中医三伏灸、穴位注射配合肺功能康复治疗稳定期慢性阻塞性肺疾病的随机对照研究

目的:分析总结在稳定期慢性阻塞性肺疾病(COPD)治疗中,中医三伏灸、穴位注射配合肺功能康复治疗的应用效果。方法:选取2015年6月至2017年6月罗定市中医院收治的稳定期慢性阻塞性肺患者120例作为研究对象,随机分为对照组和观察组,每组60例,其中对照组患者给予对症处理、家庭氧疗以及健康指导等常规治疗,观察组患者在上述治疗的基础上外加中医冬病夏治(用本院自制灸热贴按疗程规范进行三伏灸)、穴位注射药物(黄芪注射液)治疗,比较2组患者治疗前后的免疫功能、肺功能指标以及每年的发病次数和医疗花费情况,分析2组患者治疗后的症状改善以及临床疗效。结果:2组患者治疗前的T淋巴细胞亚群、免疫球蛋白以及肺功能指标变化不显著(P0.05),具有可比性;治疗后2组患者的CD4~+、CD3~+以及CD4~+/CD8~+比值均有不同程度的升高,CD8~+降低,但观察组患者T淋巴细胞亚群变化更为显著(P0.05);治疗后,观察组患者的血清Ig M、Ig G、Ig A显著高于对照组,而COPD发病次数和患者的医疗费用均明显低于对照组,差异有统计学意义(P0.05);2组患者治疗前后的FEV1、FEV1%以及FVC%差异不显著(P0.05)。对照组患者的治疗有效率为53.33%,观察组的治疗有效率为76.78%,观察组治疗效果显著优于对照组(P0.05)。结论:中医三伏灸、穴位注射配合肺功能康复治疗稳定期疗法可以显著增强患者机体免疫力,降低发病次数,减少医疗开支,减轻家庭经济负担,对肺功能指标改善较弱,但可以显著减轻咳、痰、喘、气促等临床症状,增强治疗有效率。     

冬病夏治穴位贴敷联合中医辨证治疗儿童咳嗽变异性哮喘的临床疗效

目的:分析冬病夏治穴位贴敷联合中医辨证治疗儿童咳嗽变异性哮喘(Cough Variant Asthma,CVA)的临床疗效。方法:选取2014年8月至2016年10月CVA患儿90例,按照随机数表法将所有的入选患儿分为观察和对照组,各45例,对照组给予中医辨证的常规治疗,观察组在中医辨证基础上给予冬病夏治穴位贴敷治疗,观察比较2组的治疗前后血清免疫球蛋白水平情况、临床症状改善情况、疗效和观察指标情况以及患儿家属对治疗的满意度。结果:2组患儿治疗前Lg A、Lg M、Lg G、Lg E指标,差异无统计学意义(P0.05),治疗后,观察组患儿的Lg A、Lg M、Lg G指标均高于对照组,Lg E指标低于对照组,差异有统计学意义(P0.05);治疗后,观察组出现阵发呛咳、痰黏难咳、手足心热、夜卧不安、大便秘结症状的例数均少于对照组,差异有统计学意义(P0.05);观察组总有效率(86.67%)高于对照组(68.89%),差异有统计学意义(P0.05);观察组每年复发次数、复发咳嗽症状持续时间、每年因此病住院人数和每年感冒次数均少于对照组,差异有统计学意义(P0.05);观察组患儿家属对治疗的满意度(91.11%)高于对照组(75.56%),差异有统计学意义(P0.05)。结论 :对CVA儿童进行冬病夏治穴位贴敷联合中医辨证治疗,安全可靠,治疗效果好,患儿家属满意度高。     

清营汤合青蒿鳖甲汤治疗疑难热病1则

文章报道1则以发热3个月、神志不清22 d为主诉病例,详细记录患者的发病时节及望、闻、问、切四诊资料,诊断该案患者辨病属暑温,辨证属暑犯气营证,前期治疗以清营透热转气法为主,方选清营汤加减,后期兼顾阴液,方选清营汤合青蒿鳖甲汤加减。治疗半个月余,患者再无发热,症状好转出院。兹以报道,以期为现代临床发热性疾病的治疗提供新的治疗思路。     

