火龙罐综合灸疗法对慢阻肺咳喘患者的影响

doi:10.3760/cma.j.cn441417-20240704-01026

摘要/Abstract

摘要：

目的　探讨火龙罐综合灸疗法对慢阻肺咳喘患者的影响。方法　本研究为随机对照试验。采用便利抽样法，选取2022年10月至2023年10月广州中医药大学深圳医院（福田）收治的86例慢阻肺咳喘患者作为研究对象。采用随机数字表法，将患者分为对照组（43例）与治疗组（43例）。治疗组因疾病加重入住重症加强护理病房无法继续研究脱落3例，对照组因患者离开深圳无法继续研究脱落2例，未能遵循医嘱自行退出1例，治疗组、对照组各40例完成本研究。对照组男28例，女12例；年龄43～79（60.12±5.23）岁；病程2～13（10.09±2.23）年。治疗组男30例，女10例；年龄41～78（60.56±5.18）岁。病程2～14（10.12±2.13）年。对照组采用常规治疗护理和康复训练，治疗组在对照组基础上采用火龙罐综合灸疗法。两组均连续治疗30 d。比较两组咳喘缓解情况，治疗前后肺功能指标［最大肺活量（FVC）、第1秒用力呼气容积（FEV₁）、FEV₁/FVC］、晨间症状［慢阻肺晨间症状量表（COPD-MSD）］、呼吸功能［圣乔治呼吸问卷（SGRQ）、改良呼吸困难指数（mMRC）］、中医证候评分、血气指标［氧分压（PaO₂）、二氧化碳分压（PaCO₂）］。采用独立样本t检验、配对t检验和χ²检验进行统计学分析。结果　治疗组咳喘总缓解率高于对照组［95.00%（38/40）比80.00%（32/40）］（P<0.05）。治疗后，治疗组FVC、FEV₁和FEV₁/FVC均高于对照组［（2.51±0.38）L比（2.17±0.35）L、（1.38±0.43）L比（1.13±0.37）L、（65.47±5.34）%比（62.11±5.17）%］（均P<0.05）；治疗组COPD-MSD、SGRQ和mMRC评分均低于对照组［（51.78±3.21）分比（63.22±3.23）分、（48.19±6.23）分比（55.23±6.21）分、（1.48±0.51）分比（2.48±0.72）分］（均P<0.05）；治疗组中医证候量表主症、次症评分和总分均低于对照组［（5.58±1.42）分比（8.55±1.71）分、（3.11±0.31）分比（5.23±0.44）分、（8.12±0.55）分比（13.62±0.72）分］（均P<0.05）；治疗组PaO₂高于对照组［（76.11±5.12）mmHg（1 mmHg=0.133 kPa）比（65.15±5.11）mmHg］，PaCO₂低于对照组［（48.17±6.32）mmHg比（55.23±6.21）mmHg］（均P<0.05）。结论　火龙罐综合灸疗法可有效缓解慢阻肺咳喘患者症状，改善肺功能、呼吸功能及晨间症状。

关键词:

慢阻肺, 咳喘, 火龙罐综合灸疗法, 肺功能, 晨间症状

Abstract:

Objective　To explore the effect of integrated moxibustion therapy with fire dragon pot on patients with cough and asthma of chronic obstructive pulmonary disease (COPD). Methods　This study was a randomized controlled trial. A total of 86 COPD patients with cough and asthma admitted to Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian) from October 2022 to October 2023 were selected as the study objects by the convenience sampling method. The patients were divided into a control group (43 cases) and a treatment group (43 cases) by the random number table method. In the treatment group, 3 patients were admitted to the intensive care unit due to aggravation of the disease and could not continue the study; in the control group, 2 patients could not continue the study because the patient left Shenzhen, and 1 patient failed to follow the doctor's advice to withdraw by themselves. Each 40 patients in the treatment group and control group completed the study. In the control group, there were 28 males and 12 females, aged 43-79 (60.12±5.23) years, and the course of disease ranged from 2 to 13 (10.09±2.23) years. In the treatment group, there were 30 males and 10 females, aged 41-78 (60.56±5.18) years, and the course of disease ranged from 2 to 14 (10.12±2.13) years. The control group was treated with routine nursing and rehabilitation training, and the treatment group was treated with integrated moxibustion therapy with fire dragon pot on the basis of the control group. Both groups were treated continuously for 30 days. The cough and asthma relief rate and pulmonary function indicators [forced vital capacity (FVC), forced expiratory volume in the first second (FEV₁), and FEV₁/FVC], morning symptoms [Chronic Obstructive Pulmonary Disease Morning Symptom Diary (CPLD-MSD)], respiratory function [St.George's Respiratory Questionnaire (SGRQ) and modified Medical Research Council (mMRC)], traditional Chinese medicine (TCM) syndrome score, blood gas analysis indexes [oxygen partial pressure (PaO₂) and carbon dioxide partial pressure (PaCO₂)] before and after treatment were compared between the two groups. Independent sample t test, paired t test, and χ² test were used for statistical analysis. Results　The total relief rate of cough and asthma in the treatment group was higher than that in the control group [95.00% (38/40) vs. 80.00% (32/40)] (P<0.05). After treatment, the FVC, FEV₁, and FEV₁/FVC in the treatment group were higher than those in the control group [(2.51±0.38) L vs. (2.17±0.35) L, (1.38±0.43) L vs. (1.13±0.37) L, (65.47±5.34)% vs. (62.11±5.17)%] (all P<0.05). The scores of COPD-MSD, SGRQ, and mMRC in the treatment group were lower than those in the control group [(51.78±3.21) points vs. (63.22±3.23) points, (48.19±6.23) points vs. (55.23±6.21) points, (1.48±0.51) points vs. (2.48±0.72) points] (all P<0.05). The main symptom score, secondary symptom score, and total score of TCM syndrome scale in the treatment group were lower than those in the control group [(5.58±1.42) points vs. (8.55±1.71) points, (3.11±0.31) points vs. (5.23±0.44) points, (8.12±0.55) points vs. (13.62±0.72) points] (all P<0.05). The PaO₂ of the treatment group was higher than that of the control group [(76.11±5.12) mmHg (1 mmHg = 0.133 kPa) vs. (65.15±5.11) mmHg], but the PaCO₂ was lower than that of the control group [(48.17±6.32) mmHg vs. (55.23±6.21) mmHg] (both P<0.05). Conclusion　The choice of integrated moxibustion therapy with fire dragon pot for patients with COPD cough and asthma can not only effectively relieve the patients' cough and asthma symptoms, but also enhance their lung function, improve their respiratory function and morning symptoms.

