"三伏贴"对慢性阻塞性肺病系统炎症的影响

Impacts of Acupoint Sticking in Dog Days on Systenic Inflammation and Prognosis of COPD Patients

目的:观察"三伏贴"对稳定期慢性阻塞性肺疾病(COPD)患者系统炎症的影响,并评价其有效性。方法:收集稳定期慢性阻塞性肺疾病患者60例,按随机数字表随机分为"三伏贴"治疗组与安慰剂治疗组,每组30例;在常规西医治疗的基础上,分别给予"三伏贴"和安慰剂贴敷治疗,分别在入伏、初伏、中伏及末伏进行4次穴位贴敷,完成1疗程治疗者共56例。观察治疗前、1个疗程结束时、治疗后3个月、治疗后6个月血清炎症因子的变化。应用酶联免疫吸附试验(ELISA)检测血清白细胞介素-8(IL-8),免疫比浊法测定血清CRP,比较治疗前后两组间的炎症因子变化趋势,同时比较治疗前后两组间CAT评分(COPD assessment test,CAT)、呼吸困难评分(MRC)及生存质量评分。结果:"三伏贴"组、安慰剂组血清IL-8、CRP随时间变化趋势不同;其中试验组血清炎症因子随时间呈逐渐下降趋势,但治疗后6个月时炎症因子略有升高,而安慰剂组炎症因子水平呈逐渐升高趋势,治疗前试验组与安慰剂组炎症因子水平差异无统计学意义,治疗3个月后,两组患者IL-8、CRP水平差异即有统计学意义(P<0.05)。试验组患者治疗后CAT评分、MRC评分较治疗前下降,生存质量评分升高,差异有统计学意义(P<0.05),而安慰剂组患者在治疗后CAT评分、MRC评分较治疗前升高,差异有统计学意义(P<0.05),生存质量评分下降,差异有统计学意义(P<0.05)。同一时间点,试验组较安慰剂组CAT评分、MRC评分下降,生存质量评分明显升高,差异有统计学意义(P<0.05)。结论:冬病夏治穴位敷帖可以改善COPD患者生存质量,缓解症状,其作用机理可能与降低系统炎症相关因子有关。

Objective： To observe the influence on systemic inflammation responses in patients with stable chronic obstructive pulmonary disease （COPD） treated with acupoint sticking in dog days, to explore its efficacy mechanism. Methods： Patients were randomly divided into two groups： the trial group （30 cases） treated with drugs, and the control group （30 cases） treated with placebo. Acupointing in V, Chu Fu, ambush and Mofu fouth times. To detect the levels of IL-8, CRP in serum by enzyme linked immunosorbent assay （ELISA） or immunoturibidimetry 4 times before and after treatment. At the same time, two groups were compared by CAT score （COPD assessment test, CAT）, dyspnea score （MRC） and the quality of life score. Results： There was no statistical difference in levels of IL-8, CRP in serum before treating between two groups （P〉0.05）. After treating, in trial group, levels of IL-8, CRP decreased gradually, but that of the control group was increase. 3th month, levels of IL-8, CRP level lower apparently than that of the control group（P〈0.05）. The study revealed CAT grading, MRC grading and WHOQOL-BREF grading after treatment there was a significant difference（P〈0.05） between two groups compared with before treatment, and there was significant difference （P〈0.05） between two groups. Conclusions： Acupoint sticking in dog days relieve the clinical symptoms apparently in patients with stable COPD, its mechanism may be associated with reducing systemic inflammation.