自血穴位注射疗法联合马来酸茚达特罗治疗老年稳定期慢性阻塞性肺疾病的临床分析
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摘要
目的探讨自血穴位注射疗法联合马来酸茚达特罗治疗老年稳定期慢性阻塞性肺疾病(COPD)的临床疗效及其对患者炎性因子、免疫功能及肺功能的影响。方法将2015年5月至2016年5月我院收治的86例老年缓解期COPD患者分为观察组与对照组。对照组给予马来酸茚达特罗治疗,观察组在对照组治疗基础上另给予自血穴位注射疗法。治疗12周后,评价2组临床疗效。治疗前及治疗12周后,分别检测2组患者肺功能指标(FEV_1、FVC与PEF),炎性因子(IL-8、α1-AT、IL-6及TNF-α),免疫功能指标(Ig G、Ig A、CD3~+及CD4~+)水平。治疗期间,对2组患者的不良反应进行密切观察。结果治疗后二组患者各项检测指标均优于治疗前。治疗12周后,观察组总有效率为90.7%,明显高于对照组的72.1%(P<0.05)。治疗12周后,观察组FEV_1、FVC与PEF等肺功能指标,Ig G、Ig A、CD3~+及CD4~+等免疫功能指标水平均明显高于对照组(P<0.05),而IL-8、α1-AT、IL-6及TNF-α含量分别为(23.23±3.87)ng/L、(3.43±0.41) g/L、(52.25±5.38) ng/L及(43.12±3.98) ng/L,改善程度均明显优于对照组(P<0.05)。治疗期间,2组患者均未出现严重不良反应。结论自血穴位注射疗法联合马来酸茚达特罗治疗老年稳定期COPD疗效确切,可有效改善患者炎症水平,值得进行深入研究。
Objective To explore the clinical efficacy of autoblood acupoint-injection therapy combined with indacaterol maleate on the elderly patients with chronic obstructive pulmonary disease (COPD)in the stable phase and its influence on the levels of inflammation index,immune function index and lung function index. Methods A total of 86 elderly COPD patients in the stable phase treated in our hospital from May 2015 to May 2016 were divided into an observation group and a control group. The control group was given indacaterol maleate,while the treatment group was treated with indacaterol maleate and autoblood acupointinjection therapy. Before treatment and 12 weeks after treatment,the levels of lung function index (FEV_1,FVC and PEF),inflammation index (IL-8,α1-AT,IL-6 and TNF-α),and immune function index (Ig G,Ig A,CD3~+and CD4~+) were detected and compared between the two groups. The adverse reactions in the two groups were also observed. Results At 12 weeks after treatment,the total effective rate was 90.7% in the treatment group,which was significantly higher than that of the control group (70. 2%,P < 0. 05). And 12 weeks after treatment,the levels of lung function index (including FEV_1,FVC and PEF) and immune function index (containing Ig G,Ig A,CD3~+and CD4~+) in the treatment group were significantly higher than those of the control group (P<0.05),while the levels of IL-8,α1-AT,IL-6 and TNF-α were (23.23±3.87) ng/L, (3.43±0.41) g/L, (52.25± 5.38) ng/L and (43.12 ± 3. 98) ng/L,respectively,which were significantly lower than those of the control group (P< 0.05). There were no serious adverse reactions in the two groups. Conclusion The curative effect of autoblood acupoint-injection therapy combined with indacaterol maleate on the elderly COPD patients in the stable phase is affirmative,which can ameliorate the inflammation status of the patients.
Objective To explore the clinical efficacy of autoblood acupoint-injection therapy combined with indacaterol maleate on the elderly patients with chronic obstructive pulmonary disease (COPD)in the stable phase and its influence on the levels of inflammation index,immune function index and lung function index. Methods A total of 86 elderly COPD patients in the stable phase treated in our hospital from May 2015 to May 2016 were divided into an observation group and a control group. The control group was given indacaterol maleate,while the treatment group was treated with indacaterol maleate and autoblood acupointinjection therapy. Before treatment and 12 weeks after treatment,the levels of lung function index (FEV_1,FVC and PEF),inflammation index (IL-8,α1-AT,IL-6 and TNF-α),and immune function index (Ig G,Ig A,CD3~+and CD4~+) were detected and compared between the two groups. The adverse reactions in the two groups were also observed. Results At 12 weeks after treatment,the total effective rate was 90.7% in the treatment group,which was significantly higher than that of the control group (70. 2%,P < 0. 05). And 12 weeks after treatment,the levels of lung function index (including FEV_1,FVC and PEF) and immune function index (containing Ig G,Ig A,CD3~+and CD4~+) in the treatment group were significantly higher than those of the control group (P<0.05),while the levels of IL-8,α1-AT,IL-6 and TNF-α were (23.23±3.87) ng/L, (3.43±0.41) g/L, (52.25± 5.38) ng/L and (43.12 ± 3. 98) ng/L,respectively,which were significantly lower than those of the control group (P< 0.05). There were no serious adverse reactions in the two groups. Conclusion The curative effect of autoblood acupoint-injection therapy combined with indacaterol maleate on the elderly COPD patients in the stable phase is affirmative,which can ameliorate the inflammation status of the patients.
