穴位贴敷防治支气管哮喘的疗效观察
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摘要
目的观察穴位贴敷防治支气管哮喘的临床疗效及穴位贴敷后皮肤反应情况。方法将60例支气管哮喘患者随机分为治疗组和对照组,每组30例。两组均于三伏天初、中、末伏的前3 d在肺俞、心俞、膈俞的对照穴位上进行低剂量药物穴位贴敷治疗,对照组次年在相同时间进行相同治疗,治疗组次年于三伏天初、中、末伏的前3 d在肺俞、心俞、膈俞穴上进行常规剂量药物穴位贴敷治疗。观察两组治疗前后哮喘发作次数、肺功能各项指标[最大呼气中期流量(maximum mid-expiratory flow, MMEF)、用力呼气25%肺活量的瞬间流速(forced expiratory flow at 25% of the pulmonary volume, FEF25%)、用力呼气50%肺活量的瞬间流速(FEF50%)及用力呼气75%肺活量的瞬间流速(FEF75%)]及贴敷后皮肤反应情况。结果治疗组治疗2年后哮喘发作次数与治疗前比较,差异具有统计学意义(P<0.05)。治疗组治疗2年后肺功能各项指标与治疗前及治疗1年后比较,差异均具有统计学意义(P<0.05)。两组治疗2年后肺功能各项指标及皮肤反应比较,差异均具有统计学意义(P<0.05)。结论穴位贴敷能有效改善哮喘患者的小气道功能,从而减少哮喘的发作,其疗效与贴敷后出现皮肤反应可能相关。
Objective To observe the clinical efficacy of acupoint application in preventing and treating bronchial asthma and the skin reaction after acupoint application. Method Sixty patients with bronchial asthma were randomized into treatment and control groups, with 30 cases in each group. Both groups were intervened by acupoint application at the control acupoints of Feishu(BL13), Xinshu(BL15) and Geshu(BL17) with low-dose medication three days during the first, second and last of the three periods of the hot season. The control group was intervened by the same treatment at the same time in the next year, while the treatment group was intervened by acupoint application at Feishu(BL13), Xinshu(BL15) and Geshu(BL17) with regular-dose medication. The number of asthma attack,indicators of lung function [maximum mid-expiratory flow(MMEF), forced expiratory flow at 25% of the pulmonary volume(FEF25%), FEF50% and FEF75%] and the skin reaction after acupoint application in the two groups were observed before and at the end of the treatment. Result After two-year treatment, the number of asthma attack in the treatment group was significantly different from that before the treatment(P<0.05). After two-year treatment, the indicators of lung function in the treatment group were significantly different from those before the treatment or after one-year treatment(P<0.05). After two-year treatment, the indicators of lung function and the skin reaction after acupoint application in the treatment group were significantly different from those in the control group(P<0.05).Conclusion Acupoint application can effectively improve small airway function in the patients with bronchial asthma,and therefore reduce asthma attacks. The efficacy is possibly related to the skin reaction after acupoint application.
Objective To observe the clinical efficacy of acupoint application in preventing and treating bronchial asthma and the skin reaction after acupoint application. Method Sixty patients with bronchial asthma were randomized into treatment and control groups, with 30 cases in each group. Both groups were intervened by acupoint application at the control acupoints of Feishu(BL13), Xinshu(BL15) and Geshu(BL17) with low-dose medication three days during the first, second and last of the three periods of the hot season. The control group was intervened by the same treatment at the same time in the next year, while the treatment group was intervened by acupoint application at Feishu(BL13), Xinshu(BL15) and Geshu(BL17) with regular-dose medication. The number of asthma attack,indicators of lung function [maximum mid-expiratory flow(MMEF), forced expiratory flow at 25% of the pulmonary volume(FEF25%), FEF50% and FEF75%] and the skin reaction after acupoint application in the two groups were observed before and at the end of the treatment. Result After two-year treatment, the number of asthma attack in the treatment group was significantly different from that before the treatment(P<0.05). After two-year treatment, the indicators of lung function in the treatment group were significantly different from those before the treatment or after one-year treatment(P<0.05). After two-year treatment, the indicators of lung function and the skin reaction after acupoint application in the treatment group were significantly different from those in the control group(P<0.05).Conclusion Acupoint application can effectively improve small airway function in the patients with bronchial asthma,and therefore reduce asthma attacks. The efficacy is possibly related to the skin reaction after acupoint application.
引文
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[2]文碧玲,周华,刘保延,等.冬病夏治穴位贴敷疗法防治慢性咳喘穴位处方探析[J].中国针灸,2010,30(8):647-652.
[3]中华医学会呼吸病学分会哮喘学组,中华医学会全科医学分会.中国支气管哮喘防治指南(基层版)[J].中华结核和呼吸杂志,2013,36(5):331-336.
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[6]中国针灸学会.“冬病夏治穴位贴敷”疗法临床应用指导意见(草案)[J].中国针灸,2009,29(7):541-542.
[7]邓亚宁,杨红新,唐敏,等.三伏平喘贴联合三九止喘贴对不同体质小儿支气管哮喘的疗效观察[J].中国针灸,2017,37(4):386-390.
