火龙灸对慢性阻塞性肺疾病稳定期肺肾气虚证患者肺功能及生存质量的影响

Effect of Fire-dragon Moxibustion on Lung Function and Quality of Life in Patients at Stable Stage of Chronic Obstructive Pulmonary Disease with Qi Deficiency of Lung and Kidney Syndrome

【目的】探讨火龙灸对慢性阻塞性肺疾病(COPD)稳定期肺肾气虚证患者肺功能及生存质量的影响。【方法】将96例COPD稳定期肺肾气虚证患者随机分为观察组和对照组,每组各48例。对照组给予健康宣教及常规支气管舒张剂治疗。观察组在对照组治疗的基础上,给予火龙灸治疗。2组疗程均为25 d,治疗后30 d和90 d进行随访。治疗30 d后,观察2组患者治疗前后肺功能的变化情况,包括第一秒用力呼气容积(FEV1)占预计值的百分比(FEV1%),用力肺活量(FVC)占预计值百分比(FVC%),第一秒用力呼气容积占肺活量的百分比(FEV1/FVC%)。比较2组患者治疗前后改良英国医学研究学会呼吸困难指数(mMRC)量表评分、慢阻肺临床症状问卷(CCQ)评分、BODE指数评分的变化情况。分别于治疗30 d和90 d后,比较2组患者生活质量评估问卷(CAT)评分的变化情况。【结果】(1)研究过程中,观察组失访4例,对照组失访1例。最终观察组44例、对照组47例纳入研究。(2)治疗后,对照组患者FEV1%、FVC%、FEV1/FVC%改善不明显,与治疗前比较,差异无统计学意义(P>0.05)。治疗后,观察组患者FEV1%、FVC%、FEV1/FVC%均明显改善(P<0.05),且观察组在改善FEV1%、FVC%、FEV1/FVC%方面明显优于对照组,差异有统计学意义(P<0.05)。(3)治疗后,2组患者mMRC分级均有明显改善(P<0.05),但2组在改善m MRC分级方面,效果相当,差异无统计学意义(P>0.05)。(4)治疗后,观察组的CCQ评分、BODE指数较治疗前明显改善(P<0.05),对照组的CCQ评分、BODE指数改善不明显(P>0.05),观察组在改善CCQ评分、BODE指数方面明显优于对照组,差异有统计学意义(P<0.05)。(5)治疗后30 d和90 d,2组患者的CAT评分均较治疗前明显改善,差异均有统计学意义(P<0.05);且观察组在改善CAT评分方面明显优于同期对照组,差异有统计学意义(P<0.05)。【结论】火龙灸可改善慢性阻塞性肺疾病稳定期肺肾气虚证患者的肺功能,改善患者的临床症状,从而提高患者的生存质量,疗效显著。

Objective To investigate the effect of Fire-dragon moxibustion on lung function and quality of life in patients at stable stage of chronic obstructive pulmonary disease(COPD)with qi deficiency of lung and kidney syndrome.Methods Ninety-six patients of stable COPD with qi deficiency of lung and kidney syndrome were randomly divided into observation group and control group,with 48 cases in each group.The control group was given health education and conventional bronchodilator treatment,and the observation group was treated with Firedragon moxibustion on the basis of the control group.The treatment course of both groups was 25 days,followed up at day 30 and day 90 after treatment.After 30 days of treatment,the changes of lung function in two groups were observed before and after treatment,including the percentage of forced expiratory volume in the first second(FEV1)in the predicted value(FEV1%),the percentage of forced expiratory volume in the first second(FVC)in the predicted value(FVC%),and the percentage of forced expiratory volume in the first second(FEV1/FVC%).The changes of mMRC scale score,CCQ score and BODE index score in two groups were compared before and after treatment.After 30 days and 90 days of treatment,the changes of COPD Assessment test(CAT)scores for quality of life of two groups were compared.Results(1)During the study,there were 4 cases of lost follow-up in the observation group and one case in the control group.Finally,44 cases in the observation group and 47 cases in the control group were included in the study.(2)After treatment,FEV1%,FVC%and FEV1/FVC%in the control group were not significantly improved,and the difference was not statistically significant compared with those before treatment(P>0.05).After treatment,FEV1%,FVC%and FEV1/FVC%in the observation group were significantly improved(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(3)After treatment,mMRC grading in both groups was significantly improved(P<0.05),but there was no statistical significance in improving mMRC grading in the two groups(P>0.05).(4)After treatment,CCQ score and BODE index of the observation group were significantly improved compared with those before treatment(P<0.05),while there was no significant improvement in the control group(P>0.05).The observation group was significantly superior to the control group in improving CCQ score and BODE index,the difference being statistically significant(P<0.05).(5)CAT scores in both groups were significantly improved at 30 days and 90 days after treatment,the difference being statistically significant(P<0.05);the observation group was significantly superior to the control group in improving CAT score,the difference being statistically significant(P<0.05).Conclusion Fire-dragon moxibustion is effective in improving the lung function and clinical symptoms of patients at stable stage of COPD with qi deficiency of lung and kidney syndrome,so as to improve the quality of life of patients with a significant effect.