培元养心温针灸治疗咳嗽变异性哮喘临床疗效观察

Clinical Observation of Peiyuan Yangxin Warm-Needling Acup-moxibustion Therapy in the Treatment of Cough Variant Asthma

【目的】观察培元养心理论指导下温针灸治疗咳嗽变异性哮喘(cough variant asthma,CVA)患者的临床疗效。【方法】将70例CVA患者随机分为治疗组与对照组,每组各35例。对照组给予布地奈德福莫特罗吸入粉雾剂(信必可都保)治疗,治疗组给予培元养心温针灸治疗(其中,肺俞、心俞、膏肓俞、脾俞、肾俞、关元、足三里温针灸,天突、膻中、神门常规针刺),疗程为8周并随访3个月。观察2组患者治疗前、治疗后及随访时的改良简易咳嗽评价量表(CET)评分和焦虑自评量表(SAS)评分的变化情况,比较2组患者的临床疗效、复发率和不良反应情况。【结果】(1)治疗8周后,治疗组的临床控制率和总有效率分别为22.86%(8/35)、97.14%(34/35),对照组分别为2.86%(1/35)、88.57%(31/35),治疗组的临床控制率和总有效率均高于对照组,其中,2组的临床控制率比较差异有统计学意义(P<0.05),而总有效率比较差异无统计学意义(P>0.05)。(2)治疗后和随访时,2组患者的改良CET评分及治疗组的SAS评分均较治疗前明显降低(P<0.01),且治疗组在治疗后和随访时对改良CET评分及SAS评分的降低作用均明显优于对照组,差异均有统计学意义(P<0.01)。(3)治疗后3个月随访时,治疗组的复发率为5.88%(2/34),明显低于对照组的29.03%(9/31),差异有统计学意义(P<0.05)。(4)治疗过程中,治疗组无不良反应发生,对照组有4例(11.42%)患者出现轻度不适症状,2组患者的不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】培元养心理论指导下的温针灸疗法可更好地改善CVA患者的咳嗽症状及焦虑情绪,且远期疗效更好,复发率低于西药治疗的对照组。

Objective To observe the clinical efficacy of warm-needling acup-moxibustion therapy guided by the theory of replenishing primordial qi to nourish heart(Peiyuan Yangxin)in the treatment of patients with cough variant asthma(CVA).Methods Seventy patients with CVA were randomly divided into a treatment group and a control group,with 35 patients in each group.The control group was given Budesonide and Formoterol Fumarate Powder for Inhalation(Symbicort),while the treatment group was given Peiyuan Yangxin warm-needling acupmoxibustion therapy,i.e.,warm-needling moxibustion on Feishu(BL13),Xinshu(BL15),Gaohuangshu(BL43),Pishu(BL20),Shenshu(BL23),Guanyuanshu(BL26)and Zusanli(ST36),and conventional acupuncture on Tiantu(CV22),Danzhong(CV17)and Shenmen(HT7).Both groups were treated for a period of 8 weeks and followed up for 3 months.Changes in the modified simple cough evaluation test(CET)scores and selfrating anxiety scale(SAS)scores of the two groups were observed before and after treatment and at follow-up.After treatment,the clinical efficacy,recurrence rate and incidence of adverse reactions in the two groups were compared.Results(1)After 8 weeks of treatment,the clinical control rate and total effective rate of the treatment group were 22.86%(8/35)and 97.14%(34/35)respectively,while those in the control group were 2.86%(1/35)and 88.57%(31/35)respectively.The intergroup comparison showed that the clinical control rate and the total effective rate in the treatment group were higher than those in the control group,and the difference of clinical control rate between the two groups was statistically significant(P<0.05)while there was no significant difference in the total effective rate(P>0.05).(2)After treatment and at follow-up,the modified CET scores in both groups and SAS scores in the treatment group were significantly decreased compared with those before treatment(P<0.01),and the effect on decreasing the scores in the treatment group was significantly superior to that in the control group,the difference being statistically significant(P<0.01).(3)At the 3-month follow-up after treatment,the recurrence rate in the treatment group was 5.88%(2/34),which was significantly lower than that of the control group[29.03%(9/31)],and the difference was statistically significant(P<0.05).(4)During the treatment,no adverse reactions occurred in the treatment group,while 4 patients(11.42%)in the control group had mild discomforts.The difference of the incidence of adverse reactions between the two groups was not statistically significant(P>0.05).Conclusion Warm-needling acup-moxibustion therapy guided by the theory of replenishing primordial qi to nourish heart(Peiyuan Yangxin)is more effective on relieving the cough symptoms and anxiety of CVA patients,and exerts stronger long-term efficacy and lower recurrence rate than the control group treated with western medicine.