针刺治疗慢性阻塞性肺疾病的研究进展
|
摘要
慢性阻塞性肺疾病(COPD)是一种严重危害公众健康的重大疾病。近年来,针刺治疗COPD稳定期和急性加重期均取得了一定进展。文章基于近五年国内外相关文献,根据主要症状或主要辨证分型选取针刺治疗COPD的常用穴位有肺俞、足三里、膻中、肾俞、定喘、大椎、太渊等;针刺可改善COPD急性加重期患者的临床症状,降低病死率,有待进一步研究;明显改善稳定期患者肺功能、生活质量,提高呼吸肌力量和运动能力等;其作用机制可能与炎性反应或免疫调节有关。针对针刺治疗COPD的相文献数量较少、缺少统一的疗效评价标准、缺乏深入的机制探讨等问题提出几点建议,为下一步研究方向提供依据。
Chronic obstructive pulmonary disease(COPD), a global disease with high morbidity and mortality as well as heavy economic burden, has become a serious problem that affects public health. In recent years, acupuncture therapy has made great progress in COPD treatment. Based on the relevant literatures at home and abroad in the past 5 years, the acupoints used commonly were Feishu(BL13), Zusanli(ST36), Tanzhong(RN17), Shenshu(BL23), Dingchuan(EX-B1), Dazhui(DU14), Taiyuan(LU9), and so on according to the main symptoms or the main syndrome. Acupuncture can improve the clinical symptoms, reduce mortality in patients with acute exacerbation of COPD(AECOPD), which needs further study. Acupuncture can also improve lung function and quality of life, as well as muscle strength and respiratory muscle exercise in patients with stable COPD. Its mechanism may be related to inflammatory response or immune regulation. Several problems about acupuncture treatment of COPD has been shown as follows: there are limited literatures about acupuncture treatment of COPD, a unified standard of diagnosis and treatment has not been formed, the in-depth mechanisms has not been explored. Suggestions are put forward to provide the basis for further study.
Chronic obstructive pulmonary disease(COPD), a global disease with high morbidity and mortality as well as heavy economic burden, has become a serious problem that affects public health. In recent years, acupuncture therapy has made great progress in COPD treatment. Based on the relevant literatures at home and abroad in the past 5 years, the acupoints used commonly were Feishu(BL13), Zusanli(ST36), Tanzhong(RN17), Shenshu(BL23), Dingchuan(EX-B1), Dazhui(DU14), Taiyuan(LU9), and so on according to the main symptoms or the main syndrome. Acupuncture can improve the clinical symptoms, reduce mortality in patients with acute exacerbation of COPD(AECOPD), which needs further study. Acupuncture can also improve lung function and quality of life, as well as muscle strength and respiratory muscle exercise in patients with stable COPD. Its mechanism may be related to inflammatory response or immune regulation. Several problems about acupuncture treatment of COPD has been shown as follows: there are limited literatures about acupuncture treatment of COPD, a unified standard of diagnosis and treatment has not been formed, the in-depth mechanisms has not been explored. Suggestions are put forward to provide the basis for further study.
引文
[1]Global Initiative for Chronic Obstructive Lung Disease.Global strategy for the diagnosis,management,and prevention of chronic obstructive pulmonary disease 2017 report.2016-11-16[2016-12-09].http://www.goldcopd.org.
