世界中医药

目的：探究穴位贴敷联合常规西药治疗慢性阻塞性肺疾病（COPD）稳定期患者的疗效及对肺功能、生命质量、细胞因子的影响。方法：选取2016年12月至2018年8月南京脑科医院收治的COPD稳定期患者65例作为研究对象，按照就诊顺序编号随机分为对照组（n=32）和观察组（n=33）。对照组常规西药治疗，观察组在对照组基础上加用穴位贴敷，2组均同时治疗8周。观察2组治疗前、治疗后肺功能、生命质量、炎性反应递质、免疫功能变化并比较；治疗后进行疗效比较。结果：治疗后2组用力肺活量（FVC）、第一秒钟用力呼气容积（FEV1）、FEV1/FVCF较治疗前均显著升高，差异有统计学意义（P<0.05）；观察组以上指标均显著高于对照组，差异有统计学意义（P<0.05）。治疗后2组肿瘤坏死因子-α（TNF-α）、转化生长因子-β1（TGF-β1）、辅助性T细胞17（Th17）较治疗前显著下降，调节性T细胞（Treg）、白细胞介素-4（IL-4）、IL-10较治疗前均显著升高，差异有统计学意义（P<0.05），治疗后观察组Treg、IL-4、IL-10显著高于对照组，余显著低于对照组，差异有统计学意义（P<0.05）。治疗后2组呼吸症状、活动受限、疾病影响较治疗前显著下降，差异有统计学意义（P<0.05），治疗后观察组以上指标显著低于对照组，差异有统计学意义（P<0.05）。治疗后观察组临床控制率、治疗有效率显著高于对照组，差异有统计学意义（P<0.05）。5）治疗后2组IgE、CD4+、CD8+、CD4+/CD8+较治疗前均显著下降，差异有统计学意义（P<0.05），而IgA、IgM比较，差异无统计学意义（P>0.05），治疗后观察组IgE、CD4+、CD8+、CD4+/CD8+显著低于对照组，差异有统计学意义（P<0.05）。结论：穴位贴敷联合常规西药能改善COPD稳定期肺功能，抑制炎性反应，改善气道高反应性，从而提高疗效和生命质量。

English Summary:

To explore the effects of acupoint sticking therapy combined with conventional western medicine on stable phase of chronic obstructive pulmonary disease(COPD)and its influence on pulmonary function, quality of life and cytokines.Methods:A total of 65 patients with stable COPD in Nanjing Brain Hospital from December 2016 to August 2018 were enrolled.They were randomly divided into a control group(32 cases)and an observation group(33 cases).The control group was treated with routine western medicine, while the observation group was treated with acupoint sticking therapy on the basis of the control group for 8 weeks at the same time.The changes of pulmonary function, quality of life, inflammatory cytokines and immune function before and after treatment were observed and compared between the 2 groups.The curative effect after treatment was compared.Results:After treatment, the forced vital capacity(FVC), forced expiratory volume(FEV1)and FEV1/FVCF in both groups were significantly increased than those before treatment(P<0.05), and the above indexes in the observation group were significantly higher than those in the control group(P<0.05).2)Tumor necrosis factor-alpha(TNF-alpha), transforming growth factor(TGF-beta 1), helper T cell 17(Th17)were significantly decreased after treatment in both groups, while regulatory T cells(Treg), interleukin-4(IL-4), and IL-10 were significantly increased after treatment(P<0.05).Treg, IL-4 and IL-10 in the observation group were significantly higher than those in the control group after treatment, and the rest were significantly lower than those in the control group(P<0.05).3)After treatment, the respiratory symptoms, activity limitation and disease influence of the 2 groups decreased significantly before treatment(P<0.05).After treatment, the above indexes of the observation group were significantly lower than those of the control group(P<0.05).4)After treatment, the clinical control rate and total effective rate of the observation group were significantly higher than those of the control group, and the difference was statistically significant(P<0.05).After treatment, IgE, CD4+, CD8+, CD4+/CD8+ in the 2 groups decreased significantly compared with before treatment(P<0.05), but there was no significant difference in IgA and IgM(P>0.05).After treatment, IgE, CD4+, CD8+, CD4+/CD8+ in the observation group were significantly lower than those in the control group(P<0.05).Conclusion:Acupoint sticking therapy combined with routine western medicine can improve pulmonary function, inhibit inflammation and improve airway hyperresponsiveness in stable stage of COPD, so as to improve curative effect and quality of life.

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