脐灸治疗肺脾气虚型特发性肺间质纤维化合并胃食管反流疗效观察

Umbilical moxibustion for patients with idiopathic pulmonary fibrosis complicated with gastroesophageal reflux of lung-spleen qi deficiency

目的:评价脐灸治疗肺脾气虚型特发性肺间质纤维化合并胃食管反流患者的临床疗效。方法:将116例肺脾气虚型特发性肺间质纤维化合并胃食管反流的患者随机分为对照组和观察组,每组58例。对照组采用常规治疗,观察组在对照组常规治疗基础上给予脐灸治疗,每周2次,每次2 h,治疗12周,治疗后随访12周。比较治疗前后两组复合生理指标(CPI)、中医证候评分、圣乔治呼吸问卷(SGRQ)评分及6分钟步行试验(6MWT)。结果:在中医证候评分(咳嗽、活动后气促、倦怠乏力、烧心、反酸)、CPI评分、6MWT方面,观察组改善情况优于对照组(均P<0.05),两组治疗后SGRQ评分比较差异无统计学意义(P>0.05);治疗结束后12周随访时两组CPI评分及中医证候(咳嗽、倦怠乏力)评分比较差异无统计学意义(均P>0.05),6MWT、SGRQ情况及中医证候(活动后气促、反酸、烧心)评分观察组优于对照组(均P<0.05)。结论:脐灸治疗可以改善肺脾气虚型特发性肺间质纤维化合并胃食管反流患者肺的通气及弥散功能,减轻临床症状,提高患者的生活质量及活动耐力,具有一定的长期疗效。

Objective To evaluate the clinical efficacy of umbilical moxibustion in the treatment of patients with idiopathic pulmonary interstitial fibrosis complicated with gastroesophageal reflux of lung-spleen qi deficiency. Methods A total of 116 patients with idiopathic pulmonary fibrosis complicated with gastroesophageal reflux of lung spleen-deficiency were randomized into an observation group(58 cases) and a control group(58 cases). In the control group, the routine treatment was applied;in the observation group, on the base of the treatment as the control group, the umbilical moxibustion was used. The treatment was given 2 times a week, 2 h each time for 12 weeks, and followed up for 12 weeks after treatment. The composite physiological indicators(CPI), TCM syndrome scores, the St. George respiratory questionnaire score(SGRQ) and 6-minute walk test(6 MWT) were compared before and after treatment in the two groups.Results The improvement of the TCM syndrome scores(cough, post-activity shortness of breath, fatigue, heartburn, acid reflux), CPI score and 6 MWT in the observation group was better than those in the control group(all P<0.05). There was no significant difference in the scores of SGRQ scale between the two groups after treatment(P>0.05). There was no significant difference in the scores of CPI scores and syndromes(cough and fatigue) between the two groups at 12 weeks after treatment(all P>0.05). The 6 MWT, SGRQ scale scores and syndrome scores(post-activity shortness of breath,acid reflux, heartburn) were better than those in the control group in the follow up(all P<0.05). Conclusion Umbilical moxibustion can improve the ventilation and diffusion function of lung in patients with idiopathic pulmonary fibrosis and gastroesophageal reflux of lung-spleen qi deficiency, reduce clinical symptoms and improve patients’ quality of life and activity endurance. And it has long-term effect.