Yang Shu-Quan, Zhang Wei, Li Jin-Xiang, Lou Bi-Dan, Li Xiao-Ping, Li Wu, Huang Xiang-Hong, Liu Xing-Ping, Yang Li-Bai, Shi Wen-Ying, Cao Yue
Department of Acupuncture-Moxibustion, Massage and Rehabilitation, Changde Municipal First Hospital of TCM, Changde 415000, Hunan Province, China.
Zhongguo Zhen Jiu. 2012 Feb;32(2):117-22.
To systematically observe the clinical effect on chronic obstructive pulmonary disease (COPD) at the stable stage, differentiated as cold phlegm blocking the lung type, treated with acupoint sticking therapy during the dog days and the three nine-day periods after the winter solstice so as to propose the latest clinical idea and theoretic evidence for the treatment of COPD.
One hundred and fifty cases of COPD at stable stage, which were in accordance with the inclusive standard were randomly divided into three groups, named group A (treatment in dog days and the three nine-day periods after the winter solstice), group B (treatment in dog days) and group C (treatment in the three nine-day periods after the winter solstice), 50 cases in each group. The ingredients (Semen Brassicae, Euphoribia Kansui, Asarum, Rhizome Corydalis, Cinnamon, ginger juice) and doses of herbal medicine plaster were same in each group. The herbal plaster was applied to Feishu (BL 13), Shenshu (BL 23), Dazhui (GV 14), Tiantu (CV 22), Danzhong (CV 17) and Zhongfu (LU 1). In group B, the treatment was given once on the 1st day of each dog-day period, totally 3 treatments were included. In group C, the treatment was given once on the 1st day of each nine-day periods after the winter solstice, totally, 3 treatments were involved. In group A, the treatment was given once on the 1st day of each dog-day period and each nine-day periods after the winter solstice separately, totally 6 treatments were required. The therapeutic effect was evaluated in 4 aspects, named comprehensive clinical efficacy, survival quality (the scores for symptoms, activity limitation and influence on daily life), the attach frequency and pulmonary function.
The total effective rate was 88.0% (46/50) in group A, which was superior to 76.0% (38/50) in group B and 70.0% (35/50) in group C separately (P < 0.01, P < 0.001). The results of the attack frequency, clinical symptom score and pulmonary function indices after treatment were all improved apparently as compared with those before treatment in each group (all P < 0.01). All the above indices in group A were improved much apparently as compared with the other two groups (P < 0.01, P < 0.001). Except for the level of forced vital capacity (FVC), the results of clinical symptom score and the other pulmonary function indices in group B were all improved significantly as compared with group C (P < 0.05, P < 0.001).
Acupoint sticking therapy during different season of the year achieves a superior clinical efficacy for the patients with COPD at stable stage. This therapy can reduce the attack frequency and improve the survival quality and pulmonary function for the patients. It is concluded that the efficacy of the treatment in dog days and the three nine-day periods after the winter solstice is superior to simple dog-day treatment and the treatment in the three nine-day periods after the winter solstice, and the efficacy of dog days treatment is better than that in the three nine-day periods after the winter solstice.
系统观察三伏天及冬至后三九期间穴位贴敷治疗稳定期慢性阻塞性肺疾病(COPD)之寒痰阻肺证的临床疗效,为COPD的治疗提供新的临床思路和理论依据。
将符合纳入标准的150例稳定期COPD患者随机分为三组,即A组(三伏天及冬至后三九期间治疗)、B组(三伏天治疗)和C组(冬至后三九期间治疗),每组50例。三组中药膏剂的药物组成(白芥子、甘遂、细辛、延胡索、肉桂、姜汁)及剂量相同。将药膏贴于肺俞(BL 13)、肾俞(BL 23)、大椎(GV 14)、天突(CV 22)、膻中(CV 17)、中府(LU 1)。B组于每个三伏天的第1天治疗1次,共治疗3次。C组于冬至后每个九天的第1天治疗1次,共治疗3次。A组分别于每个三伏天及冬至后每个九天的第1天各治疗1次,共治疗6次。从综合临床疗效、生存质量(症状、活动受限及对日常生活的影响评分)、发作频次及肺功能4个方面进行疗效评价。
A组总有效率为88.0%(46/50),分别优于B组(76.0%,38/50)和C组(70.0%,35/50)(P<0.01,P<0.001)。三组治疗后发作频次、临床症状评分及肺功能指标均较治疗前明显改善(均P<0.01)。A组上述指标改善程度明显优于其他两组(P<0.01,P<0.001)。B组除用力肺活量(FVC)水平外,临床症状评分及其他肺功能指标改善程度均明显优于C组(P<0.05,P<0.001)。
穴位贴敷治疗稳定期COPD患者在不同季节均有较好疗效,可减少发作频次,提高生存质量及肺功能。三伏天及冬至后三九期间穴位贴敷治疗COPD稳定期疗效优于单纯三伏天治疗及单纯冬至后三九期间治疗,且三伏天治疗疗效优于冬至后三九期间治疗。