基于哮喘慢病管理平台观察穴位贴敷后皮肤反应对支气管哮喘的影响

Clinical therapeutic effect on bronchial asthma by the observation of skin reaction after acupoint application based on chronic disease management platform of asthma

目的:观察穴位贴敷后有无皮肤反应对支气管哮喘疗效的影响。方法:对61例支气管哮喘患者于三伏期间行穴位贴敷治疗,穴取定喘、肺俞、心俞、脾俞、肾俞,每隔7 d贴敷1次,每次贴敷6 h,共贴敷4次,根据贴敷后局部皮肤反应分为有皮肤反应组(30例,脱落2例)和无皮肤反应组(31例)。于治疗前、治疗结束1年后,采用哮喘慢病管理平台在线记录两组患者治疗前后哮喘发作次数、哮喘控制测试量表(ACT)评分、哮喘生活质量问卷(AQLQ)评分,并于治疗结束1年后观察两组疗效。结果:治疗结束1年后,两组患者哮喘发作次数较治疗前减少(P<0.001),ACT评分与AQLQ活动受限、哮喘症状、心理状况、对刺激源的反应、对自身健康的关心各分项评分及总分均较治疗前升高(P<0.001),有皮肤反应组患者哮喘发作次数少于无皮肤反应组(P<0.05),ACT评分与AQLQ各分项评分及总分均高于无皮肤反应组(P<0.05,P<0.01)。有皮肤反应组总有效率为82.1%(23/28),优于无皮肤反应组的67.7%(21/31,P<0.05)。结论:穴位贴敷治疗支气管哮喘,贴敷后局部出现皮肤反应者临床疗效更佳,哮喘慢病管理平台在线评价便捷。

Objective To compare the therapeutic effect on bronchial asthma between presence of skin reaction and the absence of skin reaction after acupoint application. Methods Sixty-one patients with bronchial asthma were treated with acupoint application during the hottest periods of summer( "dog days"). The acupoints included Dingchuan(EX-B 1), Feishu(BL 13), Xinshu(BL 15), Pishu(BL 20) and Shenshu(BL 23). The treatment was given once every 7 days, with the herbal plaster remained for 6 h each time, and 4 treatments were required totally. According to the local skin reaction after acupoint application, a skin reaction group(30 cases, 2 cases dropped off) and a non-skin reaction group(31 cases) were divided.Separately, before treatment and 1 year after treatment, using chronic disease management platform of asthma, the number of asthma attacks, the score of asthma control test(ACT) and the score of asthma quality of life questionnaire(AQLQ) were recorded online. Besides, the therapeutic effect was observed in the two groups 1 year after treatment. Results One year after treatment, the number of asthma attacks was reduced as compared with that before treatment in the patients of either group(P<0.001), the score of ACT and each domain in AQLQ, i.e. activity limitation, asthma symptoms, psychological state, reactions to stimuli and self-health care as well as the total scores of AQLQ were all increased as compared with those before treatment(P<0.001). The number of asthma attacks in the skin reaction group was less than the non-skin reaction group(P<0.05), the score of ACT and each domain of AQLQ and the total scores of AQLQ were all higher than the non-skin reaction group successively(P<0.05, P<0.01). The total effective rate was 82.1%(23/28) in the skin reaction group, better than 67.7%(21/31) in the non-skin reaction group(P<0.05). Conclusion In treatment of acupoint application for bronchial asthma, the clinical therapeutic effect is better in the patients with local skin reaction after acupoint application. The chronic disease management platform of asthma is convenient for online evaluation.