摘要
目的:探讨穴位经皮给药对急性发作期支气管哮喘(Asthma)患者的疗效和机理。方法:90名急性发作期的支气管哮喘患者随机分为治疗组(46例)和对照组(44例),治疗组在常规用药的基础上给予穴位经皮给药治疗,观察两组治疗两周后患者的喘息、气急、胸闷或咳嗽等症状好转的情况。采用酶联免疫吸附(ELISA)及放射免疫方法测定90例支气管哮喘急性发作期患者入院初及治疗后血清中的白细胞介素-5(IL-5)及血浆中血栓素B2(TXB2)的水平,并同时做肺功能(FEV1%pre、FEV1/FVC、PEF%pre)测定。对数据的统计分析计量资料采用t检验或方差分析,计数资料采用x~2检验或秩和检验,以上均采用SPSS11.5软件进行数据间的统计学处理,以P值＜0.05为有统计学意义的标志。结果:(1)治疗后两组中医证候积分及ACT评分均较治疗前明显改善(P＜0.05),治疗后两组间中医证候积分无统计学意义(P＞0.05),而ACT评分治疗组较对照组明显改善(P＜0.05)。治疗后两组综合疗效评定治疗组优于对照组(P＜0.05)。治疗组中冷哮型疗效优于虚哮型(P＜0.05)。(2)两组治疗后FEV1%pre、FEV1/FVC、PEF%pre均较治疗前明显改善(P＜0.05),且治疗组FEV1%pre、PEF%pre的改善优于比对照组(P＜0.05)。(3)治疗后两组IL-5及TXB2浓度均明显下降(P＜0.05),且治疗组下降的水平优于对照组(P＜0.05)。结论:穴位经皮给药治疗后可明显改善患者的喘息、气急、胸闷或咳嗽等临床症状。改善肺的通气功能。从对细胞因子的影响可推测穴位经皮给药可能具有调节患者细胞免疫和体液免疫的功能,增强患者抵抗力,有利于疾病的恢复。
Objective:To discuss the curative effect and mechanisms of point application used in curing the acute exacerbations of asthma.Methods:The 90 patients with acute exacerbations of asthma were randomly divided into treatment group(46cases)and control group(44cases),the treatment group was treated by point application on the basis of regular method.The symptoms such as shortness of breath,wheezing,chest tightness, and cough etc of both groups who were treated by point application for two weeks were observed.The serum(or plasma)levels of IL-5,TXB2 both of the admission of hospital and after being treated by ELISA and RIA(radioimmunoassay)method were measured in 90 cases of acute exacerbations of asthma.Meanwhile the pulmonary function was also measured(FEV1%pre、FEV1/FVC,PEF%pre).Result:(1)The clinical symptoms of TCM and the scores of ACT on both treatment group and control group were improved obviously(P＜0.05).After treatment,the clinical symptoms of TCM are equivalent between the two groups(P＞0.05).But the scores of ACT are different.The scores of treatment group was better than that of the control group(P＜0.05).In the treatment group, the curative effect of cold asthma was better than the deficiengy asthma(P＜0.05).(2)After treatment,the levels of FEV1%Pre,FEV1/FVC and PEF%pre were better than before in two groups(P＜0.05),and the levels of FEV1%Pre and PEF%pre in the treatment group were better than in the control group(P＜0.05).(3)The level of IL-5 and TXB2 were decreased in two groups after treatment(P＜0.05),meanwhile in the treatment group it was better than in the control group(P＜0.05).Conclusion:It is obvious that the use of point application can improve the clinical symptoms of TCM and pulmonary ventilation function and decrease the airway resistance.We can suspect that the treatment of point application may has not only the function to adjust cellular immunity and humoral immunity but also the power to reinforce patients' resistance from the effect on cytokine. It benefits patients' recovery.
引文
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