌武 马彦俏 冯卿 LI Binwu;MA Yanqiao;FENG Qing(Fenghua District Traditional Chinese Medicine Hospital of Ningbo,Ningbo Zhejiang 315500,China)

机构地区：[1]宁波市奉化区中医医院,浙江宁波315500

出　　处：《新中医》2024年第15期19-23,共5页New Chinese Medicine

基　　金：浙江省中医药科学研究基金项目(A类)(2020ZA106)。

摘　　要：目的:观察加味生脉散联合铺灸法治疗慢性持续期肥胖型哮喘的临床疗效。方法:选取90例肥胖型哮喘患者,根据随机数字表法分为A、B、C 3组各30例。A组予加味生脉散治疗,B组予药物铺灸法治疗,C组予加味生脉散联合药物铺灸法联合治疗,连续治疗4周。比较3组治疗前后中医证候评分、哮喘控制测试(ACT)评分、肺功能指标[最大呼气流速(PEF)、用力肺活量(FVC)、第1秒用力呼气容积(FEV1)/FVC]、血清学指标[白细胞介素-6 (IL-6)、白细胞介素-18 (IL-18)、干扰素-γ (INF-γ)、免疫球蛋白E (IgE)、脂联素、瘦素],并比较3组不良反应发生情况。结果:治疗后,3组中医证候评分均降低(P<0.05),且C组低于A组、B组(P<0.05);3组ACT评分均升高(P<0.05),C组高于A组、B组(P<0.05);A、B 2组中医证候评分、ACT评分比较,差异均无统计学意义(P>0.05)。治疗后,3组FVC、FEV1/FVC、PEF均升高(P<0.05),且C组均高于A组、B组(P<0.05);A、B 2组比较,差异均无统计学意义(P>0.05)。治疗后,3组血清IL-6、IL-18、IgE、瘦素均降低(P<0.05),且C组低于A组、B组(P<0.05);3组脂联素、INF-γ均升高(P<0.05),且C组高于A组、B组(P<0.05);A、B 2组上述血清指标比较,差异均无统计学意义(P>0.05)。3组均未发生严重不良反应。结论:加味生脉散联合铺灸法治疗慢性持续期肥胖型哮喘患者,可改善哮喘情况,减轻临床症状,改善肺功能,其作用机制可能与调控细胞因子和炎性因子水平、降低炎症反应、改善中医体质有关。Objective:To observe the clinical effect of modified Shengmai San combined with longsnake moxibustion for chronic persistent asthma with obesity.Methods:A total of 90 cases of patients with asthma with obesity were selected and divided into group A,B,and C according to the random number table method,with 30 cases in each group.group A was treated with modified Shengmai San,group B with medicinal long-snake moxibustion,and group C with modified Shengmai San and long-snake moxibustion.All groups were continuously treated for four weeks.Traditional Chinese medicine syndrome scores,Asthma Control Test(ACT)scores,lung function indicator[peak expiratory flow(PEF),forced vital capacity(FVC),and forced expiratory volume in the first second(FEV1)/FVC],serological indicators[interleukin-6(IL-6),interleukin-18(IL-18),interferon-γ(INF-γ),immunoglobulin E(IgE),adiponectin,and leptin]were compared among the three groups before and after treatment;adverse reactions were compared among the three groups.Results:After treatment,traditional Chinese medicine syndrome scores in the three groups were declined (P<0.05), and the scores in group C were lower than those ingroups A and B (P<0.05);ACT scores in the three groups were increased (P<0.05), and the scores ingroup C were higher than those in group A and B (P<0.05);there was no significant difference being foundbetween group A and B (P>0.05). After treatment, FVC, FEV1/FVC, and PEF in the three groups wereimproved (P<0.05),and the above indicators in group C were higher than those in group A and B (P<0.05);there was no significant difference being found between group A and B (P>0.05). After treatment,IL-6,IL-18,IgE,and leptin in serum in the three groups were decreased (P<0.05),and the above indicators ingroup C were lower than those in group A and B (P<0.05);adiponectin, and INF- γ in the three groupswere increased (P<0.05),and the above indicators in group C were higher than those in group A and B (P<0.05);there was no significant difference being found between group A and B

关 键 词：肥胖型哮喘 慢性持续期 生脉散 铺灸法 作用机制 肺功能 中医证候评分 

分 类 号：R562.25[医药卫生—呼吸系统]