天灸疗法治疗支气管哮喘的时效关系研究

目的:对三伏天灸与日常天灸、“庚”日天灸与“辛”日天灸的疗效进行观察对比。方法:将162例支气管哮喘患者分为三伏组和日常组,以甘遂、白芥子、麻黄、细辛等药物各等分,上加0.3g麝香制成的1cm×1cm大小药膏在肺俞、定喘等穴位进行贴敷治疗。日常组每隔10d贴药1次,3次为1疗程;三伏组分别于初伏、中伏、末伏贴药治疗。1个疗程后观察疗效、血清IgE含量、淋巴细胞转换率、嗜酸性粒细胞计数的变化并对比。另将80例支气管哮喘患者分为“庚”日和“辛”日贴药组治疗并比较其疗效。结果:①三伏组与日常组治疗后的疗效及血清IgE含量、淋巴细胞转换率、嗜酸性粒细胞计数比较无显著性统计学差异(P>0.05)。②“庚”日天灸组与“辛”日天灸组疗效无显著性统计学差异(P>0.05)。结论:天灸疗法主要通过经穴及药物双重作用起效,适宜全年开展此项治疗。

A Study on the Time-effect Relationship in the Treatment of Bronchial Asthma with Medicinal Vesiculation Therapy

OBJECTIVE: To compare the therapeutic effects of medicinal vesiculation performed in the dog-days and ordinary-days, as well as "Xin"-days and "Geng"-days in the treatment of bronchial asthma. METHODS: A total of 162 bronchial asthma patients were divided into ordinary-days group (n = 80) and dog-days group (n = 82) according to the time sequence. Plasters made up of Gansui (Radix Euphorbiae Kansui), Baijiezi (Semen Sinapis Albae), Mahuang (Herba Ephedrae), Xixin (Herba Asari), etc. were applied to Feishu (BL 13), Fengmen (BL 12), Dingchuan (EX-B 1), Pishu (BL 20) Shenshu (BL 23), etc. during ordinary days (spring, summer, autumn and winter), dog days (the 1st-, 2nd- and 3rd-10 day periods of the hot season) for each group, once every 10 days and with 3 times being a therapeutic course. After a course of treatment, the curative effect was assessed. Before and 5 days after the treatment, venous blood samples were collected for detecting serum immunoglobulin E (IgE), lymphocyte transformation rate (LTR) and the number of eosinophile granulocytes (Eos) separately. In addition, other 80 asthma patients were treated during "Geng"-days ( (n = 42) and "Xin"-days (n = 38) separately with the same methods mentioned above. RESULTS: After one course of treatment, or the 82 and 80 cases in dog-days group and ordinary-days groups, 35 (43%) and 31(39%) experienced marked improvement in clinical symptoms, 41 (50%) and 37 (46%) had an improvement, 6 (7%) and 12 (15%) failed, with the effective rates being 93% and 85% respectively. After the treatment, serum IgE and Eos count of the two groups decreased significantly (P < 0.01, 0.05), and LTR of the two groups increased evidently (P < 0.01). No significant differences were found between two groups in the therapeutic effect and the 3 biochemical indexes. In other 80 asthma patients, of the 42 and 38 cases in "Geng"-days group and "Xin"-days group, 23 (54.76%) and 17 (44.74%) experienced marked improvement in their symptoms, 17 (40.47%) and 19 (50.00%) had an improvement, 2 (4.76%) and 2 (5.26%) failed, with the effective rates being 95.23% and 94.74% separately. No significant difference was found between two groups in the therapeutic effect (P > 0.05). CONCLUSION: Medicinal vesiculation therapy can effectively improve asthma patients' clinical symptoms, lower serum IgE and Eos count and raise LTR whenever performed in the ordinary days, dog days, "Xin" days or "Geng" days. Thus, this therapy is applicable all year round.