冬病夏治穴位贴敷预防支气管哮喘急性发作的临床研究
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摘要
目的观察冬病夏治穴位贴敷预防支气管哮喘(以下简称哮喘)急性发作的临床疗效。方法将40例哮喘非急性发作期患者按照随机数字表法分为2组。试验组21例第1年采用1号药膏治疗,第2、3年采用2号药膏治疗;对照组19例3年均采用1号药膏治疗。2组均于2015、2016、2017年的头伏、二伏、三伏的第1 d各贴敷1次。2组每年治疗结束后均于次年头伏第1 d治疗前随访1次,采用哮喘控制测试(ACT)评价3年哮喘控制情况,比较2组3年肺功能指标[第1 s用力呼气容积占预计值百分比(FEV_1%)、第1 s用力呼气容积占用力肺活量百分比(FEV_1/FVC)、呼气峰值流速(PEF)]及哮喘急性发作次数,并观察穴位贴敷治疗期间皮肤反应。结果 2组随访时哮喘控制率逐年升高,其中试验组第3次随访控制率高于第1次随访(P<0.05);试验组第3次随访时哮喘控制率高于对照组(P<0.05)。2组第1、2、3次随访时FEV_1%、FEV_1/FVC、PEF较本组治疗前均升高(P<0.05),第2、3次随访时FEV_1%、FEV_1/FVC、PEF均高于第1次随访(P<0.05);试验组第3次随访时FEV_1%、FEV_1/FVC、PEF均高于第2次随访(P<0.05)。试验组第2、3次随访时FEV_1%、FEV_1/FVC、PEF均高于对照组(P<0.05)。2组第2、3次随访时急性发作次数均低于第1次随访(P<0.05),第3次随访时急性发作次数低于第2次随访(P<0.05)。2组第1次随访时急性发作次数比较差异无统计学意义(P>0.05),第2、3次随访时试验组急性发作次数低于对照组(P<0.05)。2组第1、2、3年皮肤红斑、水疱评分比较差异无统计学意义(P>0.05)。结论冬病夏治穴位贴敷可改善非急性发作期哮喘患者肺功能,减少每年急性发作次数,随着贴敷药物剂量增加效果更加显著,且不会加重皮肤刺激反应,安全性较高。
Objective To observe the clinical effects of acupoint application of "winter disease cured in summer" on prevention attack of bronchial asthma(hereinafter referred to as asthma). Methods 40 patients with non-acute asthma attack were divided into two groups according to random number table method. 21 cases in experimental group were treated by No. 1 ointment in the first year and No. 2 ointment in the second and third years. 19 cases in control group were treated by No. 1 ointment for 3 years. Each group was pasted once in the first day of the first, the middle and the last of the dog days of 2015, 2016 and 2017. Both groups were followed up once a year before the first day of the first of dog days of the next year after the end of treatment. The asthma control test(ACT) was used to evaluate the control of asthma for 3 years. The pulmonary function index [ the percentage of forced expiratory volume in predicted value(FEV_1%), the percentage of forced expiratory volume occupied by forced vital capacity(FEV_1/FVC) and peak expiratory flow(PEF)]and the number of acute attacks of asthma were compared between the two groups, and the skin reaction during acupoint application therapy was observed. Results The control rate of asthma increased year by year in the two groups. The control rate of the third follow-up in the experimental group was higher than that in the first follow-up(P<0.05). The control rate of asthma in the experimental group was higher than that in the control group in the third follow-up(P<0.05). The FEV_1%, FEV_1/FVC and PEF in the first, second and third follow-up of two groups were higher than those in the group before treatment(P<0.05). The FEV_1%, FEV_1/FVC and PEF of two groups in the second and third follow-up were higher than those in the group in the first follow-up(P<0.05). The FEV_1%, FEV_1/FVC and PEF in the experimental group in the third follow-up were higher than those in the second follow-up(P<0.05). The FEV_1%, FEV_1/FVC and PEF in the experimental group were higher than those in the control group in the second and third follow-up(P<0.05). The number of acute attacks of two groups in the second and third follow-up was lower than that in the first follow-up(P<0.05), and the number of acute attacks of two groups in the third follow-up was lower than that in the second follow-up(P<0.05). There was no significant difference in the number of acute attacks between the two groups at the first follow-up(P>0.05). The number of acute attacks in the experimental group was lower than that in the control group in the second and third follow-up(P<0.05). There was no significant difference in skin erythema and blister scores between the two groups in the first, second and third years(P>0.05). Conclusion Acupoint application of "winter disease cured in summer" can improve pulmonary function of non-acute attack asthma patients and reduce the number of acute attacks every year. With the increase of the dosage of application, the effect is more significant, and it will not aggravate the skin irritation reaction, and the safety is higher.
