冬病夏治穴位疗法对稳定期脾肾阳虚型COPD患者呼吸力学的影响

目的：观察基于＂温阳抗寒法＂和＂穴位疗法＂的冬病夏治穴位疗法对稳定期脾肾阳虚型COPD患者呼吸力学的影响,探讨其可能作用机制及在稳定期COPD防治中的应用价值。方法：将纳入的72例,按随机数字表法随机分成两组。对照组36例,予西医常规治疗。治疗组36例,予西医常规治疗＋冬病夏治（＂温阳抗寒敷贴方＂穴位敷贴＋＂喘可治＂穴位注射）,2次/周,12次为1疗程。观察比较两组治疗前、治疗结束时、治疗结束后6个月常规肺功能（FEV1/pre、FEV1/FVC、FVC/pre、IC）、IOS气道阻力（Fres、Z5/pre、R5/pre、R20/pre、R5-20/pre、X5）。结果：（1）常规肺功能治疗结束时,两组与本组治疗前比较均无显著差异（P〉0.05）。治疗结束后6个月,治疗组与治疗前比较FEV1/pre、FEV1/FVC均有显著上升（P〈0.01）;对照组与治疗前比较FEV1/pre、FEV1/FVC均有显著下降（P〈0.01或P〈0.05）;两组间比较均无显著差异（P〉0.05）。（2）IOS气道阻力治疗结束时,治疗组与治疗前比较各项均无显著差异（P〉0.05）;两组间比较均无显著差异（P〉0.05）。治疗结束后6个月,治疗组与治疗前比较Fres有显著下降（P〈0.05）;对照组与治疗前比较各项均无显著差异（P〉0.05）,两组间比较均无显著差异（P〉0.05）。结论：基于＂温阳抗寒法＂和＂穴位疗法＂的＂冬病夏治＂特色治疗具有改善COPD患者气道通气功能效应,可能延缓或阻止COPD患者气道通气功能进行性下降和气道阻力增加,可能通过神经、内分泌、免疫网络发挥综合效应。

Effect of Winter Disease Cured in Summer by Acupuncturetherapy in Respiratory Mechanics of Chronic Obstructive Pulmonary Disease of Spleen and Kidney Yang Deficiency

Objective：To observe effect of Winter Disease Cured in Summer Which based on ＂Method of Nourishing Yang to Dispel Cold＂ and Acupuncturetherapy in Respiratory Mechanics of Chronic Obstructive Pulmonary Disease of Spleen and Kidney Yang Deficiency,and explore the possible mechanism and value in Chronic Obstructive Pulmonary Disease.Methods：Seventy-two cases were randomized into two groups：the control group in which 36 cases were treated with Western medicine.And the treatment group in which 36 cases were treated with ＂Winter Disease Cured in Summer（Acupoint Application by ＂Nourishing Yang to Dispel Cold＋ acupoint injection by Chuankezhi）＂ On the basis of Western medicine. With a course of 12 to 18 times and 2 times / week. Observe and compare the two groups before/after treatment and at the end of 6 months after treatment withpulmonary function （FEV1/pre,FEV1/FVC,FVC / pre,IC） and IOS Index （Fres,Z5/pre,R5/pre,R20/pre,R5-20/pre,X5）.Results：（1）Pulmonary function After treatment,compared with before treatment of the treatment group were also as the control group there was no significant difference（P0.05）. After treatment for 6 months,the treatment group were increased （P 0.01） on FEV1/pre,FEV1/FVC vs the control group t here was reduced（（P 0.05,P 0.01））on FEV1/pre、FEV1/FVC. But there was no significant difference（P0.05）between two groups with FEV1/pre,FEV1/FVC,FVC / pre,IC.（2）IOS Index After treatment,compared with before treatment of the control group there was no significant change（P0.05）on Z5/pre、R5/pre、R20/pre、R5-20/pre. There was no significant difference（P0.05）between two groups.After treatment for 6 months,the treatment group were reduced （P 0.01） on Fres vs the control group there was no significant difference（P0.05）,there was no significant difference（P0.05）between two groups.Conclusions：Winter Disease Cured in Summer Which based on ＂Method of Nourishing Yang to Dispel Cold＂ and Acupuncturetherapy features full distinct characteristics of Traditional Chinese Medicine（TCM）,can improve Pulmonary Function in patients with airway effects,may delay or prevent the function of COPD airway gradual obstruction and increasing of Airway resistance,possibly through neural,endocrine,immune network combined effect to play.