培土生金中药联合穴位埋线在慢性阻塞性肺疾病稳定期的疗效及作用机制

目的] 探讨培土生金中药联合穴位埋线在慢性阻塞性肺疾病（COPD）稳定期的治疗作用。方法] 选取苏州高新区人民医院164例COPD稳定期患者为研究对象，采用随机数字表分A组（41例，常规西药治疗）、B组（41例，常规西药治疗+穴位埋线）、C组（41例，常规西药治疗+培土生金中药）、D组（41例，常规西药治疗+穴位埋线+培土生金中药），治疗时间均12周。对比4组治疗期间COPD急性加重发作次数、治疗后疗效、治疗前后肺功能指标及血清炎症因子水平。结果] 4组治疗期间COPD急性加重发作次数中3次+4次占比比较，D组P>0.05），其余2组间3次+4次占比差异均有统计学意义（P<0.05）；治疗前4组中医症状评分差异均无统计学意义（P>0.05），治疗后4组中医症状评分均降低（P<0.05），且治疗后D组P>0.05），其余2组间差异均有统计学意义（P<0.05），4组患者临床疗效分布差异显著（P<0.05），组间总有效率差异有统计学意义（P<0.05），且D组总有效率明显高于A组（P<0.01）；治疗前4组用力肺活量（FVC）、第1秒用力呼气量（FEV1）及第1秒用力呼气量占预计值比值（FEV1%）水平差异均无统计学意义（P>0.05），治疗后4组FVC、FEV1、FEV1%水平均提高（P<0.05），且治疗后D组>C组，B组>A组，除B组与C组FVC、FEV1、FEV1%水平相近（P>0.05），其余两组间FVC、FEV1、FEV1%水平差异均有统计学意义（P<0.05）；治疗前4组血清白介素-17（IL-17）、表面活性蛋白-D（SP-D）、C反应蛋白（CRP）水平差异均无统计学意义（P>0.05），治疗后4组血清IL-17、SP-D、CRP水平均下降（P<0.05），且治疗后D组P>0.05），其余2组间IL-17、SP-D、CRP水平差异均有统计学意义（P<0.05）。结论] 培土生金中药和穴位埋线均可减少COPD稳定期患者治疗期间COPD急性加重发作次数，改善症状，提升临床疗效，提高肺功能，调节血清炎症因子水平，当两者联合使用时治疗作用更佳。

Investigate the therapeutic effect of traditional Chinese medicine of Peitu Shengjin combined with acupoint catgut embedding in the stable stage of chronic obstructive pulmonary disease

Objective] To investigate the therapeutic effect of traditional Chinese medicine of Peitu Shengjin combined with acupoint catgut embedding in the stable stage of chronic obstructive pulmonary disease (COPD).Methods] The 164 patients with stable COPD in our hospital were selected and randomly divided into group A (41 cases,conventional western medicine treatment),group B (41 cases,conventional Western medicine treatment+acupoint catgut embedding),group C (41 cases,conventional Western medicine treatment+traditional Chinese medicine of Peitu Shengjin),and group D(41 cases,conventional Western medicine treatment+acupoint catgut embedding+traditional Chinese medicine of Peitu Shengjin),all lasted for 12 weeks. The frequency of acute exacerbation of COPD during treatment,curative effect,pulmonary function indexes and levels of serum inflammatory factors before and after treatment were compared among the four groups.Results] Compared with the proportion of 3 times+4 times in the frequencies of acute exacerbation of COPD during treatment among the four groups,group DP>0.05),the differences between each two groups were statistically significant (P<0.05). There was no significant difference in traditional Chinese medicine symptom scores among the four groups before treatment(P>0.05),After treatment,the traditional Chinese medicine symptom scores in four groups were decreased(P<0.05),which in group DP>0.05),the differences between each two groups were statistically significant (P<0.05). There were significant differences in the distribution of clinical efficacy among the four groups(P<0.05),and the total effective rates among the four groups were significantly different (P<0.05),and the total effective rate of group D was significantly higher than that of group A (P<0.01). There was no significant difference in the levels of forced vital capacity (FVC),forced expiratory volume in the first second(FEV1) and ratio of forced expiratory volume to predicted value in the first second(FEV1%) among the four groups before treatment(P>0.05),after treatment,the levels of FVC,FEV1 and FEV1% in the four groups were increased (P<0.05),and after treatment,which in group D>group C/group B>group A,except the levels of FVC,FEV1 and FEV1% in group B and group C were similar (P>0.05),the differences of FVC,FEV1 and FEV1% between each other two groups were statistically significant (P<0.05). There was no significant difference in levels of serum Interleukin-17 (IL-17),Surfactant protein-D (SP-D) and C-reactive protein (CRP) among the four groups before treatment,after treatment,the levels of serum IL-17,SP-D and CRP in four groups were decreased (P<0.05),and after treatment,which in group DP>0.05),and the differences of IL-17,SP-D and CRP between each other two groups were statistically significant(P<0.05).Conclusion] Both the traditional Chinese medicine of Peitu Shengjin and acupoint catgut embedding can reduce the frequency of acute exacerbations of COPD,meliorate symptoms,lift clinical efficacy,improve lung function,and regulate the levels of serum inflammatory factors in patients with stable COPD to the same extent,when they are used together,the therapeutic effect is better.