Objective To observe the clinical effects of acupoint application of "winter disease cured in summer" on prevention attack of bronchial asthma(hereinafter referred to as asthma). Methods 40 patients with non-acute asthma attack were divided into two groups according to random number table method. 21 cases in experimental group were treated by No. 1 ointment in the first year and No. 2 ointment in the second and third years. 19 cases in control group were treated by No. 1 ointment for 3 years. Each group was pasted once in the first day of the first, the middle and the last of the dog days of 2015, 2016 and 2017. Both groups were followed up once a year before the first day of the first of dog days of the next year after the end of treatment. The asthma control test(ACT) was used to evaluate the control of asthma for 3 years. The pulmonary function index [ the percentage of forced expiratory volume in predicted value(FEV_1%), the percentage of forced expiratory volume occupied by forced vital capacity(FEV_1/FVC) and peak expiratory flow(PEF)]and the number of acute attacks of asthma were compared between the two groups, and the skin reaction during acupoint application therapy was observed. Results The control rate of asthma increased year by year in the two groups. The control rate of the third follow-up in the experimental group was higher than that in the first follow-up(P<0.05). The control rate of asthma in the experimental group was higher than that in the control group in the third follow-up(P<0.05). The FEV_1%, FEV_1/FVC and PEF in the first, second and third follow-up of two groups were higher than those in the group before treatment(P<0.05). The FEV_1%, FEV_1/FVC and PEF of two groups in the second and third follow-up were higher than those in the group in the first follow-up(P<0.05). The FEV_1%, FEV_1/FVC and PEF in the experimental group in the third follow-up were higher than those in the second follow-up(P<0.05). The FEV_1%, FEV_1/FVC and PEF in the experimental group were higher than those in the control group in the second and third follow-up(P<0.05). The number of acute attacks of two groups in the second and third follow-up was lower than that in the first follow-up(P<0.05), and the number of acute attacks of two groups in the third follow-up was lower than that in the second follow-up(P<0.05). There was no significant difference in the number of acute attacks between the two groups at the first follow-up(P>0.05). The number of acute attacks in the experimental group was lower than that in the control group in the second and third follow-up(P<0.05). There was no significant difference in skin erythema and blister scores between the two groups in the first, second and third years(P>0.05). Conclusion Acupoint application of "winter disease cured in summer" can improve pulmonary function of non-acute attack asthma patients and reduce the number of acute attacks every year. With the increase of the dosage of application, the effect is more significant, and it will not aggravate the skin irritation reaction, and the safety is higher.
引文
[1] Hall SC,Agrawal DK.Vitamin D and Bronchial Asthma:An Overview of Data From the Past 5 Years[J].Clin Ther,2017,39(5):917-929.
[2] 蒋朱秀,郑小伟,江劲,等.金匮肾气丸联合穴位敷贴对支气管哮喘临床缓解期肾阳虚证患者免疫功能的影响[J].中医杂志,2016,57(11):938-941.
[3] 苏慧,岳琳,刘颖,等.芥子及莱菔子饮片炮制前后物质基础变化规律分析[J].中国实验方剂学杂志,2018,41(7):23-26.
[4] 中华医学会呼吸病学分会哮喘学组.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.
[5] Nathan RA,Sorkness CA,Kosinski M,et al.Development of the asthma control test:a survey for assessing asthma control[J].J Allergy Clin Immunol,2004,113(1):59-65.
[6] 中华人民共和国卫生部药政局.新药(西药)临床前研究指导原则汇编(药学、药理学、毒理学)[M].北京,1993:205-206.
[7] 郭丹丹,郑湘榕.哮喘治疗药物生物通路的基因多态性研究进展[J].中国当代儿科杂志,2016,18(6):567-573.
[8] 闫翠环,王亚利,张明泉,等.冬病夏治穴位贴敷疗法对慢性支气管炎缓解期患者炎症细胞因子及血清肺表面活性蛋白的影响[J].中医杂志,2016,57(8):665-668.
