School of TCM, Weifang Medical University, Weifang 261000, Shandong Province, China.
School of Acupuncture-Moxibustion and Tuina, Shandong University of TCM.
Zhongguo Zhen Jiu. 2024 Mar 12;44(3):261-265. doi: 10.13703/j.0255-2930.20230509-0001.
To observe the clinical effect of the modified painless blistering moxibustion with wheat-grain sized moxa cone on cough variant asthma (CVA) differentiated as pathogenic wind attacking the lung and explore the influences on eosinophil count (EOS) in the peripheral blood and the content of interleukin-4 (IL-4) and tumor necrosis factor-α (TNF-α) in the serum of patients.
Ninety-two patients with CVA of pathogenic wind attacking the lung were randomly divided into an observation group and a control group, 46 cases in each group. In the observation group, the modified painless blistering moxibustion with wheat-grain sized moxa cone was applied to the unilateral Feishu (BL 13), Gaohuang (BL 43) and Zusanli (ST 36) in each session of treatment, once every 3 days. In the control group, budesonide and formoterol powder inhaler was delivered, 4.5 μg per inhalation, once every half an hour after breakfast and dinner; one more time of inhalation needed if the symptoms were not well controlled, but less than 6 times of inhalation per day. The duration of treatment was 8 weeks in both groups. Separately, before and after treatment, and during the 1-month follow-up after treatment completion, the score of the symptoms of traditional Chinese medicine (TCM) was observed in the two groups; using the lung function detector, the indexes of pulmonary function (forced expiratory volume in one second [FEV1], FEV1/forced vital capacity [FVC] and peak expiratory flow [PEF]) were determined, and the count of EOS in the peripheral blood and the content of IL-4 and TNF-α in the serum were determined before and after treatment; and the clinical effect was compared between the two groups.
After treatment and in follow-up, the TCM symptom scores were decreased compared with those before treatment in the two groups (<0.05), and the score in the observation group was lower than that of the control group in follow-up (<0.05). After treatment, FEV1, FEV1/FVC and PEF were increased when compared with those before treatment in the two groups (<0.05), and the count of EOS in the peripheral blood and the content of IL-4 and TNF-α in the serum were reduced (<0.05); there was no statistical difference in these indexes between the two groups (>0.05). After treatment, the total effective rate of the observation group was 95.7% (44/46), which was not different statistically in comparison with the control group (93.5% [43/46], >0.05). In the follow-up, the total effective rate of the observation group was 95.7% (44/46), which was higher than that of the control group (78.3% [36/46], <0.05).
The modified painless blistering moxibustion with wheat-grain sized moxa cone may ameliorate the symptoms of CVA of pathogenic wind attacking the lung and improve the pulmonary functions, which is probably related to the regulation of the count of EOS in the peripheral blood and the content of IL-4 and TNF-α in the serum, thereby, reducing the inflammatory response.
观察麦粒大艾炷无痛瘢痕灸治疗风邪犯肺型咳嗽变异性哮喘（CVA）的临床疗效，探讨其对患者外周血嗜酸性粒细胞（EOS）计数及血清白细胞介素-4（IL-4）、肿瘤坏死因子-α（TNF-α）含量的影响。
将 92 例风邪犯肺型 CVA 患者随机分为观察组和对照组，每组 46 例。观察组采用麦粒大艾炷无痛瘢痕灸，每次治疗单侧肺俞（BL13）、膏肓（BL43）、足三里（ST36）各 1 壮，每 3 天 1 次。对照组采用布地奈德福莫特罗粉吸入剂，每次 4.5μg，每日早餐及晚餐后半小时各 1 吸；症状控制不佳时可增加 1 吸，但每日不超过 6 吸。两组疗程均为 8 周。分别于治疗前后及治疗结束后 1 个月随访时观察两组中医证候评分；采用肺功能检测仪测定肺功能指标[第 1 秒用力呼气容积（FEV1）、FEV1/用力肺活量（FVC）、呼气峰流速（PEF）]，测定外周血 EOS 计数及血清 IL-4、TNF-α含量；比较两组临床疗效。
治疗后及随访时，两组中医证候评分均较治疗前降低（<0.05），且观察组随访时评分低于对照组（<0.05）。治疗后，两组 FEV1、FEV1/FVC、PEF 均较治疗前升高（<0.05），外周血 EOS 计数及血清 IL-4、TNF-α含量均降低（<0.05）；两组上述指标比较，差异均无统计学意义（>0.05）。治疗后，观察组总有效率为 95.7%（44/46），与对照组的 93.5%（43/46）比较，差异无统计学意义（>0.05）。随访时，观察组总有效率为 95.7%（44/46），高于对照组的 78.3%（36/46）（<0.05）。
麦粒大艾炷无痛瘢痕灸可改善风邪犯肺型 CVA 患者的症状，提高肺功能，其作用机制可能与调节外周血 EOS 计数及血清 IL-4、TNF-α含量，减轻炎症反应有关。