[2]GBD 2013 Mortality and Causes of Death Collaborators.2013Mortality and Causes of Death Collaborators.Global,regional,and national age-sex specific all-cause and cause-specific mortality for 240 causes of death,1990-2013:A systematic analysis for the Global Burden of Disease Study 2013.Lancet,2015,385(9963):117-171
[3]张艳敏,廖辉.针刺抑喘方对慢性阻塞性肺疾急性加重期患者肺功能和体液免疫的影响.天津中医药大学学报,2013,32(2):80-83
[4]曹琳,邵媚媚,刘智艳.针刺配合耳穴对提高COPD急性加重期患者生活质量的研究.云南中医中药杂志,2012,33(4):53-55
[5]李娜,张中新,李双霞.针刺联合加味麻杏石甘汤治疗慢性阻塞性肺病急性加重期46例.中医临床研究,2013,5(9):56-57
[6]张玉梅,何柳,覃少佳,等.针灸对慢性阻塞性肺疾病急性发作期患者肺功能的影响.新中医,2016,48(5):66-68
[7]高扬,马尧,孙丽蓉,等.慢性阻塞性肺疾病急性加重期针刺治疗的疗效及评估研究.中国临床医生,2014,42(10):42-44
[8]Whale C A,MacLaran S J,Whale C I,et al.Pilot study to assess the credibility of acupuncture in acute exacerbations of chronic obstructive pulmonary disease.Acupunct Med,2009,27(1):13-15
[9]苏铭瑞,张纾难.补肺益肾法对慢性阻塞性肺疾病稳定期患者的疗效及生活质量影响的临床研究.中华中医药学刊,2015,33(8):1837-1839
[10]郭泳梅,童娟,姚红.针刺疗法对稳定期慢性阻塞性肺疾病患者呼吸功能的影响.广州中医药大学学报,2013,30(5):658-662
[11]Junfei Feng,Xuehui Wang,Xing Li,et al.Acupuncture for chronic obstructive pulmonary disease(COPD):A multicenter,randomized,sham-controlled trial.Medicine(Baltimore), 2016,95(40):e4879
[12]童娟,郭泳梅,何颖.针刺对稳定期慢性阻塞性肺病患者运动耐量的调节作用:随机对照研究.中国针灸,2014,34(9):846-850
[13]李美玲,徐超,李映霞,等.肺肾同治结合针刺法对慢性阻塞性肺疾病稳定期(肺肾气虚型)患者的中医肺康复观察.中医药通报,2016,15(6):55-57
[14]楚二星,蔡圣朝.针刺联合西药治疗慢性阻塞性肺疾病稳定期疗效观察.中医药临床杂志,2015,27(1):82-84
[15]葛炎,姚红,童娟,等.针刺疗法对稳定期慢性阻塞性肺疾病患者外周骨骼肌运动能力的影响.中国针灸,2017,37(4):366-371
[16]Liu Lu-jiong,Shi Miao-yan,Song Xiu-ming,et al.Clinical effect observation on acupuncture for chronic obstructive pulmonary disease.Journal of Acupuncture and Tuina Science,2015,13(5):306-311
[17]Suzuki M,Namura K,Ohno Y,et al.Combined standard medication and acupuncture for COPD:A case series.Acupunct Med,2012,30(2):96-102
[18]Coyle M E,Shergis J L,Huang E T,et al.Acupuncture therapies for chronic obstructive pulmonary disease:A systematic review of randomized,controlled trials.Altern Ther Health Med,2014,20(6):10-23
[19]邱超,程凤宽,任红,等.中药穴位注射联合刺络法治疗慢性阻塞性肺疾病260例疗效观察.临床合理用药,2011,4(7A):145-147
[20]彭学强,李兰芳,刘鉴,等.电针经穴对慢性阻塞性肺疾病患者单肺通气期间气道阻力和氧合功能的影响.新中医,2014,46(7):180-182
[21]Zhang X F,Zhu J,Geng W Y,et al.Electroacupuncture at Feishu(BL13)and Zusanli(ST36)down-regulates the expression of orexins and their receptors in rats with chronic obstructive pulmonary disease.J Integr Med,2014,12(5):417-424
[22]Geng W Y,Zhang G H,Jin W Z,et al.Effects of electroacupuncture at Zusanli(ST36)on inflammatory cytokines in a rat model of smoke-induced chronic obstructive pulmonary disease.J Integr Med, 2013,11(3):213-219
[23]Jia Li,Song Wu,Hongtu Tang,et al.Long-term effects of acupuncture treatment on airway smooth muscle in a rat model of smokeinduced chronic obstructive pulmonary disease.Acupunct Med,2016,34(2):107-113
[24]程淼,张新芳,张洁,等.针刺治疗对COPD模型大鼠Th1/Th2细胞亚群格局的影响.中国老年学杂志,2014,34(2):399-402
