揿针治疗肺肾气虚型慢性阻塞性肺疾病稳定期疗效研究

Effect of needle therapy in the stable phase of pulmonary and renal qi deficiency chronic obstructive pulmonary disease

目的:研究揿针治疗肺肾气虚型慢性阻塞性肺疾病(COPD)稳定期的临床疗效。方法:前瞻性选择COPD患者200例,随机分为两组,对照组给予常规西医治疗,观察组在其基础上加用予揿针治疗,疗程为8周。记录两组的临床疗效,并比较两组治疗前后中医症状积分、6 min步行距离和衰弱筛查量表评分、改良英国MRC呼吸困难指数问卷(mMRC)、肺功能及圣乔治呼吸问卷(SGRQ)评分。两组治疗后均随访6个月,记录两组急性加重的次数。结果:观察组与对照组临床总有效率分别为92.00%和71.00%,前者显著高于后者(P<0.05)。与治疗前比较,两组治疗后中医症状积分和衰弱筛查量表评分均明显降低,6 min步行距离增加(P<0.05),且观察组治疗后中医症状积分和衰弱筛查量表评分低于对照组,6 min步行距离大于对照组(P<0.05)。与治疗前比较,两组治疗后mMRC分级及平均分、SGRQ问卷总分及各维度评分均明显降低,第1秒用力呼气容积(FEV 1)、用力肺活量(FVC)、最大呼气流量(PEF)、第1秒用力呼气量/用力肺活量(FEV 1/FVC)均明显增大(P<0.05),且观察组治疗后的mMRC分级及平均分、SGRQ问卷总分及各维度评分均低于对照组(P<0.05),肺功能指标高于对照组(P<0.05)。两组治疗后均随访6个月,观察组急性加重次数显著低于对照组(P<0.05)。结论:揿针治疗肺肾气虚型COPD稳定期患者的疗效确定,不仅能改善其临床症状,改善疲劳衰弱状况与增强运动耐量,还能减轻呼吸困难程度并提高肺功能,显著改善生存质量,减少COPD急性发作次数。

Objective:To study the clinical efficacy of needle in the treatment of chronic obstructive pulmonary disease(COPD)with lung and kidney qi deficiency.Methods:A total of 200 patients with COPD diagnosed were divided into 2 groups according to the random number table method,the control group was given conventional western medicine treatment,and the observation group was given needle treatment on the basis of the control group,and the treatment course of both groups was 8 weeks.The clinical efficacy of the two groups was recorded,and the scores of TCM symptoms,6 min walking distance and frailty screening scale,modified British MRC dyspnea index(mMRC),lung function and St.George’s Respiratory Questionnaire(SGRQ)before and after treatment were compared.Both groups were followed for 6 months after treatment,and the number of acute exacerbations in both groups was recorded.Results:The clinically effective of the observation group and control group were 92.00%and 71.00%,respectively,and the former was significantly higher than that of the latter(P<0.05).Compared with the pre-treatment period,the TCM symptom score and frailty screening scale scores of the two groups were significantly reduced,and the walking distance increased at 6 min(P<0.05),and the TCM symptom score and frailty screening scale scores in the observation group after treatment were lower than those in the control group,and the walking distance in 6 min was greater than that in the control group(P<0.05).Compared with the pre-treatment period,the mMRC grade and mean score of the two groups after treatment were significantly reduced,and the forced expiratory volume(FEV 1),forced vital capacity(FVC),forced expiratory volume/forced vital capacity(FEV 1/FVC)and maximum expiratory flow(PEF)in the first second were significantly increased(P<0.05),and the mMRC grade and average score after treatment in the observation group were lower than control group(P<0.05).Compared with before treatment,respiratory symptoms,activity limitation,disease impact scores and total scores in the SGRQ questionnaire were significantly lower in the two groups after treatment.Both groups were followed for 6 months after treatment.Conclusion:The efficacy of acupuncture in the treatment of patients with stable COPD with lung and kidney qi deficiency can not only improve clinical symptoms,exercise capacity and fatigue and debilitation,but also improve lung function and relieves breathing difficulties,significantly improve quality of life,and reduce the number of acute episodes of COPD.