择时穴位贴敷在慢性阻塞性肺疾病急性期患者喘咳症中的疗效

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摘要目的探讨择时穴位贴敷在慢性阻塞性肺疾病（COPD）急性期患者喘咳症中的临床疗效。方法运用前瞻性观察性研究方法，选取广东省中医院2019年3月—2020年6月收治的COPD急性期患者90例按照随机数字表法将其分为三组，每组各30例。对照组给予常规治疗1周，非择时穴位贴敷组在常规治疗的基础上给予穴位贴敷治疗1周，择时穴位贴敷组在常规治疗的基础上给予择时穴位贴敷治疗1周，于肺经最弱的申时与肾经气最旺的酉时配合进行穴位贴敷治疗。比较三组治疗后临床疗效、改良英国医学研究理事会呼吸困难指数（mMRC）分级情况及治疗前后肺功能指标水平、临床症状积分。结果治疗后，择时穴位贴敷组总有效率明显高于非择时穴位贴敷组、对照组，非择时穴位贴敷组总有效率明显高于对照组（P < 0.05）。治疗后，三组第1秒用力呼气容积（FEV1）、用力肺活量（FVC）均高于治疗前，择时穴位贴敷组FEV1、FVC均高于非择时穴位贴敷组、对照组，非择时穴位贴敷组FEV1、FVC均高于对照组（P < 0.05）。治疗后，三组气短、咳痰、咳嗽、喘息积分均低于治疗前，择时穴位贴敷组气短、咳痰、咳嗽、喘息积分均低于非择时穴位贴敷组、对照组，非择时穴位贴敷组气短、咳痰、咳嗽、喘息积分均低于对照组（P < 0.05）。三组治疗后mMRC分级情况比较差异有统计学意义（P < 0.05），择时穴位贴敷组治疗后mMRC分级优于对照组（P < 0.05）。结论择时穴位贴敷在COPD急性期患者喘咳症中临床疗效显著，可改善患者气短、咳痰、咳嗽等症状，提高肺功能，值得临床推广应用。

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	何文芳熊淑云李观蓝周逊程丹微

关键词 ：择时穴位贴敷, 慢性阻塞性肺疾病, 急性期, 喘咳症

Abstract：Objective To investigate the clinical effect of selective acupoint application on dyspnea and cough in patients with acute stage of chronic obstructive pulmonary disease (COPD). Methods By using prospective observational research method, 90 COPD patients admitted to Guangdong Provincial Hospital of Traditional Chinese Medicine from March 2019 to June 2020 were selected and divided into three groups according to random number table method, with 30 cases in each group. Control group was treated with routine therapy for one week. Non selective acupoint application group was treated with acupoint application for one week on the basis of routine therapy, selective acupoint application group was treated with selective acupoint application for one week on the basis of routine therapy, and acupoint application was treated with the combination of the weakest lung meridian and the most vigorous kidney meridian. Clinical efficacy, modified Medical Research Council dyspnea index (mMRC) grading after treatment and pulmonary function indicators’ level and clinical symptom score before and after treatment among three groups were compared. Results After treatment, total effective rate of selective acupoint application group was significantly higher than that of non selective acupoint application group and control group, and total effective rate of non selective acupoint application group was significantly higher than that of control group (P < 0.05). After treatment, forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) of three groups were higher than those before treatment, FEV1 and FVC of selective acupoint application group were higher than those of non selective acupoint application group and control group, and FEV1 and FVC of non selective acupoint application group were higher than those of control group (P < 0.05). After treatment, the scores of shortness of breath, expectoration, cough and gasping in three groups were lower than those before treatment, the scores of shortness of breath, expectoration, cough and gasping in selective acupoint application group were lower than those in non selective acupoint application group and control group, while those in non selective acupoint application group were lower than those in control group (P < 0.05). The difference of mMRC grading among three groups after treatment was statistically significant (P < 0.05); the mMRC grading of selective acupoint application group after treatment was better than that of control group (P < 0.05). Conclusion Selective acupoint application is effective in treating dyspnea and cough in patients with acute stage of COPD, it can improve the symptoms of shortness of breath, expectoration, cough, gasping, and the pulmonary function, it is worthy of clinical application.

Key words： Selective acupoint application Chronic obstructive pulmonary disease Acute phase Dyspnea and cough

基金资助:广东省中医药局科研项目（20181136）；
广东省中医院中医药科学技术研究专项课题（YN2018HL07）。

引用本文:

何文芳熊淑云李观蓝周逊程丹微. 择时穴位贴敷在慢性阻塞性肺疾病急性期患者喘咳症中的疗效[J]. 中国医药导报, 2021, 18(1): 140-144.
HE Wenfang XIONG Shuyun LI Guanlan ZHOU Xun CHENG Danwei. Effect of selective acupoint application on dyspnea and cough in patients with acute stage of chronic obstructive pulmonary disease. 中国医药导报, 2021, 18(1): 140-144.

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