[9] 王列,马铁明,于本性,等.基于“冬病夏治”论穴位贴敷结合小儿推拿治疗小儿慢性咳嗽[J].辽宁中医杂志,2017,44(12):2623-2625.
[10] 王琳琳,庞立健,白晓红,等.冬病夏治贴敷疗法防治儿童反复肺炎临床疗效观察[J].中国针灸,2016,36(3):261-265.
[11] 阮世发,乡世健,安佰超,等.白芥子挥发油促进冬病夏治方经皮渗透研究[J].中药新药与临床药理,2018,29(2):155-161.
[12] 赵娟萍,刘剑桥,杨柳,等.白芥子涂法的研究进展[J].中国实验方剂学杂志,2018,24(10):221-226.
[13] 苏慧,岳琳,刘颖,等.芥子及莱菔子饮片炮制前后物质基础变化规律分析[J].中国实验方剂学杂志,2018,24(7):23-26.
[14] 王洋,张罗丹,尚芳,等.冬病夏治三伏贴治疗支气管哮喘缓解期肺肾两虚证临床观察[J].中国实验方剂学杂志,2017,23(20):185-189.
[15] 刘美颖,李琰峰,仇小欢,等.温阳化痰穴贴联合常规疗法治疗慢性阻塞性肺疾病稳定期110例临床观察[J].中医杂志,2016,57(19):1670-1673.
[16] 雒志明,高赏,任魁,等.支气管哮喘控制测试评分与外周血嗜酸性粒细胞计数的相关性研究[J].中国病案,2018,19(1):91-94.
[2] 蒋朱秀,郑小伟,江劲,等.金匮肾气丸联合穴位敷贴对支气管哮喘临床缓解期肾阳虚证患者免疫功能的影响[J].中医杂志,2016,57(11):938-941.
[3] 苏慧,岳琳,刘颖,等.芥子及莱菔子饮片炮制前后物质基础变化规律分析[J].中国实验方剂学杂志,2018,41(7):23-26.
[4] 中华医学会呼吸病学分会哮喘学组.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.
[5] Nathan RA,Sorkness CA,Kosinski M,et al.Development of the asthma control test:a survey for assessing asthma control[J].J Allergy Clin Immunol,2004,113(1):59-65.
[6] 中华人民共和国卫生部药政局.新药(西药)临床前研究指导原则汇编(药学、药理学、毒理学)[M].北京,1993:205-206.
[7] 郭丹丹,郑湘榕.哮喘治疗药物生物通路的基因多态性研究进展[J].中国当代儿科杂志,2016,18(6):567-573.
[8] 闫翠环,王亚利,张明泉,等.冬病夏治穴位贴敷疗法对慢性支气管炎缓解期患者炎症细胞因子及血清肺表面活性蛋白的影响[J].中医杂志,2016,57(8):665-668.
[9] 王列,马铁明,于本性,等.基于“冬病夏治”论穴位贴敷结合小儿推拿治疗小儿慢性咳嗽[J].辽宁中医杂志,2017,44(12):2623-2625.
[10] 王琳琳,庞立健,白晓红,等.冬病夏治贴敷疗法防治儿童反复肺炎临床疗效观察[J].中国针灸,2016,36(3):261-265.
[11] 阮世发,乡世健,安佰超,等.白芥子挥发油促进冬病夏治方经皮渗透研究[J].中药新药与临床药理,2018,29(2):155-161.
[12] 赵娟萍,刘剑桥,杨柳,等.白芥子涂法的研究进展[J].中国实验方剂学杂志,2018,24(10):221-226.
[13] 苏慧,岳琳,刘颖,等.芥子及莱菔子饮片炮制前后物质基础变化规律分析[J].中国实验方剂学杂志,2018,24(7):23-26.
[14] 王洋,张罗丹,尚芳,等.冬病夏治三伏贴治疗支气管哮喘缓解期肺肾两虚证临床观察[J].中国实验方剂学杂志,2017,23(20):185-189.
[15] 刘美颖,李琰峰,仇小欢,等.温阳化痰穴贴联合常规疗法治疗慢性阻塞性肺疾病稳定期110例临床观察[J].中医杂志,2016,57(19):1670-1673.
[16] 雒志明,高赏,任魁,等.支气管哮喘控制测试评分与外周血嗜酸性粒细胞计数的相关性研究[J].中国病案,2018,19(1):91-94.