中医三伏灸、穴位注射配合肺功能康复治疗稳定期慢性阻塞性肺疾病的随机对照研究

A Randomized Controlled Study on the Treatment of Chronic Obstructive Pulmonary Disease with Three-fu Moxibustion,Acupoint Injection and Pulmonary Function Rehabilitation

目的:分析总结在稳定期慢性阻塞性肺疾病(COPD)治疗中,中医三伏灸、穴位注射配合肺功能康复治疗的应用效果。方法:选取2015年6月至2017年6月罗定市中医院收治的稳定期慢性阻塞性肺患者120例作为研究对象,随机分为对照组和观察组,每组60例,其中对照组患者给予对症处理、家庭氧疗以及健康指导等常规治疗,观察组患者在上述治疗的基础上外加中医冬病夏治(用本院自制灸热贴按疗程规范进行三伏灸)、穴位注射药物(黄芪注射液)治疗,比较2组患者治疗前后的免疫功能、肺功能指标以及每年的发病次数和医疗花费情况,分析2组患者治疗后的症状改善以及临床疗效。结果:2组患者治疗前的T淋巴细胞亚群、免疫球蛋白以及肺功能指标变化不显著(P>0.05),具有可比性;治疗后2组患者的CD4^+、CD3^+以及CD4^+/CD8^+比值均有不同程度的升高,CD8^+降低,但观察组患者T淋巴细胞亚群变化更为显著(P<0.05);治疗后,观察组患者的血清Ig M、Ig G、Ig A显著高于对照组,而COPD发病次数和患者的医疗费用均明显低于对照组,差异有统计学意义(P<0.05);2组患者治疗前后的FEV1、FEV1%以及FVC%差异不显著(P>0.05)。对照组患者的治疗有效率为53.33%,观察组的治疗有效率为76.78%,观察组治疗效果显著优于对照组(P<0.05)。结论:中医三伏灸、穴位注射配合肺功能康复治疗稳定期疗法可以显著增强患者机体免疫力,降低发病次数,减少医疗开支,减轻家庭经济负担,对肺功能指标改善较弱,但可以显著减轻咳、痰、喘、气促等临床症状,增强治疗有效率。

Objective：Analysis summary in the treatment of stable chronic obstructive pulmonary disease（COPD）,the Chinese medicine three volts moxibustion,acupoint injection combined with pulmonary function rehabilitation treatment effect.Methods：A total of 120 patients with stable chronic obstructive pulmonary disease admitted to our hospital from June 2015 to June 2017 were chosen as the research object,group A and group B were randomly divided into two groups,60 cases in each group.Group A patients were given symptomatic treatment,family oxygen therapy and health guidance and other routine treatment.Patients in group B,on the basis of the above treatment,The hospital made moxibustion heat paste according to the norms of treatment of three-point moxibustion）,point injection of drugs（astragalus injection）treatment,the treatment period of three years,compared two groups of patients before and after treatment of immune function,lung function indicators and the number of annual incidence and medical Spending,analysis of two groups of patients after treatment to improve the symptoms and clinical efficacy.Results：The levels of T lymphocyte subsets,immunoglobulin and pulmonary function before treatment in two groups were not significantly different（P〉0.05）,and the ratios of CD4^＋,CD3^＋and CD4^＋/CD8^＋（P〉0.05）.After treatment,the serum Ig M,Ig G and Ig A in group B were significantly higher than that in group A,while the level of CD8^＋（P〈0.05）.There was no significant difference in FEV1,FEV1%and FVC%between the two groups before and after treatment（P〉0.05）.The effective rate of treatment in group A was53.33%,that in group B was 76.78%,and that in group B was significantly better than that in group A（P〈0.05）.Conclusion：Three-point moxibustion and acupoint injection combined with pulmonary function rehabilitation can significantly improve the immunity of the patients,reduce the incidence of the disease,reduce the medical expenses,reduce the economic burden of the family,and weaken the lung function indexes,but can significantly reduce the cough,Phlegm,asthma,shortness of breath and other clinical symptoms,enhance the effectiveness of treatment.