穴位贴敷不同皮肤反应对防治支气管哮喘发作的影响

Influence of Different Skin Reactions of Acupoint-application on Clinical Outcomes in the Prevention and Treatment of Bronchial Asthma

目的:观察穴位贴敷防治支气管哮喘所出现的不同皮肤反应对疗效的影响。方法:对支气管哮喘患者于三伏天穴位贴敷,选天突、膻中、定喘、肺俞、心俞、膈俞等穴,每伏贴敷1次,共3次。根据穴位贴敷后所表现的皮肤反应评分情况分为无反应组43例、轻反应组42例、中反应组39例、重反应组40例。观察各组治疗后1年内的哮喘评分、哮鸣音评分、发作次数,并评价临床疗效。结果:与各组治疗前比较,4组治疗后咳喘评分、哮鸣音评分、哮喘发作次数均明显下降(P<0.05,P<0.01)。治疗后咳喘评分、哮鸣音评分及哮喘发作次数组间比较,无反应组、轻反应组各项指标的改善差于中反应组、重反应组(P<0.05,P<0.01),中反应组与重反应组比较差异无统计学意义(P>0.05)。无反应组疗效差于其它3组(P<0.01),轻反应组疗效差于中反应组、重反应组(P<0.05),中反应组与重反应组疗效比较差异无统计学意义(P>0.05)。结论:穴位贴敷能有效改善支气管哮喘发作情况,有皮肤反应疗效优于无皮肤反应,随着皮肤反应的增强,疗效也有明显提高,但当皮肤反应达到一定程度,疗效不再随皮肤反应增强而增加,中度皮肤反应即可达到最佳防治效果。

Objective To observe the influence of different skin reactions of acupoint-application in summer on outcomes of prevention and treatment of bronchial asthma. Methods All of the bronchial asthma patients were treated with acupoint-application therapy in the dog-days of summer, once every ten days, 3 times altogether. After the treatment, according to scores of the skin reactions including flush, itching, pain, vesicles, etc. induced by acupoint-application of prepared Chinese medical herb paste, 164 cases were divided into four groups ： no reaction （n = 43）, mild reaction （ n = 42）, moderate reaction （ n = 39） and severe reaction （n =40）. One-year＇s follow-up was conducted after the treatment for assessing the asthma patients＇ cough-asthma score, wheezing tale score, and for recording the attack times. Results After the treatment, the cough-asthma scores, wheezing rale scores, and asthmatic attack times were obviously decreased in all the 4 groups compared to pre-treatment （P〈0.05, P〈0.01）. Comparison among the 4 groups showed that the levels of the 3 indexes were significantly higher in the no reaction group and mild reaction group than in the moderate and severe reaction groups after the treatment （P^0.05, P-〈0.01）, suggesting a better therapeutic effect in patients undergoing moderate and severe skin reactions. There were no significant diffe- rences between the no reaction and mild reaction groups, and between the moderate reaction and severe reaction groups in the levels of the 3 indexes （P〈0.05）. The total effective rates of the no reaction, mild reaction, moderate reaction and severe reaction groups were 58.14 %, 88.10 %, 94.87 % and 97.50 %, respectively. The mild, moderate and severe reaction groups were better than the no reaction group in the therapeutic effect （P〈0.01）. The mild reaction group was poorer than the moderate and severe reaction groups in clinical efficacy （P〈0.05）. There was no marked difference between the moderate and severe reaction groups in clinical outcomes （P〉0.05）. Conclusion Acupoint-application in the dog-days can effectively improve the asthma patients＇ symptoms, and the therapeutic effect of patients experiencing moderate and severe skin reactions was better.