慢性阻塞性肺疾病稳定期穴位贴敷用药及选穴初探
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摘要
目的穴位贴敷治疗慢性阻塞性肺疾病(COPD)稳定期用药、选穴情况,初步总结规律,为穴位贴敷在COPD稳定期进一步规范应用奠定基础。方法检索2013年3月—2018年3月中国期刊全文数据库(CNKI)、万方数据库、中文科技期刊数据库(VIP)关于穴位贴敷治疗COPD稳定期随机对照试验,对符合入选标准研究的选穴及用药进行归类分析,总结规律。结果穴位贴敷干预COPD稳定期治疗包括冬病夏治、三九贴敷及普通穴位贴敷;选择高频次穴位依次为肺俞、膈俞、定喘、天突、脾俞,出现频率高达40%以上,其中普通穴位贴敷疗法与冬病夏治贴敷相比,肾俞、脾俞频次明显高于膈俞、定喘、天突穴;在用药方面,白芥子、细辛、延胡索、甘遂出现频率大于50%,普通穴位贴敷与冬病夏治贴敷用药对比,黄芪在普通穴位贴敷应用较多,附子、花椒在冬病夏治贴敷中用药频次相对较多。结论肺俞、脾俞、膈俞、定喘、天突有可能成为穴位贴敷治疗COPD稳定期基本穴位,而在普通穴位贴敷治疗COPD稳定期时,脾俞穴应更引起重视;在白芥子、细辛、延胡索、甘遂可能成为穴位贴敷处方基本组成,而在冬病夏治贴敷处方中可加入温阳药物,在普通穴位贴敷处方则可加入偏于补气药物可能疗效更可靠。
Objective Acupoint application for the treatment of chronic obstructive pulmonary disease(COPD) in stable phase, selection of points, preliminary summary of the law, and lay a foundation for further application of acupoint application in the stable phase of COPD. Methods From March 2013 to March 2018, China Journal Full-text Database(CNKI),Wanfang Database, and Chinese Science and Technology Periodical Database(VIP) were conducted on acupoint-paste treatment for stable COPD-controlled trials. Acupoints and medications were classified and analyzed to summarize the rules.Results Acupoint application intervention in the stable phase of COPD treatment included disease in winter and be cured in the summer, Sanjiu application and common acupoint application; the selection of high-frequency acupoints in the order of Feiyu, Geyu, Dingchuan, Tiantu, and spleen, frequency up to 40% or more, of which the common acupoint sticking therapy compared with the winter disease cured in summer patch, the frequency of Shenyu and spleen was significantly higher than that of Geyu, Dingchuan and Tiantu points; in terms of medication, white mustard, asarum, the frequency of occurrence of Yanhusuo and Ganzhu was more than 50%. Compared with the application of traditional acupoint sticking and winter disease in summer, the application of Astragalus membranaceus in common acupoints was more. The frequency of aconite and pepper in the application of winter disease and summer cure was relatively more. Conclusion Feiyu, spleen, Geyu,Dingchuan and Tiantu may become acupoints for the treatment of COPD in stable phase. However, when the acupoint stick is applied to treat the stable period of COPD, the spleen should be paid more attention. White mustard, Asarum, Corydalis,and Glycyrrhizae may become the basic components of acupoint application prescriptions. In the prescription of winter disease and summer treatment, Wenyang drugs may be added. In the case of ordinary acupoint application, the prescription may be added. The effect is more reliable.
