针刺对稳定期慢性阻塞性肺病患者运动耐量的调节作用:随机对照研究

Regulatory effects of acupuncture on exercise tolerance in patients with chronic obstructive pulmonary disease at stable phase:a randomized controlled trial

目的：验证针刺疗法对稳定期慢性阻塞性肺病（COPD）患者运动耐量的调节作用。方法：将30例患者随机分为治疗组（16例）和安慰组（14例）。在规定的有氧运动训练基础上分别予以治疗针（治疗组）及安慰针（安慰组）治疗,穴取膻中、乳根、关元、中脘、天枢等,安慰针不刺入体内。每周治疗2~3次,共治疗5周。观察两组患者治疗前后运动耐力指标6min步行距离（6-MWD）值、运动时间值、最大摄氧量（VO2max）的变化,及肺通气功能中1秒钟用力呼气容量（FEV1）和用力肺活量（FVC）占预计值百分比、FEV1/FVC、最大通气量（MVV）占预计值百分比及生存质量评分（SGRQ）变化。结果：运动耐量：两组间6-MWD、运动时间的差值比较差异有统计学意义（均P〈0.01）,治疗组优于安慰组;治疗组治疗后VO2max明显提高（P〈0.05）,但两组间差异无统计学意义（P〉0.05）。肺通气功能：两组间FEV1%、FEV1/FVC、MVV%差值比较差异有统计学意义（P〈0.05,P〈0.01）,治疗组明显优于安慰组。SGRQ评分：治疗组治疗后SGRQ评分优于治疗前（P〈0.05）,但组间治疗前后差值比较差异无统计学意义（P〉0.05）。结论：针刺可提高稳定期COPD患者运动耐量,并可缩短有氧运动训练的起效时间。而且,针刺配合有氧运动训练可更有效地提高稳定期COPD患者肺功能。

Objective To verify the regulatory effects of acupuncture on exercise tolerance in patients with chronic obstructive pulmonary disease （COPD） at stable phase. Methods Thirty cases of COPD were randomly divided into a treatment group （16 cases） and a placebo group （14 cases）. Based on specified aerobic exercise, acupuncture was applied in the treatment group and placebo acupuncture was used in the placebo group. The acupoints included Danzhong （CV 17）, Rugen （ST 18）, Guanyuan （CV 4）, Zhongwan （CV 12）, Tianshu （ST 25） and so on. The needle did not penetrate into the skin for the placebo group. The treatment was required for 2 to 3 times per week for totally 5 weeks. The indices of exercise tolerance, including 6-min walking distance （6-MWD）, exercise time, maximum oxygen uptake （VO2max）, forced expiratory volume in 1 second （FEV1）/forced vital capacity （FVC）, maximum ventilatory volume （MVV）, St. George respiratory questionnaire （SGRQ） were observed in two groups before and after treatment. Results （1）Exercise tolerance： the differences of 6-MWD and exercise time were statistically significant between groups, which were more superior in the treatment group （both P〈0.01）; the VO2max was significantly increased after treatment in the treatment group （P〈0.05）, but there was no difference between two groups （P〈0.05）. （2）Pulmonary ventilation function： the differences of FEV1%, FEV1/FVC and MVV% were statistically significant between groups, which were more superior in the treatment group （P〈0.05, P〈0.01） ;（3）SGRQ： the SGRQ was significantly improved after treatment in the treatment group （P〈0. 05）, but there was no difference between two groups （P〉0.05）. Conclusion The acupuncture could improve the exercise tolerance in patients with chronic obstructive pulmonary disease at stable phase, and shorten the onset time of aerobic exercise. Besides, acupuncture combined with aerobic exercise could effectively improve the pulmonary function.