针刺肺经、大肠经腧穴治疗支气管哮喘慢性持续期临床研究

Clinical Study of Acupuncture at Acupoints of the Lung and Large Intestine Meridians for Bronchial Asthma in Chronic Persistent Stage

目的基于“肺与大肠相表里”理论观察针刺肺经、大肠经腧穴治疗支气管哮喘慢性持续期的临床疗效,探讨其相关机制。方法将156例支气管哮喘慢性持续期患者随机分为治疗组和对照组,每组78例。对照组采用常规药物治疗,治疗组在对照组基础上采用针刺肺经、大肠经腧穴治疗。观察两组治疗前后各项肺功能指标[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、最大呼气流量(PEF)]、炎症介质指标[呼出气一氧化氮含量(FeNO)、血清免疫球蛋白E(IgE)、血清嗜酸性粒细胞阳离子蛋白(ECP)、嗜酸性粒细胞(EO)、γ干扰素(IFN-γ)、白细胞介素-4(IL-4)、白细胞介素-17(IL-17)]、免疫功能指标(CD^3﹢、CD^4﹢、CD^8﹢、CD^4﹢/CD^8﹢)、圣乔治呼吸问卷(SGRQ)评分、临床症状评分(日间和夜间)、中医证候评分及哮喘生命质量调查问卷量表评分的变化情况。结果两组治疗后各项肺功能指标、炎症介质指标、免疫功能指标、SGRQ评分、日间症状评分、夜间症状评分、中医证候评分及哮喘生命质量调查问卷量表各项评分(哮喘症状、活动受限、情感功能、环境刺激)与同组治疗前比较差异均具有统计学意义(P<0.05)。治疗组治疗后各项肺功能指标、炎症介质指标、免疫功能指标、SGRQ评分、日间症状评分、夜间症状评分、中医证候评分及哮喘生命质量调查问卷量表各项评分与对照组比较差异均具有统计学意义(P<0.05)。结论针刺肺经、大肠经腧穴是一种治疗支气管哮喘慢性持续期的有效方法,能通过促进刺激神经和抑制气道高反应性,改善患者肺功能和免疫功能,提高其生活质量。

Objective To observe the clinical efficacy of acupuncture at the acupoints of the Lung and Large Intestine Meridians in treating bronchial asthma in chronic persistent stage and to discuss the relevant mechanism based on the theory that“the lung and large intestine are interiorly-exteriorly related”.Method A total of 156 patients with bronchial asthma in chronic persistent state were randomized into a treatment group and a control group,with 78 cases in each group.The control group was treated with conventional medication,while the treatment group was given additional acupuncture treatment applied to the acupoints of the Lung and Large Intestine Meridians on the basis of the control group.Before and after treatment,the pulmonary function indexes[forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC)and peak expiratory flow(PEF)],inflammatory mediator indexes[fractional exhaled nitric oxide(FeNO),serum immunoglobulin E(IgE),serum eosinophil cationic protein(ECP),eosinophil(EO),interferon(IFN)-γ,interleukin(IL)-4 and IL-17],immune function parameters(CD^3﹢,CD^4﹢,CD^8﹢and CD^4﹢/CD^8﹢),St George’s Respiratory Questionnaire(SGRQ),clinical symptom scores(diurnal and nocturnal),traditional Chinese medicine(TCM)symptom scores and Asthma Quality of Life Questionnaire(AQLQ)score were observed in the two groups.Result The pulmonary function,inflammatory mediator and immune function indexes,and the scores of SGRQ,diurnal and nocturnal symptoms,TCM symptoms and AQLQ(asthmatic symptoms,activity limitation,emotional function and environmental exposure)changed significantly after intervention in both groups(P<0.05).After treatment,the pulmonary function,inflammatory mediator and immune function indexes,and the scores of SGRQ,diurnal and nocturnal symptoms,TCM symptoms and AQLQ in the treatment group were significantly different from those in the control group(P<0.05).Conclusion Acupuncture at the acupoints of the Lung and Large Intestine Meridians is an effective approach for bronchial asthma in chronic persistent stage;it can improve the pulmonary and immune functions and the quality of life in the patients through boosting the stimulation to nerves and inhibiting airway hyper-responsiveness.