Objective Acupoint application for the treatment of chronic obstructive pulmonary disease(COPD) in stable phase, selection of points, preliminary summary of the law, and lay a foundation for further application of acupoint application in the stable phase of COPD. Methods From March 2013 to March 2018, China Journal Full-text Database(CNKI),Wanfang Database, and Chinese Science and Technology Periodical Database(VIP) were conducted on acupoint-paste treatment for stable COPD-controlled trials. Acupoints and medications were classified and analyzed to summarize the rules.Results Acupoint application intervention in the stable phase of COPD treatment included disease in winter and be cured in the summer, Sanjiu application and common acupoint application; the selection of high-frequency acupoints in the order of Feiyu, Geyu, Dingchuan, Tiantu, and spleen, frequency up to 40% or more, of which the common acupoint sticking therapy compared with the winter disease cured in summer patch, the frequency of Shenyu and spleen was significantly higher than that of Geyu, Dingchuan and Tiantu points; in terms of medication, white mustard, asarum, the frequency of occurrence of Yanhusuo and Ganzhu was more than 50%. Compared with the application of traditional acupoint sticking and winter disease in summer, the application of Astragalus membranaceus in common acupoints was more. The frequency of aconite and pepper in the application of winter disease and summer cure was relatively more. Conclusion Feiyu, spleen, Geyu,Dingchuan and Tiantu may become acupoints for the treatment of COPD in stable phase. However, when the acupoint stick is applied to treat the stable period of COPD, the spleen should be paid more attention. White mustard, Asarum, Corydalis,and Glycyrrhizae may become the basic components of acupoint application prescriptions. In the prescription of winter disease and summer treatment, Wenyang drugs may be added. In the case of ordinary acupoint application, the prescription may be added. The effect is more reliable.
引文
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[8]吴启相.小青龙汤联合沐舒坦治疗慢性阻塞性肺病临床研究[J].陕西中医,2018(7):87.
[9]周胜利,李京,童佳兵,等.中药穴位贴敷对COPD稳定期肺肾气虚证肺功能及生活质量影响[J].辽宁中医药大学学报,2016,18(12):84-87.
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[12]尹霞,张景涛.贝前列素联合西地那非治疗慢性阻塞性肺病合并肺动脉高压疗效研究[J].临床军医杂志,2018(8):993-994.
[13]居来提·艾买提,努尔买买提·艾则孜.中药穴位贴敷联合西医常规治疗对老年慢性阻塞性肺疾病患者炎症因子及免疫功能的影响[J].现代中西医结合杂志,2016,25(30):3393-3396.
[14]胡凤臻,李秀荣,孙红红,等.中药穴位贴敷联合沙美特罗替卡松粉治疗慢性阻塞性肺疾病患者有效性和安全性研究[J].中国医药导报,2016,13(30):142-145.
[15]胡凤臻,孙红红,武自力,等.中药穴位贴敷对慢性阻塞性肺疾病稳定期患者免疫功能的影响[J].现代中西医结合杂志,2017,26(20):2203-2205,2280.
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[18]冯永海,李宏云,秦超.黄芪注射液联合丹参注射液治疗慢性阻塞性肺疾病临床研究及对患者氧化应激水平的影响[J].陕西中医,2018,256(8):1048-1050.
[19]韩雪,宋文甲.穴位贴敷法治疗慢性阻塞性肺疾病的临床效果研究[J].中国实用医药,2014,9(18):248.
[20]耿新普,刘荣,乐兆喜,等.沙美特罗替卡松治疗中重度慢性阻塞性肺疾病的效果分析[J].解放军医药杂志,2018,15(8):70-73,77.
[21]丁荣敏,潘和蹇,刘竞天,等.消喘膏穴位贴敷治疗稳定期慢性阻塞性肺病的疗效及对患者气道炎性反应的影响[J].世界中医药,2016,11(12):2669-2672,2677.
[22]陈建武,蒋红生,许雪原.九味解毒宣降汤治疗慢性阻塞性肺疾病急性加重期的疗效分析[J].中国中医药科技,2018,22(4):546-547.
[23]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.
[24]杨洁,杨彦伟,张波,等.双息咳喘膏贴敷对肺肾两虚型COPD稳定期患者肺功能的影响[J].中国中医药科技,2017,24(4):476-477.
[25]姚诗清,朱裕林,赵皓,等.三伏贴治疗稳定期慢性阻塞性肺疾病的疗效及对白细胞介素-8、肿瘤坏死因子-α的影响[J].中国老年学杂志,2016(8):1912-1914.
[26]李竹英,王婷,滕超.三伏贴治疗慢性阻塞性肺疾病稳定期临床观察[J].中国中医急症,2017(1):112-114.
[27]唐莲.关于中药治疗慢性阻塞性肺疾病的研究[J].特别健康,2018,23(20):277.
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