摘要
目的:比较穴位割治联合西药与单纯穴位割治、单纯西药治疗慢性阻塞性肺疾病(COPD)稳定期患者的临床疗效差异。方法:将120例COPD患者随机分为3组,每组40例。割治组,痰浊壅盛证型取肺俞、膻中、定喘、鱼际为主穴,列缺、偏历为配穴;肾元不固证型取肾俞、脾俞、关元、鱼际为主穴,厥阴俞、足三里为配穴,每次取3穴,每10天割治1次,穴位交替进行,3次为一疗程,治疗2个疗程。西药组采用硫酸沙丁胺醇气雾剂,每晚1揿(200μg/揿);沙美特罗替卡松粉吸入剂,每晚1吸,1个月为一疗程,治疗2个疗程。割治联合西药组采用以上两种疗法联合治疗。观察各组治疗前后临床症状评分、肺功能测定、动脉血气分析、双肺充气程度等的变化情况及临床疗效。结果:各组治疗后除双肺充气程度外,临床症状评分、肺功能测定指标、动脉血氧分压(PaO2)、二氧化碳分压(PaCO2)均较治疗前明显改善(均P<0.05),割治联合西药组、割治组治疗后均较西药组改善明显(均P<0.05)。割治联合西药组总有效率为77.5%(31/40),割治组为75.0%(30/40),均优于西药组的60.0%(24/40,均P<0.05)。结论:单纯穴位辨证割治法及割治联合西药治疗COPD稳定期的疗效优于单纯西药治疗,其作用机制可能与持续穴位刺激改善支气管通气功能有关。
Objective To compare the difference in clinical efficacy on chronic obstructive pulmonary disease （COPD） at stable stage in the patients among the combined therapy of cutting method and western medication （combined therapy）, simple cutting method and simple western medication. Methods One hundred and twenty cases of COPD were randomized into three groups, 40 cases in each one. In the cutting method group, for exces- sive phlegm pattern/syndrome, Feishu （BL 13）, Danzhong （CV 17）, Dingchuan （EX-B 1） and Yuji （LU 10） were selected as the main acupoints, and Lieque （LU 7） and Pianli （LI 6） were as the supplementary acupoints. For the pattern/syndrome of failure to consolidate kidney primary, Shenshu （BL 23）, Pishu （BL 20）, Guanyuan （CV 4） and Yuji （LU 10） were selected as main acupoints, and Jueyinshu （BL 14） and Zusanli （ST 36） were as the supplementary acupoint. Three acupoints were selected alternatively in each treatment and the cutting method was applied once every 10 days. Three treatments made one session. Two sessions of treatment were required. In the western medication group, salbutamol sulfate aerosol, one press （200 μg/press） was used each night, as well as salmeteroI xinafoate and fluticasone propionate powder for inhalation, one inhalation each night. The treatment of 1 month made one session. Two sessions were required. In the combined therapy group, the cutting method and western medication were applied in combination. The results of clinical symptom score, lung function test, arterial blood gas analysis, dgree of inflation as well as clinical efficacy were observed before and after treatment in each group. Results Except the degree of lung inflation, the clinical symptom score, indices of lung function test, par- tial pressure of arterial blood gas （PaO2） and partial pressure of carbon dioxide （PaCO2） were all obviously im- proved after treatment as compared with those before treatment in each group （all P〈0.05）. They were apparently improved after treatment in the combined therapy group and the cutting method group as compared with those in the western medication group （all P〈0.05）. The total effective rate was 77.5 % （31/40） in the combined therapy group and was 75.0% （30/40） in the cutting method group, both better than 60.0% （24/40） in the western me- dication group （both P〈0.05）. Conclusion The simple cutting method based on syndrome differentiation and the combined therapy with western medication achieve the superior efficacy on COPD at stable stage as compared with the simple western medication. The effect mechanism is possibly related to the improvement of bronchial airway function through constant acupoint stimulation.
出处
《中国针灸》
CAS
CSCD
北大核心
2014年第10期951-955,共5页
Chinese Acupuncture & Moxibustion
