咳喘散穴位敷贴联合喘可治穴位注射治疗支气管哮喘临床研究

Clinical study of the Kechuansan acupoint plaster combined with acupoint injection of Chuankezhi in treating bronchial asthma

目的评价咳喘散穴位敷贴联合喘可治穴位注射治疗支气管哮喘的临床疗效。方法将符合入选标准的2018年6-9月上海市中医医院肺病科65例支气管哮喘患者采用随机数字表法分为对照组32例、观察组33例。对照组给予喘可治足三里穴位注射治疗,观察组在对照组基础上穴位敷贴咳喘散。2组均治疗6周。分别于治疗前后进行中医证候评分并记录治疗前后1年的急性发作次数,采用哮喘控制水平测试量表(Asthma Control Test, ACT)评估患者生活质量,采用Sunvou-P100纳库伦呼吸分析仪检测呼出气一氧化氮(fractional exhaled nitric oxide, FeNO)水平,评价临床疗效。结果治疗期间,观察组脱落3例,对照组脱落2例,2组各有30例患者完成疗效观察。观察组总有效率为93.3%(28/30)、对照组为73.3%(22/30),2组比较差异有统计学意义(χ^2=4.320,P=0.038)。治疗后,观察组中医证候评分、ACT评分高于对照组(t值分别为4.834、5.642,P值均<0.01),FeNO水平低于对照组(t=3.180,P=0.020),1年内哮喘急性发作次数低于对照组(t=5.466,P<0.01)。结论咳喘散穴位敷贴联合喘可治穴位注射可明显改善支气管哮喘患者的临床症状,减少哮喘急性发作次数,提高哮喘控制水平,降低气道炎症,且总有效率高于单纯穴位注射治疗。

Objective To evaluate the clinical efficacy of the Kechuansan acupoint plaster combined with acupoint injection of Chuankezhi in treating bronchial asthma.Methods A total of 65 patients with bronchial asthma,who met the inclusion criteria in Shanghai Municipal Hospital of TCM from June 2018 to September 2018,were selected anddivided into control group and observation group by random number table method,32 in the control group and 33 in the observation group.The control group was treated with acupoint injection of Chuankezhi,while the observation group was treated with acupoint plaster of Kechuansan combined with acupoint injection of Chuankezhi.Both groups were treated for 6 weeks.TCM syndromes and frequency of acute attackin one year before and after the treatment was scored and recorded.The patients’quality of life was assessed by Asthma Control Test(ACT)and the fractional exhaled nitric oxide(FeNO)level was measured by Sunvou-p100 nakurun breath analyzer to evaluate the clinical efficacy.Results Through out the treatment,there were 3 dropouts in the observation group and 2 dropouts in the control group.30 cases were completed in each group.The total effective rate in the observation group was 93.3%(28/30),and the control group was 73.3%(22/30).The difference was statistically significant(χ^2=4.320,P=0.038).After the treatment,the scores of TCM syndromes and ACT in the observation groups were significantly higher than those of the control group(t values were 4.834 and 5.642,respectively,all Ps<0.01).The FeNO in the observation group were significantly lower than those in the control group(t=3.180,P=0.020).The frequency of acute attack in one year in the observation group was less than that ofthe control group(t=5.466,P<0.01).Conclusions Acupoint plaster Kechuansan combined with acupoint injection of Chuankezhi can relieve the clinical symptoms of asthma,reduce the frequency of asthma attack,improve the control ability of asthma,reduce airway inflammation,which is more effective than using acupoint injection therapy alone.