中药穴位贴敷对AECOPD的疗效及对血清炎性因子水平的影响

Effects of acupoint application of TCM on AECOPD and levels of inflammatory factors

目的探讨中药穴位贴敷治疗慢性阻塞性肺疾病急性加重期(AECOPD)的疗效及对血清炎性因子的影响。方法 128例AECOPD患者随机分为中药组(n=66)及对照组(n=62),对照组给予抗炎、平喘、化痰、吸氧等综合治疗;中药组在对照组治疗的基础上,辅以中药穴位贴敷治疗。分别在治疗前和治疗后3 d、1 w、2 w,检测患者的COPD症状评分及血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)水平,并比较两组疗效。结果治疗1 w后,中药组总有效率(87.8%)显著高于对照组(64.51%)(P<0.01);治疗2 w后,中药组总有效率(96.97%)与对照组(96.77%)无统计学差异(P>0.05)。治疗后两组IL-6、TNF-α、CRP及症状评分经均呈逐渐下降趋势,而中药组与对照组相比下降更加显著(P<0.05)。结论中药穴位贴敷有助于降低AECOPD患者血清CRP、IL-6、TNF-α水平,提高临床疗效。

Objective To explore the effects of acupoint application of TCM on acute exacerbation of chronic obstructive pulmonary disease （AECOPD） and levels of inflammatory factors. Methods A total of 128 AECOPD patients were selected and randomly divided into a TCM group（n=66） and a control group（n=62）. The control group was treated with anti-inflammation, relieving asthma, reducing phlegm, oxygen inhalation and other complex treatment; on this basis, the TCM group was additionally treated with acupoint application of TCM. The COPD symptom scores and the levels of IL-6, TNF-α and CRP of patients in the two groups were detected three days, one week and two weeks before and after the treatment. The effects in the two groups were compared. Results One week after the treatment, the overall response rate （ORR） （87.8%） in the TCM group was significantly higher than that in the control group （64.51%）（P 〈 0.01）; two weeks after the treatment, there was no significant difference in the ORR between the TCM group （96.97%） and the control group （96.77%） （P 〉 0.05）. The levels of IL-6, TNF-α and CRP and symptom scores in the two groups after the treatment decreased gradually, but those in the TCM group decreased more greatly than those in the control group （P 〈 0.05）. Conclusion Acupoint application of TCM can help lower the levels of CRP, IL-6 and TNF-α of AECOPD patients and improve clinical effects.