穴位透刺对慢性阻塞性肺疾病急性期C反应蛋白的影响

Effects of acupuncture on C-reactive protein during exacerbations of chronic obstructive pulmonary disease

目的观察粗针透刺膻中穴对慢性阻塞性肺疾病急性加重期患者C反应蛋白(CRP)的影响。方法将90例慢性阻塞性肺疾病急性加重期患者按随机原则分为对照组、传统毫针组、粗针透刺组,每组30例。对照组只常规抗感染、雾化吸入平喘、抗炎、化痰药物及支持、对症治疗;传统毫针组在对照组治疗基础上加毫针(直径0.4 mm)紫宫穴透刺膻中穴,每次进针100 mm,留针3 h;粗针透刺组在对照组治疗基础上加用粗针(直径0.8 mm)紫宫穴透刺膻中穴,每次进针100 mm,留针3 h;3组均治疗10 d。观察3组患者治疗前与治疗10 d后血清CRP的变化情况。使用SPSS13.0软件进行统计分析,3组患者血清CRP检测结果为计量资料,呈正态分布,以均数±标准差(±s)表示,多组间均数差异比较采用单因素方差分析,组间均数的两两比较采用LSD-t检验,治疗前后比较采用配对设计t检验,以P<0.05为差异有统计学意义。结果对照组患者治疗前、治疗10 d后的血清CRP分别为(2.111±0.207)mg/L和(1.676±0.321)mg/L,差异有统计学意义(t=-12.157,P<0.01);传统毫针组患者治疗前、治疗10 d后血清CRP分别为(2.033±0.204)mg/L和(1.255±0.193)mg/L,差异有统计学意义(t=-67.206,P<0.01);粗针透刺组患者治疗前、治疗10 d后血清CRP分别为(2.096±0.230)mg/L和(0.601±0.097)mg/L,差异有统计学意义(t=-60.242,P<0.01)。治疗前,3组患者血清CRP比较差异无统计学意义(F=1.603,P>0.05);治疗10 d后经方差分析,3组患者血清CRP比较,差异有统计学意义(F=176.705,P<0.01),经两两比较,传统毫针组和对照组相比,差异有统计学意义(t=7.303,P<0.01);粗针透刺组和对照组相比,差异有统计学意义(t=18.653,P<0.01);粗针透刺组和毫针组相比,差异有统计学意义(t=11.350,P<0.01)。结论穴位透刺膻中穴比对照组能降低慢性阻塞性肺疾病急性加重期患者的血清CRP,改善患者呼吸系统及全身症状,粗针透刺法比传统毫针透刺法降低的更明显,为慢性阻塞性肺疾病急性加重期患者临床治疗提供新的治疗方法。

Objective To observe effects of thick needle puncturing Danzhong（RN 17） on C-reactive protein（ CRP） in patients with acute exacerbation of chronic obstructive pulmonary disease（ AECOPD）. Methods Ninety AECOPD patients were selected and randomly divided into control group, traditional needle puncturing group and thick needle puncturing group（ n=30 for each group）. Patients in control group received symptomatic treatment, those in traditional needle puncturing group received symptomatic treatment plus acupuncture subcutaneously 100 mm deep from Zigong（ RN 19） to Danzhong（ RN 17） by a traditional needle puncturing, and retaining for 3 hours. Patients in thick needle puncturing group received symptomatic therapy plus puncturing subcutaneously 100 mm deep from Zigong（ RN 19） to Danzhong（ RN 17） by a thick stainless steel needle and retaining for 3 hours. Patients were treated for 10 days in three groups. The Serum Changes of CRP were observed before and after 10-day treatment. All data were processed by SPSS13.0 for windows. Results were demonstrated by mean±standard deviation. The single factor analysis of variance was used for comparing mean difference between groups. Data of three groups were compared using LSD-t test. The paired t test was used in data before and after treatment. When P〈0.05, it shows that the difference was statistically significant. Results Before and after 10-day treatment, the serum levels of CRP were（ 2.111±0.207） mg/L and（ 1.676±0.321） mg/L in control group respectively. The difference was statistically significant（t=-12.157,P〈0.01）. The serum levels of CRP were（ 2.033±0.204） mg/L and（ 1.255±0.193）mg/L before and after 10-day treatment in traditional needle puncturing group respectively. The difference was statistically significant（ t=-67.206,P〈0.01）. The serum levels of CRP were（ 2.096±0.230）mg/L and（ 0.601±0.097） mg/L in thick needle puncturing group before and after 10-day treatment. There was a significant difference before and after 10-day treatment（ t=-60.242,P〈0.01）. Before treatment, there were no significant differences in serum levels of CRP between three groups（ F=1.603,P〉0.05）. After 10-day treatment, there were significant differences in the serum levels of CRP（ F=176.705, P〈0.01）. There was a significant difference in the serum level of CRP between traditional needle puncturing group and control group（ t=7.303,P〈0.01）. Compared thick needle puncturing group and control group, there as a significant difference in the serum level of CRP between thick needle puncturing group and control group（t=18.653,P〈0.01）. There was also a significant difference in the serum level of CRP between thick needle puncturing group and traditional needle puncturing group（ t=11.350,P〈0.01）. Conclusion The needle puncturing（ RN 17） point through can significantly reduce the serum level of CRP in patients with AECOPD, which is more significant in thick needle puncturing group than that of traditional needle puncturing group.