针刺联合润肺清燥汤治疗慢性支气管炎迁延期肺肾阴虚证临床研究

Clinical Study on Acupuncture Combined with Runfei Qingzao Tang for Chronic Bronchitis in Remission Stage with Lung-Kidney Yin Deficiency Syndrome

目的:观察针刺联合润肺清燥汤治疗慢性支气管炎(CB)迁延期肺肾阴虚证的临床疗效,以及对患者肺通气功能及免疫功能的影响。方法:选取138例CB迁延期肺肾阴虚证患者,使用随机数字表法分为针刺组、汤剂组及联合组各46例。3组均予以常规西药治疗,在此基础上针刺组给予针刺治疗,汤剂组给予润肺清燥汤治疗,联合组给予针刺联合润肺清燥汤治疗,3组均治疗10 d。比较3组临床疗效、中医证候积分、肺通气功能、免疫功能及炎症因子水平,记录不良反应。结果:针刺组总有效率71.74%,汤剂组总有效率76.09%,联合组总有效率91.30%,联合组总有效率高于针刺组与汤剂组(P<0.05)。治疗后,3组中医证候积分均较治疗前降低(P<0.05),联合组中医证候积分低于汤剂组与针刺组(P<0.05),汤剂组中医证候积分低于针刺组(P<0.05)。治疗后,3组呼气流量峰值(PEF)、肺活量(VC)、第1秒用力呼气容积/用力肺活量(FEV/FVC)均较治疗前升高(P<0.05),联合组PEF、VC、FEV/FVC均高于针刺组及汤剂组(P<0.05)。治疗后,3组CD3~+、CD4~+水平及CD4~+/CD8~+值均较治疗前升高(P<0.05),联合组CD3~+、CD4~+水平及CD4~+/CD8~+值均高于针刺组与汤剂组(P<0.05),汤剂组CD3~+、CD4~+水平及CD4~+/CD8~+值均高于针刺组(P<0.05)。治疗后,3组可溶性细胞间黏附分子-1 (sICAM-1)、白细胞介素-8 (IL-8)水平均较治疗前降低(P<0.05),联合组sICAM-1、IL-8水平均低于针刺组与汤剂组(P<0.05)。治疗期间,3组均未出现明显不良反应。结论:针刺联合润肺清燥汤能够有效抑制CB迁延期肺肾阴虚证患者的炎症反应,提高其免疫功能,促进肺通气功能恢复,缓解临床症状。

Objective:To observe the clinical effect of acupuncture combined with Runfei Qingzao Tang for chronic bronchitis(CB) in remission stage with lung-kidney yin deficiency syndrome,and its effect on lung ventilation function and immune function of patients.Methods:A total of 138 cases of patients with CB in remission stage with lung-kidney yin deficiency syndrome were selected and divided into the acupuncture group,the decoction group and the combination group according to the random number table method,with 46 cases in each group.All the three groups were given routine western medicine treatment;the acupuncture group was additionally treated with acupuncture;the decoction group was additionally treated with Runfei Qingzao Tang;the combination group was additionally treated with acupuncture combined with Runfei Qingzao Tang.All the three groups were treated for ten days.The clinica effects,traditional Chinese medicine(TCM) syndrome scores,and lung ventilation function,immune function and levels of inflammatory factors in the three groups were compared;the adverse reactions were recorded.Results:The total effective rate was 71.74%in the acupuncture group,76.09%in the decoction group and 91.30%in the combination group;the total effective rate in the combination group was higher than those in the acupuncture group and the decoction group(P<0.05).After treatment,TCM syndrome scores in the three groups were decreased when compared with those before treatment(P<0.05);the TCM syndrome score in the combination group was lower than those in the decoction group and the acupuncture group(P<0.05);the TCM syndrome score in the decoction group was lower than that in the acupuncture group(P<0.05).After treatment,the maximum peak expiratory flow rate(PEF),vital capacity(VC) and forced expiratory volume in the first second/forced vital capacity(FEV/FVC) in the three groups were increased when compared with those before treatment(P<0.05),and PEF,VC and FEV/FVC in the combination group were higher than those in the acupuncture group and the decoction group(P<0.05).After treatment,the levels of CD3and CD4and the values of CD4/CD8in the three groups were increased when compared with those before treatment(P<0.05);the levels of CD3and CD4and the value of CD4CD8in the combination group were higher than those in the acupuncture group and the decoction group(P<0.05);the levels of CD3and CD4and the value of CD4/CD8in the decoction group were higher than those in the acupuncture group(P<0.05).After treatment,the levels of soluble intercellular adhesion molecule-1(sICAM-1) and interleukin-8(IL-8) in the three groups were decreased compared with those before treatment(P<0.05),and the levels of sICAM-1 and IL-8 in the combination group were lower than those in the acupuncture group and the decoction group(P<0.05).During treatment,there was no obvious adverse reaction in the three groups.Conclusion:The therapy of acupuncture combined with Runfe Qingzao Tang can effectively inhibit the inflammatory responses of patients with CB in remission stage with lung-kidney yin deficiency syndrome,improve their immune function,promote the recovery of lung ventilation function and relieve clinical symptoms.