脾气论

脾气即脾藏之气,是构成和维持脾藏功能活动的最基本物质。脾禀长夏之气而生,长夏之气具有升腾、温暖、湿润的特点,因此脾气也具有上升、温煦、滋润的特点;长夏在五行属土,脾藏在五行亦属土。脾气之所以具有运化和统血的功能,根本原因就在于脾气禀承了长夏之气的各种属性,因此具有了滋润、温煦、生长、承载、变化、升腾等能力。脾气在生理活动中的作用机制以及病理过程中的变化机制均是基于上述属性的失常;同时正确认识脾气属性特点,对于临床脾气虚证诊断标准的确立也大有裨益。     

45例支气管哮喘的冬病夏治

４５例支气管哮喘解期患者在夏季应用大椎,天突穴位中药敷贴,足三里穴位注射卡介菌多糖核酸方案治疗３个月,冬天再作强化治疗,以探讨冬病夏治对支气管哮喘的防治作用。     

Association between Skin Reactions and Efficacy of Summer Acupoint Application Treatment on Chronic Pulmonary Disease: A Prospective Study

Objective: To examine the variations in the prevalence of skin reactions and the association between skin reactions and efficacy of summer acupoint application treatment(SAAT) on chronic pulmonary disease(CPD). Methods: A total of 2,038 patients with CPD were enrolled at 3 independent hospitals(defined as Groups A, B and C, respectively) in China. All patients were treated by SAAT, as applying a herbal paste onto the acupoints of Fengmen(BL 12) and Feishu(BL 13) on the dog days of summer, according to the lunar calendar, in 2008. Ten days after treatment, skin reaction data(no reaction, itching, stinging, blistering, and infection) were obtained via face-to-face interviews. Patients were retreated in the same hospital one year later, thereby allowing doctors to assess treatment efficacy based on the patients’ symptoms, the severity of the spirometric abnormalities, and the concomitant medications used. Results: A large number of patients(85.3%) displayed reactive symptoms; however, the marked associations between reactive symptoms and age or gender were not observed. An increased number of patients from Group B(99.3%) and Group C(76.5%) displayed reactive symptoms due to the increased mass of crude Semen Sinapis Albae. The effective rate of SAAT was as high as 90.4% for patients of Group B, which was followed by Group A(70.9%) and Group C(42.2%). Using stratified analyses, a convincing association between reactive symptoms and therapeutic efficacy was observed for patients with asthma [itching: odds ratio(OR)=2.17, 95% confidence interval(CI): 1.49 to 3.14; blistering: OR=0.43, 95% CI: 0.25 to 0.73; and no reaction: OR=0.56, 95% CI: 0.35 to 0.90]. However, the same tendency was not observed for patients with chronic bronchitis and chronic obstructive pulmonary disease. Conclusions: SAAT can induce very mild skin reactions for patients with CPD, among which patients with asthma displayed a strong association between skin reactions and therapeutic efficacy. The skin reactions may be induced by the crude Semen Sinapis Albae.     

冬病夏治止咳贴贴敷治疗小儿咳嗽变异性哮喘40例

目的 观察冬病夏治止咳贴贴敷治疗小儿咳嗽变异性哮喘的临床疗效.方法 80例患儿随机分成两组.治疗组40例在常规治疗的基础上配合中药穴位贴敷,对照组40例给予常规药物治疗.结 果治疗组40例,治愈12例,显效15例,好转9例,总有效率为90. 0％;对照组40例,治愈7例,显效11例,好转13例,总有效率为77.5％.患儿总有效率比较,治疗组优于对照组,P＜0.05,有显著差异.结论 止咳贴贴敷治疗小儿咳嗽变异性哮喘有显著疗效,可以改善临床症状,控制病情发展.     

穴位贴敷治疗命门火衰型糖尿病肾病20例

采用冬病夏治的方法给10个因患命门火衰型糖尿病肾病而致重度水肿的患者进行穴位贴敷。结果表明经贴穴后水肿程度明显减轻。