改良督灸联合噻托溴铵吸入粉雾剂治疗慢性阻塞性肺疾病稳定期肺肾阳虚证临床观察

Clinical study on modified Du moxibustion combined with tiotropium bromide inhalation powder on stable chronic obstructive pulmonary disease of lung kidney yang deficiency syndrome

目的观察改良督灸联合噻托溴铵吸入粉雾剂治疗慢性阻塞性肺疾病(COPD)稳定期肺肾阳虚证的临床疗效。方法将108例COPD稳定期肺肾阳虚证患者按照随机数字表法分为2组,对照组54例予噻托溴铵吸入粉雾剂治疗,治疗组54例在对照组治疗基础上加改良督灸治疗,2组均治疗3个月。比较2组治疗前后中医证候积分、肺功能指标、免疫指标变化。结果2组治疗后各项证候积分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后肺功能指标第1 s用力呼气容积(FEV_(1))、用力肺活量(FVC)、FEV_(1)/FVC均较本组治疗前升高(P<0.05),且治疗组升高更明显(P<0.05)。2组治疗后CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均较本组治疗前升高(P<0.05),CD8^(+)较本组治疗前降低(P<0.05);治疗后治疗组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均高于对照组(P<0.05),CD8^(+)低于对照组(P<0.05)。结论改良督灸联合噻托溴铵吸入粉雾剂治疗COPD稳定期肺肾阳虚证,可改善患者临床证候积分,提高肺功能和免疫功能。

Objective To evaluate the effect of modified Du moxibustion combined with cetorum bromide on stable chronic obstructive pulmonary disease(COPD)of lung kidney yang deficiency syndrome and its effect on pulmonary function and immune function.Methods Totally 108 patients with stable COPD(lung kidney yang deficiency syndrome)were randomly enrolled into control group(n=54)and observation group(n=54).Patients of the control group were treated with tiotropium bromide inhalation powder,and patients of the observation group were additional treated with modified Du moxibustion.The treatment was performed for three days,aiming to compare traditional Chinese medicine(TCM)syndrome score,indexes of lung function and immune function before and after treatment between groups.Results After treatment,the TCM syndrome scores in the two groups were lower than those before treatment(P<0.05),and the decrease in the treatment group was more significant(P<0.05).The lung function indexes including forced vital capacity(FVC),forced Expiratory Volume at 1 Second(FEV 1),and FEV 1/FVC ratio in the two groups were higher than those before treatment(P<0.05),and the increase in the treatment group was more significant(P<0.05).After treatment,increased CD3+,CD4+and CD4+/CD8+ratio and decreased CD8+were detected in the two groups(P<0.05),There were significant differences in CD3+,CD4+and CD4+/CD8+ratio and CD8+between groups(P<0.05).Conclusion For patients with stable COPD(lung kidney yang deficiency syndrome),modified Du moxibustion combined with tiotropium bromide inhalation powder can improve the clinical syndrome score,lung function and immune function of the patients.