益肺灸治疗慢性阻塞性肺疾病适宜性及影响因素的专家调查

Expert Investigation on Suitability and Influencing Factors of Lung-benefiting Moxibustion in the Treatment of Chronic Obstructive Pulmonary Disease

目的:明确益肺灸治疗慢性阻塞性肺疾病(COPD)适宜性条件及相关因素,为规范技术操作、优化研究方案提供依据。方法:遴选呼吸系统疾病及从事灸法治疗的专家30名,采用信函法进行问卷调查。益肺灸治疗COPD专家问卷适宜因素包括疾病证型、治疗持续时间、间隔时间、疗程选择、结局指标选择等。回收问卷建立数据库,运用德尔菲法进行评价,采用均数、满分率、等级评价专家意见集中程度,变异系数评价专家意见协调程度。发放并回收问卷30份,专家积极系数为100.0%,专家权威程度0.9226。结果:益肺灸治疗COPD适宜因素包括适应证型(肺气虚证、肺脾气虚证等)、禁忌证(孕妇、过敏体质、心脑血管疾病急性期)、姜汁温度(37~38℃)、皮肤刺激(发红、发热、发痒感等)、更换艾柱壮数(3壮)、治疗持续时间(90 min)、治疗间隔时间(10 d或14 d)、疗程(3个月)、结局指标(临床症状、感冒次数、急性加重/发作次数等)。结论:根据问卷调查结果,确定益肺灸治疗COPD的适宜因素包括疾病证型、禁忌证、治疗持续时间、间隔时间、疗程、结局指标等9个方面,对于规范益肺灸操作流程、深入研究和推广应用具有指导意义。

Objective:This paper aims to clarify the suitable conditions and related factors of lung-benefiting moxibustion in the treatment of chronic obstructive pulmonary disease(COPD),so as to provide a basis for standardizing technical operation and optimizing the research scheme.Methods:A total of 30 experts experienced in the disease of the respiratory system and moxibustion were selected and investigated in the form of letters.Through the investigation,it was found that the suitable factors for lung-benefiting moxibustion in the treatment of COPD included disease syndrome type,treatment duration,interval time,course selection,and outcome index selection.The questionnaire was collected to establish a database,and the Delphi method was used to evaluate it.The mean,full mark rate,and grade indicators were used to evaluate the concentration degree of expert opinions,and the coefficient of variation was used to evaluate the coordination degree of expert opinions.30 questionnaires were distributed and collected.The positive coefficient of experts was 100.0%,and the degree of expert authority was 0.9226.Results:The suitable factors for lung-benefiting moxibustion in the treatment of COPD included applicable syndrome type(lung qi deficiency syndrome,lung and spleen qi deficiency syndrome,etc.),contraindications(pregnant women,allergic constitution,and acute stage of cardiovascular and cerebrovascular diseases),ginger juice temperature(37 to 38 ℃),skin irritation(redness,fever,itching,etc.),replaced moxa column(three columns),treatment duration(90 minutes),treatment interval(10 days or 14 days),course of treatment(three months),and outcome indicators(clinical symptoms,the frequency of colds,acute exacerbations/attacks,etc.).Conclusion:According to the results of the questionnaire,the suitable factors for lung-benefiting moxibustion in the treatment of COPD include nine aspects,such as disease syndrome type,contraindication,treatment duration,interval time,course of treatment,outcome index,and so on.It is of guiding significance for standardizing the operation process,in-depth research,and application of lung-benefiting moxibustion.