拔罐联合穴位注射治疗支气管哮喘慢性持续期的临床疗效研究

Clinical Effect of Cupping and Acupoint Injection Therapies on Chronic Persistent Bronchial Asthma

目的探讨拔罐联合穴位注射灭活草分枝杆菌F.U.36注射液对支气管哮喘慢性持续期的临床疗效,并探讨其作用机制。方法选取2016年1月—2017年1月河北省中医院门诊部收治的支气管哮喘慢性持续期患者90例。采用随机数字表法分为对照组和观察组,每组45例。对照组采用常规治疗法,吸入沙美特罗替卡松(250μg/50μg)2吸/d。按需吸入硫酸沙丁胺醇气雾剂;观察组在对照组的基础上,采用拔罐治疗,1次/2 d,取定喘、肺俞、膈俞、大椎、肾俞穴依次注射灭活草分枝杆菌F.U.36注射液,1次/周。两组均治疗2个月。比较两组患者治疗前后哮喘控制测试(ACT)评分、呼气峰流速(PEF)日变异率、血清免疫因子[白介素10(IL-10)、白介素17(IL-17)、免疫球蛋白E(IgE)]水平。结果治疗前两组患者ACT评分、PEF日变异率比较,差异无统计学意义(P>0.05);治疗后观察组患者ACT评分高于对照组,PEF日变异率低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者ACT评分高于治疗前,PEF日变异率低于治疗前,差异有统计学意义(P<0.05)。治疗前两组患者血清IL-10、IL-17、IgE水平比较,差异无统计学意义(P>0.05);治疗后观察组患者血清IL-10水平高于对照组,血清IL-17、IgE水平低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清IL-10水平高于治疗前,血清IL-17、IgE水平低于治疗前,差异有统计学意义(P<0.05)。结论拔罐加穴位注射灭活草分枝杆菌F.U.36注射液可以降低支气管哮喘慢性持续期患者血清IgE水平,提高血清IL-10水平,降低血清IL-17水平,有助于达到控制哮喘的目的。

Objective To investigate the clinical curative effect and mechanism of action of cupping therapy combined with acupoint injection of inactivated mycobacterium phlei F.U.36 injecta on chronic persistent period of bronchial asthma(CPBA)patients.Methods The enrolled 90 asthma outpatients were from Hebei Province Chinese Medicine Hospital between January 2016 and January 2017.By block randomization method,they were divided into the control and observation groups.Both groups received the conventional therapy〔inhaling a combination product containing fluticasone propionate(250μg)and salmeterol(50μg),twice daily and salbutamol sulphate if necessary〕,the observation group additionally received cupping therapy(applying cupping at acupoints of dingchuan,feishu,geshu,dazhui and shenshu),once every two days,and mycobacterium phlei F.U.36 injection(first injecting it then externally using it at the aforementioned acupoints),once a week.Both groups were intervened for 2 months.The indicators for evaluating the treatment effect include Asthma Control Test(ACT)score,diurnal variation in peak expiratory flow(PEF),and levels of 3 serum parameters(IL-10,IL-17 and IgE).Results Both groups had no significant differences in the baseline ACT score and diurnal variation in PEF(P>0.05),but the observation group presented obviously higher ACT score and lower diurnal variation in PEF after intervention(P<0.05).ACT score was found to be increased significantly and diurnal variation in PEF was found to be decreased significantly in both groups after intervention(P<0.05).The baseline IL-10,IL-17 and IgE levels were similar in both groups(P>0.05),but IL-10 level increased and IL-17 and IgE levels decreased substantially in the observation group after intervention(P<0.05).IL-10 grew while IL-17 and IgE levels declined significantly in the observation group after intervention(P<0.05).Conclusion Cupping therapy combined with injection of inactivated mycobacterium phlei F.U.36 could control the CPBA by reducing serum IgE,increasing IL-10 and inhibiting IL-17.