针刺联合乌梅丸治疗咳嗽变异性哮喘急性期临床研究

Efficacy of Acupuncture Combined with Wumei Pills on Patients with Acute Phase of Cough Variant Asthma

目的观察针刺联合乌梅丸治疗咳嗽变异性哮喘(CVA)急性期的疗效,并探讨其对患者肺功能的保护机制。方法选取CVA患者120例,将其随机分为对照组59例与观察组61例,对照组给予西药治疗,观察组加用针刺联合乌梅丸治疗,疗程14 d。统计并比较两组的临床疗效,并分别于治疗前后检测肺功能指标、心率变异性(HVR)频域指标、外周血炎症指标。结果观察组的总有效率为98.36%,高于对照组的88.14%(P<0.05)。治疗后,观察组的中医证候积分、视觉模拟量表和莱切斯特咳嗽生命质量问卷评分均低于对照组(P<0.05)。治疗后,观察组的用力肺活量/第1秒用力呼气容积、呼气峰值流速、24 h正常RR间期标准差和连续5 min正常RR间期差值的均方根值均高于对照组(P<0.05)。治疗后,观察组的血清嗜酸性粒细胞、白细胞介素-4、白细胞介素-8、白细胞介素-17和肿瘤坏死因子-α水平均低于对照组(P<0.05)。结论针刺联合乌梅丸治疗CVA急性期疗效确切,可改善患者的咳嗽症状,保护患者的肺功能并降低复发率,其机制可能与改善HRV及抑制气道炎症有关。

Objective:To investigate the effect of acupuncture combined with Wumei Pills on patients with acute phase of cough variant asthma(CVA)and its protective mechanism of pulmonary function.Methods:A to⁃tal of 120 patients with acute phase of CVA were randomly divided into two group:59 patients in the control group were treated with western medicine,61 patients in the observation group were treated with acupuncture com⁃bined with Wumei Pills on this basis for 14 days.The therapeutic effects of the two groups were compared.The pulmonary function indicators,heart rate variability(HVR)frequency domain indicators,and peripheral blood in⁃flammation indicators were detected before and after treatment.Results:The total effective rate of the observation group(98.36%)was higher than that of the control group(88.14%)(P<0.05).After treatment,the scores of tradi⁃tional Chinese medical syndrome score,visual analogue scale(VAS)and Leicester cough quality of life question⁃naire(LCQ)in the observation group were lower than those in the control group(P<0.05).After treatment,the forced vital capacity/forced expiratory volume in the first second(FEV1/FVC),peak expiratory flow rate(PEF),the standard deviation of 24 h normal RR interval(SDNN)and the root mean square value of continuous 5 min normal RR interval(RMSSD)in the observation group were higher than those in the control group(P<0.05).After treatment,the serum levels of eosinophils(EOS),interleukin-4(IL-4),IL-8,IL-17 and tumor necrosis factor-α(TNF-α)in the observation group were lower than those in the control group(P<0.05).Conclusion:Acupunc⁃ture combined with Wumei Pills has definite therapeutic effect on acute phase of CVA,which can improve the cough symptoms of patients,protect the pulmonary function of patients and reduce the recurrence rate,its mecha⁃nism may be related to improving HRV and inhibiting airway inflammation.