穴位贴敷联合主动呼吸循环技术对稳定期慢性阻塞性肺疾病的康复效果及相关机制探讨

Investigation of rehabilitation effect and its related mechanism of acupoint application combined with active respiratory and circulatory technology on stable chronic obstructive pulmonary disease

关键词:  慢性阻塞性肺疾病  稳定  穴位贴敷  主动呼吸循环技术  康复

Key words:  chronic obstructive pulmonary disease  stable  acupoint application  active breathing and circulation technology  recovery

摘要:

[目的] 观察穴位贴敷联合主动呼吸循环技术（ACBT）在稳定期慢性阻塞性肺疾病（COPD）肺康复治疗中效果，初步探讨其治疗机制。[方法] 选择河北省中医院2019年1月—2022年1月收治的稳定期COPD患者120例，按照数字随机表法分为2组，对照组予以中药穴位贴敷治疗，试验组予以中药穴位贴敷联合ACBT进行肺康复治疗，疗效均为12周。比较两组治疗前后第1秒呼气容积（FEV1）占预计值的百分比（FEV1% pred）、用力肺活量（FVC）占预计值的百分比（FVC% pred）、FEV1/FVC、英国医学研究委员会呼吸困难量表（MRC）分级、6 min步行距离（6 MWD）、COPD评估测试问卷（CAT）评分，并比较两组血清分泌型卷曲相关蛋白1（SFRP1）、颗粒蛋白前体（PGRN）水平和miRNA-181a相对表达量，比较两组12个月急性加重情况。[结果] 治疗后试验组FEV1% pred、FVC% pred、FEV1/FVC、6 MWD高于对照组，差异具有统计学意义（P<0.01），CAT评分低于对照组，差异具有统计学意义（P<0.01），MRC分级优于对照组（P<0.05）；试验组血清SFRP1、PGRN水平低于对照组，差异具有统计学意义（P<0.01），miRNA-181a相对表达量高于对照组（P<0.01）；对两组随访12个月，试验组12个月急性加重人次少于对照组，差异具有统计学意义（P<0.05）。[结论] 穴位贴敷联合ACBT可有效改善肺功能，减轻呼吸困难，减少病情急性加重，用于稳定期COPD肺康复治疗效果显著，其机制可能与调节血清SFRP1、PGRN水平和miRNA-181a阳性表达有关。

Abstract:

[Objective] To observe the effect of acupoint application combined with active respiratory and circulatory Technology (ACBT) in pulmonary rehabilitation of stable chronic obstructive pulmonary disease (COPD),and to explore its therapeutic mechanism.[Methods] The 120 patients with stable COPD treated in Hebei Hospital of traditional Chinese medicine from January,2019 to January,2022 were randomly divided into two groups.The control group were treated with traditional Chinese medicine acupoint application,and the experimental group were treated with traditional Chinese medicine acupoint application combined with ACBT for lung rehabilitation.The curative effects were for 12 weeks.FEV1% pred,FVC% pred,FEV1/FVC,the rating of British Medical Research Council Dyspnea Scale (MRC),6MWD,COPD evaluation questionnaire (CAT) scores before and after treatment were compared between the two groups,and the serum secretory curl associated protein (SFRP1) was compared between the two groups.The level of granule protein precursor (PGRN) and the relative expression of miRNA-181a were compared between the two groups.[Results] FEV1% PRED,FVC% PRED,FEV1/FVC and 6MWD of the experimental group after treatment were higher than those of the control group (P<0.01),and CAT score was lower than that of the control group (P<0.01),and MRC grade was better than that of the control group (P<0.05);the levels of serum SFRP1 and PGRN of the experimental group were lower than those of the control group (P<0.01),and the relative expression of miRNA-181a was higher than that of the control group (P<0.01);the two groups were followed up for 12 months.The number of acute exacerbations of the experimental group was less than that of the control group (P<0.05).[Conclusion] Acupoint application combined with ACBT can effectively improve pulmonary function,reduce dyspnea,and reduce the number of acute exacerbations.It has a significant effect on pulmonary rehabilitation of stable COPD.Its mechanism may be related to the regulation of serum SFRP1,PGRN levels and positive expression.