三伏天中药穴位贴敷治疗慢性阻塞性肺疾病稳定期临床疗效观察及其对血清TNF-α、TGF-β1水平的影响

Study on Clinical Efficacy of Chronic Obstructive Pulmonary Disease in Stable Phase Treatment with Acupoint Application of Traditional Chinese Medicine in Canicular Days and Effects on TNF-α,TGF-β1 in Serum

目的:观察三伏天中药穴位贴敷治疗慢性阻塞性肺疾病稳定期临床疗效及其对血清TNF-α、TGF-β1水平的影响。方法:选择COPD稳定期患者60例,随机分为观察组和对照组,每组30例,观察组为常规治疗+中药贴敷,对照组为常规治疗+安慰剂敷贴,于农历三伏天初、中、末伏贴敷,3次为1疗程,连续贴3年,共3个疗程,观察治疗前后患者临床症状、肺功能、血清TNF-α及TGF-β1水平变化。结果:观察组临床总有效率90%,对照组80%,治疗组优于对照组(P<0.05);两组中医证候治疗前后均有明显改善(P<0.01),在改善咳嗽气短症状方面观察组优于对照组(P<0.01,P<0.05);两组在改善喘息,咳痰症状方面无明显差异(P>0.05);肺功能FEV1%、FEV1/FVC两组治疗前后均有改善,且观察组优于对照组(P<0.01),观察组血清TNF-α、TGF-β1较治疗前有明显下降(P<0.01),对照组无明显下降(P>0.05)。结论:三伏天中药穴位贴敷有效改善患者临床症状、肺功能,降低血清TNF-α、TGF-β1水平。

Objective： To observe the clinical efficacy on Chronic Obstrucitive Pulmonary Disease（ COPD） in stable phase treated with Acupoint Application of Traditional Chinese Medicine（ TCM） in canicular days and and effects on TNF-α,TGF-β1 in serum. Methods： Sixty patients who were in stable phase of the COPD were randomly divided into observaiton group and control group,30 cases in each group. The observation group were treated by combined western medicine treatment（ routine method） and acupoint application of TCM. The control group were treated by the routine method and placebo dressing. Each group stick in canicular days,three times for a course,sticked for three years,three courses for the total treatment. Changes of clinical symptom,lung function,serum TNF-α and TGF-β1 before and after treatment were observed. Results： The total clinical effective rate was 90% in observation group and 80% in control group（ P 0. 05）,The TCM syndromes of the two groups were improved obviously before and after treatment（ P 0. 01）,the improvement of cough and shortness of breath was better in the observaiton group than in the control group（ P 0. 05,P 0. 01）. It was not significantly different in the syndromes of gasp and expectoration between the two groups（ P 0. 05）. Lung function FEV1%,FEV1/FVC were all improved before and after treatment,the observaiton group was better than control（ P 0. 01）. Serum TNF-α,TGF-β1 decresaed significantly before treatment（ P 0. 01）,there was no significant decrease in the control group（ P 0. 05）. Conclusion： The canicular days acupiont application of TCM can effectively improve the clinical symptoms and pulmonary function of the patients,reduce the level of serum TNF-α,TGF-β1.