随机单盲试验内外同治法治疗慢性阻塞性肺病稳定期患者疗效研究

The clinical efficacy of acupoint catgut implantation combined with Bufeiyishen decoction in treatment of chronic obstructive pulmonary disease at stable stage

目的随机对照单盲试验内外同治法观察穴位埋线联合补肺益肾汤治疗慢性阻塞性肺病(COPD)稳定期患者的临床疗效。方法120例符合入组标准的COPD稳定期患者随机分为3组,西医常规诊疗不变,试验组给予穴位埋线联合补肺益肾汤治疗,安慰剂组给予穴位埋线联合安慰剂治疗,对照组予以西医常规治疗,观察3组临床疗效、慢性阻塞性肺疾病评分(CAT)及Th17/Treg变化。结果试验组、安慰剂组治疗后较治疗前比较,主证咳嗽、咯痰、喘息、哮鸣差异有统计学意义(P<0.05),对照组差异无统计学意义(P>0.05),组间比较试验组较安慰剂组差异有统计学意义(P<0.05),试验组优于安慰剂、对照组;试验组、安慰剂组CAT积分较治疗前比较差异有统计学意义(P<0.05),对照组无统计学意义(P>0.05),组间比较试验组较安慰剂组差异有统计学意义(P<0.05),试验组优于安慰剂、对照组;试验组治疗后Treg、Th17、TNF-α、IL-8改变有统计学差异(P<0.05);安慰剂组治疗后Treg、Th17、TNF-α、IL-8改变有统计学差异(P<0.05);对照组治疗后Treg、Th17、TNF-α、IL-8改变无统计学差异(P>0.05),组间差异比较,试验组优于安慰剂组(P<0.05),安慰剂组优于对照组(P<0.05)。结论穴位埋线治疗可改善COPD患者的咳嗽、咯痰、喘息、哮鸣症状,联合补肺益肾汤治疗效果优于单纯穴位埋线;穴位埋线治疗能降低患者CAT积分,提高患者生活质量,内外同治效果更佳;埋线治疗可降低TNF-α、IL-8、Th17水平,升高Treg水平,改善Th17/Treg比值,联合补肺益肾汤治疗改善更为显著。

Objective To investigate the clinical efficacy of acupoint catgut implantation combined with Bufeiyishen decoction in treatment of chronic obstructive pulmonary disease(COPD)at stable stage evaluated by randomized controlled single-blind trial.Methods A total of 120 patients with stable COPD were randomly divided into three groups.The patients in control group were treated by conventional western medicine,on this basis,the patients in experimental group were treated by acupoint embedding combined with Bufeiyishen decoction,and patients in placebo group were treated by acupoint embedding combined with placebo.The clinical efficacy,chronic obstructive pulmonary disease score(CAT)and Th17/Treg changes were observed and compared among the three groups.Results There were significant differences in the main symptoms including cough,expectoration,wheezing and wheezing in experimental group and placebo group before treatment and after treatment(P<0.05),however,there were no significant differences in control group(P>0.05),moreover,which in experimental group were superior to those in placebo group and control group(P<0.05).There were significant differences in the levels of Treg,Th17,TNF-α,IL-8 in experimental group and placebo group before treatment and after treatment(P<0.05),however,there were no significant differences in control group(P>0.05),moreover,which in experimental group were superior to those in placebo group(P<0.05),which in placebo group.were superior to those in control group(P<0.05).Conclusion Acupoint catgut implantation can improve the symptoms of cough,expectoration,wheezing,and wheezing in patients with COPD.The combined treatment with Bufeiyishen decoction is better than acupoint catgut embedding only,and acupoint catgut embedding can decrease the CAT scores and improve the life quality of patient,and can decrease the levels of TNF-α,IL-8,Th17,increase the Treg levels,and improve the ratio of Th17/Treg.