引文
1任成山,钱桂生.慢性阻塞性肺疾病发病机制研究现状与展望[J/CD].中华肺部疾病杂志(电子版),2009,2(2):104-115.
2 Gologanu D,Stanescu C,Ursica T,et al.Prevalence and characteristics of pulmonary hypertension associated with COPD-a pilotstudy in Patients referred to a pulmonary rehabilitation program clinic[J].Maedica,2013,8(3):243-248.
3 Cazzola M,Rogliani P,Ora J,et al.Olodaterol and tiotropium bromide for the treatment of chronic obstructive pulmonary disease[J].Expert Rev Clin Pharmacol,2015,8(5):529-539.
4 Rycroft CE,Heyes A,Lanza L,et al.Epidemiology of chronic obstructive pulmonary disease:a literature review[J].Int J Chron Obstruct Pulmon Dis,2012,7:457-494.
5 Elbehairy AF,Ciavaglia CE,Webb KA,et al.Pulmonary gas exchange abnormalities in mild chronic obstructive pulmonary disease.Implications for dyspnea and exercise intolerance[J].Am JRespir Crit Care Med,2015,191(12):1384-1394.
6周胜利,李京,童佳兵.中药穴位贴敷治疗慢性阻塞性肺疾病稳定期肺肾气虚证[J].吉林中医药,2016,36(12):1282-1284.
7刘玮,孙增涛,魏葆琳,等.补虚活血法治疗慢性阻塞性肺疾病稳定期临床试验的系统评价[J].辽宁中医杂志,2013,40(9):1794-1797.
8中华医学会呼吸病学分会,慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2007年修订版)[J].中华结核和呼吸杂志,2007,30(1):8-17.
9李敏芳,叶小丹,熊广,等.自血穴位注射疗法治疗慢性阻塞性肺疾病稳定期的临床研究[J].中国老年保健医学,2014,12(6):41-42.
10中华人民共和国卫生部.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:72.
11周奎龙,史锁芳.清肺化痰法在慢性阻塞性肺疾病急性加重期的运用[J].中国中医基础医学杂志,2014,20(2):206-208.
12郭建辉,梁栋.喘炎宁合剂对慢性阻塞性肺疾病急性加重期痰热蕴肺证患者的影响[J].中医学报,2015,30(2):174-176.
13郭辉,李瑞萍,张思泉,等.补肺活血化痰法联合正压通气治疗慢性阻塞性肺部疾病并发呼吸衰竭的疗效观察[J].中华中医药学刊,2016,34(9):2211-2213.
14伍朝霞,陈代平,张慧芳,等.冬病夏治穴位贴敷治疗慢性阻塞性肺疾病[J].吉林中医药,2015,35(10):1016-1018.
15林良友,刘丰,蔡敬宙,等.灯盏花素联合自血穴位注射疗法治疗慢性阻塞性肺疾病急性加重期[J].广州医药,2015,46(4):47-50.
16潘光凡.自血穴位注射疗法联合布地奈德/福莫特罗粉剂吸入治疗COPD稳定期的临床疗效观察[J].中国现代药物应用,2016,10(3):275-277.
17谢展鸿,高怡,关伟杰.茚达特罗治疗极重度慢性阻塞性肺疾病患者的疗效及安全性观察[J].实用医学杂志,2014,30(11):1804-1805.
18张仕国,王荣丽,蔡懿.茚达特罗治疗慢性阻塞性肺疾病稳定期30例临床评价[J].中国药业,2015,24(16):35-37.
19时旭,郑劲平.茚达特罗的药理学及药代动力学特点[J].中华结核和呼吸杂志,2013,36(4):310-312.
20郭淑权.治疗慢性阻塞性肺疾病新药-茚达特罗[J].医药导报,2013,32(11):1470-1473.
21钱文君,王佩芳,徐慧,等.慢性阻塞性肺疾病病人外周血T淋巴细胞的检测及意义[J].中国老年学杂志,2014,34(16):4501-4502.
22王震,梅晓冬.α1-抗胰蛋白酶与慢性阻塞性肺疾病的研究进展[J].安徽医药,2011,15(1):113.