[8]洪海国,严华,陈汉平,等.化脓灸治疗支气管哮喘若干影响因素的分析[J].上海针灸杂志,1992,11(3):5-6.
[9]吴凌韬,金禹彤,宣丽华.穴位贴敷后不同皮肤反应对治疗支气管哮喘疗效的影响[J].上海针灸杂志,2017,36(3):283-286.
[10]崔淑华,李娜,邢燕军,等.穴位贴敷不同皮肤反应对防治支气管哮喘发作的影响[J].针刺研究,2014,39(3):222-227.
[11]李春雨,任传云,龚容,等.穴位贴敷治疗哮喘的皮肤反应与临床疗效关系的研究[J].北京中医药大学学报,2012,35(6):430-432.
[12]宣丽华,虞彬艳,徐福,等.不同刺激强度穴位贴敷冬病夏治防治支气管哮喘的临床研究[J].中华中医药杂志,2012,27(7):1807-1810.
[13]刘超武,袁琛,刘桂颖.支气管哮喘患者穴位贴敷治疗中皮肤反应与临床疗效的相关性研究[J].天津中医药,2016,33(7):398-402.
[14]黄秀香,李淑君,刘鹏珍,等.支气管哮喘缓解期肺功能的改变[J].临床肺科杂志,2003,8(6):555.
[15]李宁,董文秀,才丽平.白芥子涂法穴位贴敷对豚鼠支气管哮喘气道高反应性和肺组织TRPV1表达影响的研究[J].辽宁中医杂志,2017,44(6):1307-1310.
[16]金禹彤,吴凌韬,陈姗,等.穴位贴敷对过敏性哮喘大鼠血清转化生长因子?1和尾加压素Ⅱ的影响[J].中医杂志,2017,58(22):1957-1960.
[17]刘强,张璐,易延逵,等.炒制对白芥子挥发油成分的影响[J].中成药,2007,29(10):1473-1475.
[18]姚国红,徐列波.不同白芥子炒制程度对穴位贴敷后患者皮肤的影响[J].上海针灸杂志,2015,34(1):57-58.
[2]文碧玲,周华,刘保延,等.冬病夏治穴位贴敷疗法防治慢性咳喘穴位处方探析[J].中国针灸,2010,30(8):647-652.
[3]中华医学会呼吸病学分会哮喘学组,中华医学会全科医学分会.中国支气管哮喘防治指南(基层版)[J].中华结核和呼吸杂志,2013,36(5):331-336.
[4]郑筱萸.中药新药临床研究指导原则(试行)[S].北京:中国医药科技出版社,2002:61-66.
[5]中华人民共和国卫生部药政局.中药新药研究指南(药学、药理学、毒理学)[M].北京:人民卫生出版社,1994:209-212.
[6]中国针灸学会.“冬病夏治穴位贴敷”疗法临床应用指导意见(草案)[J].中国针灸,2009,29(7):541-542.
[7]邓亚宁,杨红新,唐敏,等.三伏平喘贴联合三九止喘贴对不同体质小儿支气管哮喘的疗效观察[J].中国针灸,2017,37(4):386-390.
[8]洪海国,严华,陈汉平,等.化脓灸治疗支气管哮喘若干影响因素的分析[J].上海针灸杂志,1992,11(3):5-6.
[9]吴凌韬,金禹彤,宣丽华.穴位贴敷后不同皮肤反应对治疗支气管哮喘疗效的影响[J].上海针灸杂志,2017,36(3):283-286.
[10]崔淑华,李娜,邢燕军,等.穴位贴敷不同皮肤反应对防治支气管哮喘发作的影响[J].针刺研究,2014,39(3):222-227.
[11]李春雨,任传云,龚容,等.穴位贴敷治疗哮喘的皮肤反应与临床疗效关系的研究[J].北京中医药大学学报,2012,35(6):430-432.
[12]宣丽华,虞彬艳,徐福,等.不同刺激强度穴位贴敷冬病夏治防治支气管哮喘的临床研究[J].中华中医药杂志,2012,27(7):1807-1810.
[13]刘超武,袁琛,刘桂颖.支气管哮喘患者穴位贴敷治疗中皮肤反应与临床疗效的相关性研究[J].天津中医药,2016,33(7):398-402.
[14]黄秀香,李淑君,刘鹏珍,等.支气管哮喘缓解期肺功能的改变[J].临床肺科杂志,2003,8(6):555.
[15]李宁,董文秀,才丽平.白芥子涂法穴位贴敷对豚鼠支气管哮喘气道高反应性和肺组织TRPV1表达影响的研究[J].辽宁中医杂志,2017,44(6):1307-1310.
[16]金禹彤,吴凌韬,陈姗,等.穴位贴敷对过敏性哮喘大鼠血清转化生长因子?1和尾加压素Ⅱ的影响[J].中医杂志,2017,58(22):1957-1960.
[17]刘强,张璐,易延逵,等.炒制对白芥子挥发油成分的影响[J].中成药,2007,29(10):1473-1475.
[18]姚国红,徐列波.不同白芥子炒制程度对穴位贴敷后患者皮肤的影响[J].上海针灸杂志,2015,34(1):57-58.