近十年针刺治疗支气管哮喘的临床及实验研究现状

Survey of Clinical and Experimental Researches on Mechanisms of Acupuncture Treatment of Bronchial Asthma

本文对近十年体针及电针治疗支气管哮喘的临床和实验研究进行评价分析。临床研究一般选用外周血进行检测,发现针刺能改善肺功能,调整免疫状态,减轻炎性反应,从而达到改善哮喘临床症状的目的。动物实验发现针刺能改善哮喘动物模型的肺功能,减轻哮喘症状,其疗效发生机制与针刺减少嗜酸细胞的聚集及浸润、减少细胞因子的释放以及延缓气道重塑、影响免疫应答的信号转导有关。综合分析文献资料,认为目前临床研究设计不够严格,使研究结果的可信度受到影响;动物实验的指标选择虽种类多,但探讨指标之间的联系力度不够,使得研究结果之间彼此孤立。因此还需根据循证医学原则对其疗效机制做进一步研究。

in the present paper, the authors review the development of experimental and clinical studies on acupuncturetreatment of bronchial asthma in recent 10 years. Regarding clinical studies, results showed that acupuncture could 1） regulate cardiac-pulmonary function;and 2） adjust immune state and relieve inflammatory reactions in bronchial asthma patients. Animal experiments showed that acupuncture could function in 1） improving pulmonary function; 2） reducing accumulation of the peripheral eosinophile granulocytes （EOS）, relieving the infiltration of inflammatory cells in the air-passage mucosa and promoting the apoptosis of EOS in the lung and air-passages; 3） down-regulating the expression of air-passage remodeling-related protein insulin growth factor-1; 4） suppressing the secretion of tumor necrosis factor and endothelin 5） attenuating allergic reaction 6） regulating neuroendocrine activity and 7） modulating intracellular second messenger activities. However, rigorous clinical study design is not enough, so that the reliability of the results is limited. In spite of many indicators of animal experiments have been selected, but their correlations are not in close association, resulting in poor complementation and mutual identification of the acquired findings. For this reason, its clinical efficacies need to be researched further according to principles of evidence-based medicine.