23纪颖,王心杰.血清IL-8、TNF-α在COPD不同时期的变化及意义[J].中国实用医药,2011,6(34):37.
24吴焕淦,严洁,余曙光,等.灸法的若干思考[J].上海针灸杂志,2008,27(11):35-36.
25陈日新.针灸作用的影响因素[J].江西中医学院学报,2008,20(1):49.
2 Gologanu D,Stanescu C,Ursica T,et al.Prevalence and characteristics of pulmonary hypertension associated with COPD-a pilotstudy in Patients referred to a pulmonary rehabilitation program clinic[J].Maedica,2013,8(3):243-248.
3 Cazzola M,Rogliani P,Ora J,et al.Olodaterol and tiotropium bromide for the treatment of chronic obstructive pulmonary disease[J].Expert Rev Clin Pharmacol,2015,8(5):529-539.
4 Rycroft CE,Heyes A,Lanza L,et al.Epidemiology of chronic obstructive pulmonary disease:a literature review[J].Int J Chron Obstruct Pulmon Dis,2012,7:457-494.
5 Elbehairy AF,Ciavaglia CE,Webb KA,et al.Pulmonary gas exchange abnormalities in mild chronic obstructive pulmonary disease.Implications for dyspnea and exercise intolerance[J].Am JRespir Crit Care Med,2015,191(12):1384-1394.
6周胜利,李京,童佳兵.中药穴位贴敷治疗慢性阻塞性肺疾病稳定期肺肾气虚证[J].吉林中医药,2016,36(12):1282-1284.
7刘玮,孙增涛,魏葆琳,等.补虚活血法治疗慢性阻塞性肺疾病稳定期临床试验的系统评价[J].辽宁中医杂志,2013,40(9):1794-1797.
8中华医学会呼吸病学分会,慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2007年修订版)[J].中华结核和呼吸杂志,2007,30(1):8-17.
9李敏芳,叶小丹,熊广,等.自血穴位注射疗法治疗慢性阻塞性肺疾病稳定期的临床研究[J].中国老年保健医学,2014,12(6):41-42.
10中华人民共和国卫生部.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:72.
11周奎龙,史锁芳.清肺化痰法在慢性阻塞性肺疾病急性加重期的运用[J].中国中医基础医学杂志,2014,20(2):206-208.
12郭建辉,梁栋.喘炎宁合剂对慢性阻塞性肺疾病急性加重期痰热蕴肺证患者的影响[J].中医学报,2015,30(2):174-176.
13郭辉,李瑞萍,张思泉,等.补肺活血化痰法联合正压通气治疗慢性阻塞性肺部疾病并发呼吸衰竭的疗效观察[J].中华中医药学刊,2016,34(9):2211-2213.
14伍朝霞,陈代平,张慧芳,等.冬病夏治穴位贴敷治疗慢性阻塞性肺疾病[J].吉林中医药,2015,35(10):1016-1018.
15林良友,刘丰,蔡敬宙,等.灯盏花素联合自血穴位注射疗法治疗慢性阻塞性肺疾病急性加重期[J].广州医药,2015,46(4):47-50.
16潘光凡.自血穴位注射疗法联合布地奈德/福莫特罗粉剂吸入治疗COPD稳定期的临床疗效观察[J].中国现代药物应用,2016,10(3):275-277.
17谢展鸿,高怡,关伟杰.茚达特罗治疗极重度慢性阻塞性肺疾病患者的疗效及安全性观察[J].实用医学杂志,2014,30(11):1804-1805.
18张仕国,王荣丽,蔡懿.茚达特罗治疗慢性阻塞性肺疾病稳定期30例临床评价[J].中国药业,2015,24(16):35-37.
19时旭,郑劲平.茚达特罗的药理学及药代动力学特点[J].中华结核和呼吸杂志,2013,36(4):310-312.
20郭淑权.治疗慢性阻塞性肺疾病新药-茚达特罗[J].医药导报,2013,32(11):1470-1473.
21钱文君,王佩芳,徐慧,等.慢性阻塞性肺疾病病人外周血T淋巴细胞的检测及意义[J].中国老年学杂志,2014,34(16):4501-4502.
22王震,梅晓冬.α1-抗胰蛋白酶与慢性阻塞性肺疾病的研究进展[J].安徽医药,2011,15(1):113.
23纪颖,王心杰.血清IL-8、TNF-α在COPD不同时期的变化及意义[J].中国实用医药,2011,6(34):37.
24吴焕淦,严洁,余曙光,等.灸法的若干思考[J].上海针灸杂志,2008,27(11):35-36.
25陈日新.针灸作用的影响因素[J].江西中医学院学报,2008,20(1):49.