雷火灸联合药物对肌萎缩侧索硬化患者呼吸功能的影响

目的在口服利鲁唑片基础上,观察雷火灸对肌萎缩侧索硬化(ALS)患者呼吸功能的影响。方法将60例患者随机分为对照组和观察组,每组30例。对照组予口服利鲁唑片,观察组在对照组治疗基础上加用雷火灸。治疗前后,评定ALS功能评定量表修订版(ALSFRS-R)、ALS评估问卷(ALSAQ-40),测定用力肺活量(FVC)、第1秒用力呼气量(FEV1)的肺通气功能指标及最大吸气压(MIP)、最大呼气压(MEP)的呼吸肌力指标,测定血清脂联素(APN)、补体因子D(CFD)水平。结果治疗后,对照组ALSFRS-R、ALSAQ-40与治疗前比较差异无统计学意义(P>0.05),观察组ALSFRS-R、ALSAQ-40较治疗前均明显升高(P<0.05),且均明显高于对照组(P<0.05);对照组FVC占预计值百分比、FEV1占预计值百分比均较治疗前明显降低(P<0.05),观察组FVC占预计值百分比、FEV1占预计值百分比与治疗前比较差异无统计学意义(P>0.05),且高于对照组(P<0.05);对照组MIP占预计值百分比、MEP占预计值百分比均较治疗前降低(P<0.05),观察组MIP占预计值百分比、MEP占预计值百分比与治疗前比较差异均无统计学意义(P>0.05),且高于对照组(P<0.05);观察组血清APN水平明显升高(P<0.05),血清CFD水平降低(P<0.05),且与对照组比较差异均有统计学意义(P<0.05)。结论在口服利鲁唑片基础上加用雷火灸可改善ALS患者的神经功能及生活质量,延缓肺通气功能及呼吸肌力的减退,这可能与其调节患者血清APN、CFD水平相关。

Effect of Thunder-fire Moxibustion and Medicine on Respiratory Function in Patients with Amyotrophic Lateral Sclerosis

Objective To observe the effect of thunder-fire moxibustion on respiratory function in patients with amyotrophic lateral sclerosis(ALS)based on oral administration of Riluzole tablet.Method Sixty patients were randomized into a control group and an observation group,with 30 cases in each group.The control group was given oral Riluzole tablets,while the observation group was given additional thunder-fire moxibustion.Before and after treatment,the ALS Functional Rating Scale-Revised(ALSFRS-R)and ALS Assessment Questionnaire(ALSAQ)-40 were estimated,pulmonary ventilation function indicators such as forced vital capacity(FVC)and forced expiratory volume in 1 second(FEV1),and respiratory muscle strength parameters like maximal inspiratory pressure(MIP)and maximal expiratory pressure(MEP)were measured,and the levels of serum adiponectin(APN)and complement factor D(CFD)were detected.Result After treatment,the ALSFRS-R and ALSAQ-40 scores did not show significant changes in the control group(P>0.05),while the ALSFRS-R and ALSAQ-40 scores increased significantly in the observation group(P<0.05)and were higher than those in the control group(P<0.05).The FVC percentage of the predicted value and the FEV1 percentage of the predicted value dropped significantly after treatment in the control group(P<0.05),while there were no significant changes in the FVC percentage of the predicted value and the FEV1 percentage of the predicted value in the observation group after treatment(P>0.05),and they were higher than those in the control group(P<0.05).The MIP percentage of the predicted value and the MEP percentage of the predicted value declined after treatment in the control group(P<0.05),while there were no significant changes in the MIP percentage of the predicted value and the MEP percentage of the predicted value in the observation group after treatment(P>0.05),and they were higher than those in the control group(P<0.05).The level of serum APN increased significantly(P<0.05)and the serum CFD level decreased(P<0.05)after treatment in the observation group,which were significantly difference from those in the control group(P<0.05).Conclusion Based on oral administration of Riluzole tablet,thunder-fire moxibustion can improve the neural function and quality of life,and slow down the diminution of pulmonary ventilation function and respiratory muscle strength in ALS patients,which may be associated with the regulation of serum APN and CFD levels.