[2]GBD 2013 Mortality and Causes of Death Collaborators.2013Mortality and Causes of Death Collaborators.Global,regional,and national age-sex specific all-cause and cause-specific mortality for 240 causes of death,1990-2013:A systematic analysis for the Global Burden of Disease Study 2013.Lancet,2015,385(9963):117-171
[3]张艳敏,廖辉.针刺抑喘方对慢性阻塞性肺疾急性加重期患者肺功能和体液免疫的影响.天津中医药大学学报,2013,32(2):80-83
[4]曹琳,邵媚媚,刘智艳.针刺配合耳穴对提高COPD急性加重期患者生活质量的研究.云南中医中药杂志,2012,33(4):53-55
[5]李娜,张中新,李双霞.针刺联合加味麻杏石甘汤治疗慢性阻塞性肺病急性加重期46例.中医临床研究,2013,5(9):56-57
[6]张玉梅,何柳,覃少佳,等.针灸对慢性阻塞性肺疾病急性发作期患者肺功能的影响.新中医,2016,48(5):66-68
[7]高扬,马尧,孙丽蓉,等.慢性阻塞性肺疾病急性加重期针刺治疗的疗效及评估研究.中国临床医生,2014,42(10):42-44
[8]Whale C A,MacLaran S J,Whale C I,et al.Pilot study to assess the credibility of acupuncture in acute exacerbations of chronic obstructive pulmonary disease.Acupunct Med,2009,27(1):13-15
[9]苏铭瑞,张纾难.补肺益肾法对慢性阻塞性肺疾病稳定期患者的疗效及生活质量影响的临床研究.中华中医药学刊,2015,33(8):1837-1839
[10]郭泳梅,童娟,姚红.针刺疗法对稳定期慢性阻塞性肺疾病患者呼吸功能的影响.广州中医药大学学报,2013,30(5):658-662
[11]Junfei Feng,Xuehui Wang,Xing Li,et al.Acupuncture for chronic obstructive pulmonary disease(COPD):A multicenter,randomized,sham-controlled trial.Medicine(Baltimore), 2016,95(40):e4879
[12]童娟,郭泳梅,何颖.针刺对稳定期慢性阻塞性肺病患者运动耐量的调节作用:随机对照研究.中国针灸,2014,34(9):846-850
[13]李美玲,徐超,李映霞,等.肺肾同治结合针刺法对慢性阻塞性肺疾病稳定期(肺肾气虚型)患者的中医肺康复观察.中医药通报,2016,15(6):55-57
[14]楚二星,蔡圣朝.针刺联合西药治疗慢性阻塞性肺疾病稳定期疗效观察.中医药临床杂志,2015,27(1):82-84
[15]葛炎,姚红,童娟,等.针刺疗法对稳定期慢性阻塞性肺疾病患者外周骨骼肌运动能力的影响.中国针灸,2017,37(4):366-371
[16]Liu Lu-jiong,Shi Miao-yan,Song Xiu-ming,et al.Clinical effect observation on acupuncture for chronic obstructive pulmonary disease.Journal of Acupuncture and Tuina Science,2015,13(5):306-311
[17]Suzuki M,Namura K,Ohno Y,et al.Combined standard medication and acupuncture for COPD:A case series.Acupunct Med,2012,30(2):96-102
[18]Coyle M E,Shergis J L,Huang E T,et al.Acupuncture therapies for chronic obstructive pulmonary disease:A systematic review of randomized,controlled trials.Altern Ther Health Med,2014,20(6):10-23
[19]邱超,程凤宽,任红,等.中药穴位注射联合刺络法治疗慢性阻塞性肺疾病260例疗效观察.临床合理用药,2011,4(7A):145-147
[20]彭学强,李兰芳,刘鉴,等.电针经穴对慢性阻塞性肺疾病患者单肺通气期间气道阻力和氧合功能的影响.新中医,2014,46(7):180-182
[21]Zhang X F,Zhu J,Geng W Y,et al.Electroacupuncture at Feishu(BL13)and Zusanli(ST36)down-regulates the expression of orexins and their receptors in rats with chronic obstructive pulmonary disease.J Integr Med,2014,12(5):417-424
[22]Geng W Y,Zhang G H,Jin W Z,et al.Effects of electroacupuncture at Zusanli(ST36)on inflammatory cytokines in a rat model of smoke-induced chronic obstructive pulmonary disease.J Integr Med, 2013,11(3):213-219
[23]Jia Li,Song Wu,Hongtu Tang,et al.Long-term effects of acupuncture treatment on airway smooth muscle in a rat model of smokeinduced chronic obstructive pulmonary disease.Acupunct Med,2016,34(2):107-113
[24]程淼,张新芳,张洁,等.针刺治疗对COPD模型大鼠Th1/Th2细胞亚群格局的影响.中国老年学杂志,2014,34(2):399-402