病位病性辨证结合三伏灸贴治疗支气管哮喘的临床研究

Clinical research of syndrome differentiation according to the location and the nature combined with Sanfu Plaster to treat bronchial asthma

关键词:  支气管哮喘  病位病性辨证  三伏灸贴  临床研究

Key words:  bronchial asthma  syndrome differentiation according to the location and the nature  Sanfu Plaster  clinical research

摘要:

[目的]观察病位病性辨证结合三伏灸贴治疗支气管哮喘的临床疗效。[方法]将180例患者随机分治疗组和对照组，各90例，研究中因病情恶化脱落9例，脱落率为5.0%，最终完成171例，治疗组87例，对照组84例。两组均予常规治疗。对照组给予沙美特罗替卡松粉吸入，每次1吸，每日2次；治疗组给予病位病性辨证+三伏灸贴治疗，两组均治疗1个三伏周期。比较两组治疗前后中医症状评分、生存质量评分、肺功能评分、炎性指标及治疗后有效率。[结果]与本组治疗前比较，两组患者治疗后在中医症状评分、生存质量评分均降低（P<0.05）；治疗后治疗组在喘息、咳嗽、哮鸣音、胸膈满闷、活动受限、哮喘症状及对自我健康的关心方面均低于对照组（P<0.05），在心理功能状况、对刺激原的反应方面两组比较无统计学差异（P>0.05）；治疗后治疗组在第1秒用力呼吸容积（FEV1）、FEV1/用力肺活量（FVC）、最大呼气流量（PEF）均高于对照组（P<0.05）；在白介素-4（IL-4）、肿瘤坏死因子-α（TNF-α）、血清免疫球蛋白E（IgE）低于对照组（P<0.05），在干扰素-γ（INF-γ）表达方面比较无统计学意义（P>0.05）；两组临床疗效比较差异有统计学意义（P<0.05）。[结论]在常规治疗基础上，病位病性辨证结合三伏灸贴能够有效缓解支气管哮喘患者的临床症状，改善呼吸功能，提高生存质量，其机制可能与降低血清IL-4、TNF-α、IgE表达水平相关。

Abstract:

[Objective] In order to observe the clinical curative effect by the method of syndrome differentiation according to the location and the nature combined with Sanfu Plaster to treat bronchial asthma.[Methods] Select 180 cases patients of bronchial asthma were randomly divided into the treatment group and control group, each group had 90 patients. Nine cases were lost because it get worse in the study, and the lost rate was 5.0%. A total of 171 patients were completed, including 87 in the treatment group and 84 in the control group. Both groups were treated with conventional therapy. The control group was given salmeterol fluticasone propionate powder inhalation, 1 suction/times, 2 times/d; the treatment group was given syndrome differentiation according to the location and the nature combined with Sanfu Plaster treated, and both groups were treated with a tricycle. Two groups of traditional Chinese medicine (TCM) symptom scores, quality of life score, lung function score, the inflammatory index and the efficiency after treatment were compared of before and after treatment.[Results] Compared with this group before treatment that two groups of TCM symptom and quality of life scores were lower than before treatment (P<0.05); the treatment group was lower than the control group in wheezing rale, coughing, wheezing, chest tightness, activity limitation, asthma symptoms and self-health after treatment (P<0.05); there was no statistically significant difference between the two groups in the psychological function and the response to the stimulus (P>0.05); the treatment group was higher than the control group in FEV1, FEV1/FVC and PEF after treatment(P<0.05); in IL-4, TNF-α and IgE were lower than the control group (P<0.05); there was no statistical significance in the expression of INF-γ (P>0.05); the difference between the two groups was statistically significant that clinical efficacy were compared (P<0.05).[Conclusion] Syndrome differentiation according to the location and the nature combined with Sanfu Plaster on the basis of conventional therapy can effectively relieve the clinical symptoms of patients with bronchial asthma, improve respiratory function and improve the quality of life, the mechanism may be associated with decreased serum IL-4, TNF-α and IgE expression levels.