夏秋灸治哮喘疗效与NO及肺功能关系的临床研究

Clinical Study on the Relationship among Therapeutic Effects of Moxibustion,Changes of Serum Nitric Oxide Level and Pulmonary Function in the Treatment of Asthma in Summer and Autumn

目的:比较夏秋季节灸贴治疗哮喘的疗效,探讨季节变化与支气管哮喘疗效关系的可能机制。方法:64例支气管哮喘缓解期肺气亏虚证患者按1∶1比例随机分为:夏季组32例,于传统“三伏日”初、中、末伏当日集中治疗;秋季组32例,于“秋分前10日、秋分当日及秋分后10日”3日集中治疗。两组均于首次治疗前15日及末次治疗后15日进行NO和肺功能指标检测。结果:夏季组与秋季组经灸贴治疗后临床总有效率分别为84.38%、71.88%,NO值有所下降,肺功能指标显著改善(P<0.05,0.01)。两组比较,夏季组优于秋季组(P<0.05,0.01)。结论:夏秋灸治疗哮喘的疗效差异与异常升高的NO的降低程度有关,NO的差异可能是灸治起效的关键。

Objective： To explore the relationship among therapeutic effects of moxibustion for treating asthma in summer and autumn and changes of serum nitric oxide （NO） content and pulmonary function. Methods： Sixty-four athma patients were randomly and evenly divided into summer group and autumn group which were treated by ginger moxibustion of Dazhui （GV 14） and bilateral Feishu（BL 13） plus external application of herbal drug ointment in summer （three ten-day Periods of the hot season） and autumn （ 10 days before, the same day and 10 days after Autumnal Equinox） respectively. Serum NO was assayed with nitrate reductase method and indexes [forced vital capacity （FVC）, forced expiratory volume in one second （FEV1.0）, FEV1.0%, maxium midexpiratory flow （MMEF）, peak expiratory flow （PEF）, forced expiratory flow at 25%, 50% and 75% of vital capacity （FEF25, FEF50, FEF75） ] of pulmonary function were detected on the 15^th day before the first treatment and after finishing the treatment. Results： After treatment, of the two 32 cases in summer and autumn groups, 12 （37.50%） and 3 （9.38%） had marked improvement in their symptoms, 15 （46.88%） and 20 （62.50%） had improvement, and 5 （ 15.62% ） and 9 （28.12%） failed, with the effective rates being 84.38% and 71.88% separately. The therapeutic effect of summer group was significantly superior to that of autumn group. After treatment, serum NO levels of two groups decreased obviously （ P〈0.01 ）, and the difference value between pre- and post-treatment of surmmer group was markedly bigger than that of autumn group （P〈0.05）. Compared with pre-treatment, FVC, FEV1.0, FEVI.0%, MMEF and PEF of two groups, and FEF25 and FEF50 of summer group all increased significantly （ P〈 0.05, 0.01 ） after treatment; and the difference values of summer group were significantly bigger than those of autumn group （ P 〈 0.05, 0.01 ）. The therapeutic effects of summer group were obviously better than those of autumn group in improving clinical symptoms, lowering serum NO level and raising pulmonary function. Conclusion： The therapeutic effect of summer moxibustion is significantly better than that of autumn moxibustion. The decrease of serum NO content and enhancement of pulmonary function induced by moxibustion are closely related to the better therapeutic effect of the therapy in improving clinical symptoms.