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[针刺对支气管哮喘不同状态下肺功能及心率变异性的影响]

[Effects of acupuncture on the pulmonary function and heart rate variability in different state of bronchial asthma].

作者信息

Zhang Wen-Peng

机构信息

China Academy of Chinese Medical Sciences, Beijing 100700, China.

出版信息

Zhen Ci Yan Jiu. 2007 Feb;32(1):42-8.

Abstract

OBJECTIVE

To observe the underlying mechanism of acupuncture technique for ventilating the lung, invigorating the spleen and tonifying the kidney in the treatment of bronchial asthma (or asthma for short).

METHODS

According to the severity of the disease during the persistent stage and paracmasis, 71 outpatients and inpatients were randomized into treatment group (n = 40) and control group (n = 31). Patients of treatment group were treated with acupuncture of Quchi (LI 11), Lieque (LU 7), Yuji (LU 10), Neiguan (PC 6), Zusanli (ST 36), Sanyinjiao (SP 6), Taixi (KI 3), etc., once daily and those of control group treated with anti-asthma drugs as Cromolyn sodium, Albuterol, fenoterol, etc. Before and after 12 days of the treatment, heart rate variability (HRV) and pulmonary function were detected respectively.

RESULTS

In paracmasis and mild type asthma patients, self-comparison indicated that after the treatment, total power (TP), very low frequency (VLF), triangular index (TI) and the percentage of the adjacent R-R intervals (PNN50) of HRV, and forced expiratory volume in the first second (FEV1) (% PRED), forced expiratory flow (FEF) 0.2-1.2 (L/s), FEF(75%-85%) (L/s), peak expiratory flow (PEF) (% PRED), FEF(25%) (% PRED) in treatment group increased significantly (P < 0.05, 0.01), while no significant changes of various components of both HRV and pulmonary function were found in control group (P > 0.05). Comparison between two groups showed that after the treatment, the values of TP, VLF, TI and PNN50 of HRV, and FVC (% PRED), FEV1 (% PRED), FEV1/FVC (% PRED), FEF(0.2-1.2), FEF(25%-75%), PEF (% PRED) and FEF(25%) (% PRED) in treatment group were significantly higher than those in control group (P < 0.05). In moderate and severe type asthma patients, self-comparison showed that after the treatment, TP, LF, LFnorm, VLF, LF/HF, VLF/HF, (LF + VLF)/HF, TI and PNN50 of HRV, and FVC (% PRED), FEV1 (% PRED), FEV1/FVC (% PRED), FEF(0.2-1.2), FEF(25%-75%) (% PRED), FEF(75%-85%), PEF (% PRED), FEF25% (% PRED) , FEF(50%) (%PRED and FEF(75%) (% PRED) of the pulmonary function all increased remarkably (P < 0.05, 0.01, 0.001); while in comparison with control group, LF, LFnorm, VLF, (LF + VLF)/HF and TI of HRV, and all the parameters of the pulmonary function except FEV1/FVC were significantly higher than those in control group (P < 0.05, 0.01, 0.001). No significant changes of various components of both HRV and pulmonary function were found in control group (P > 0.05).

CONCLUSION

Acupuncture is significantly superior to medication in improving the pulmonary function of asthma patients with different state of disease, which is related to its function in regulating activities of the autonomic nervous system.

摘要

目的

观察透肺健脾益肾针法治疗支气管哮喘(以下简称哮喘)的作用机制。

方法

将71例门诊及住院患者按病情缓解期和发作期的轻重程度随机分为治疗组(40例)和对照组(31例)。治疗组采用针刺曲池(LI 11)、列缺(LU 7)、鱼际(LU 10)、内关(PC 6)、足三里(ST 36)、三阴交(SP 6)、太溪(KI 3)等穴位,每日1次;对照组采用色甘酸钠、沙丁胺醇、酚妥拉明等平喘药物治疗。治疗12天前后分别检测心率变异性(HRV)和肺功能。

结果

在缓解期和轻度哮喘患者中,自身比较显示,治疗后治疗组HRV的总功率(TP)、极低频(VLF)、三角指数(TI)和相邻R-R间期百分比(PNN50),以及第1秒用力呼气容积(FEV1)(%PRED)、用力呼气流量(FEF)0.2-1.2(L/s)、FEF(75%-85%)(L/s)、呼气峰值流量(PEF)(%PRED)、FEF(25%)(%PRED)均显著增加(P<0.05,0.01),而对照组HRV和肺功能各指标均无显著变化(P>0.05)。两组比较显示,治疗后治疗组HRV的TP、VLF、TI和PNN50值,以及肺功能的FVC(%PRED)、FEV1(%PRED)、FEV1/FVC(%PRED)、FEF(0.2-1.2)、FEF(25%-75%)、PEF(%PRED)和FEF(25%)(%PRED)均显著高于对照组(P<0.05)。在中度和重度哮喘患者中,自身比较显示,治疗后HRV的TP、低频(LF)、LFnorm、VLF、LF/HF、VLF/HF、(LF + VLF)/HF、TI和PNN50,以及肺功能的FVC(%PRED)、FEV1(%PRED)、FEV1/FVC(%PRED)、FEF(0.2-1.2)、FEF(25%-75%)(%PRED)、FEF(75%-85%)、PEF(%PRED)、FEF25%(%PRED)、FEF(50%)(%PRED)和FEF(75%)(%PRED)均显著增加(P<0.05,0.01,0.001);与对照组比较,HRV的LF、LFnorm、VLF、(LF + VLF)/HF和TI,以及除FEV1/FVC外的所有肺功能参数均显著高于对照组(P<0.05,0.01,0.001)。对照组HRV和肺功能各指标均无显著变化(P>0.05)。

结论

针刺在改善不同病情状态哮喘患者肺功能方面明显优于药物,这与其调节自主神经系统活动的作用有关。

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