Key words:

Chronic obstructive pulmonary disease, Cough and asthma, Integrated moxibustion therapy with fire dragon pot, Lung function, , Morning symptom

吕海鹏陈赟高运吉朱玲易飞邓慧徐卫方.

火龙罐综合灸疗法对慢阻肺咳喘患者的影响 [J]. 国际医药卫生导报, 2025, 31(1): 121-126.

Lyu Haipeng, Chen Yun, Gao Yunji, Zhu Ling, Yi Fei, Deng Hui, Xu Weifang.

Effect of integrated moxibustion therapy with fire dragon pot on patients with cough and asthma of chronic obstructive pulmonary disease [J]. International Medicine and Health Guidance News, 2025, 31(1): 121-126.

参考文献

[1] 陈丽华,白贺芳,白丽.五禽戏联合呼吸肌锻炼在COPD稳定期患者中的应用研究[J].国际医药卫生导报,2024,30(8):1403-1408.DOI:10.3760/cma.j.issn.1007-1245.2024. 08.036.
[2] 徐健莹,吴巧媚,刘宇,等.火龙灸对慢性阻塞性肺疾病稳定期肺肾气虚证患者肺功能及生存质量的影响[J].广州中医药大学学报,2022,39(3):593-599.DOI:10.13359/j.cnki.gzxbtcm.2022.03.022.
[3] Li J, Liu X, Shi Y, et al. Differentiation in TCM patterns of chronic obstructive pulmonary disease by comprehensive metabolomic and lipidomic characterization[J]. Front Immunol, 2023, 14:1208480. DOI: 10.3389/fimmu.2023.1208480.
[4] Fang X, Ran M O, Jiang Y, et al. Effects of TCM nursing based on syndrome differentiation on pulmonary function and quality of life in patients with acute exacerbation of COPD[J]. Medicinal Plant, 2023, 14(4):77-79. DOI:10.19600/j.cnki2152-3924.2023.04.019.
[5] Li J, Chen R, Yu X, et al. Guidelines of integrated Chinese and western medicine for diagnosis and treatment of chronic obstructive pulmonary disease (2022)[J]. J Evid Based Med, 2023, 16(4):565-580. DOI: 10.1111/jebm.12578.
[6] 中华医学会呼吸病学分会慢性阻塞性肺疾病学组,中国医师协会呼吸医师分会慢性阻塞性肺疾病工作委员会.慢性阻塞性肺疾病诊治指南(2021年修订版)[J].中华结核和呼吸杂志,2021,44(3):170-205.DOI:10.3760/cma.j.cn112147-20210109-00031.
[7] 国家卫生健康委员会急诊医学质控中心,中华医学会急诊医学分会,中国医师协会急诊医师分会,等.中国慢性阻塞性肺疾病急性加重中西医诊治专家共识(2021)[J].中华危重病急救医学,2021,33(11):1281-1290.DOI:10.3760/cma.j.cn121430-20211003-01438.
[8] 耿艳娜,王雷,耿立梅,等.雷火灸联合呼吸康复训练对老年慢性阻塞性肺疾病急性加重期心肺功能和运动耐力的影响[J].中国老年学杂志,2023,43(12):2872-2876.DOI:10.3969/j.issn.1005-9202.2023.12.015.
[9] 李晓云,成玮,段佳熙,等.慢性阻塞性肺疾病晨间症状量表中文版研制及信效度验证[J].中华结核和呼吸杂志,2019,42(6):444-450.DOI:10.3760/cma.j.issn.1001-0939.2019. 06.008.
[10] 孟现玲,何玉廷,毛若琳,等.圣乔治呼吸问卷、CAT及mMRC评分在慢性阻塞性肺病中的应用[J].复旦学报(医学版),2022,49(6):862-868,876.DOI:10.3969/j.issn.1672- 8467.2022.06.004.
[11] 吕佳康.慢性阻塞性肺疾病中药新药临床研究指导原则制定的可行性探讨[J].中国临床药理学杂志,2013,29(6):477-480.DOI:10.3969/j.issn.1001-6821.2013.06.024.
[12] 曹志超,李小娟,栾哲宇.中医外治疗法治疗慢性阻塞性肺疾病急性加重期的研究进展[J].中国中医急症,2022,31(12):2242-2245.DOI:10.3969/j.issn.1004- 745X.2022.12.046.
[13] 谢彩凤.背部腧穴艾灸联合耳穴压豆干预在慢性阻塞性肺疾病伴睡眠障碍中的应用研究[J].中国民族医药杂志,2023,29(4):29-31,66.DOI:10.3969/j.issn.1006-6810. 2023.04.013.
[14] 刘智霖,史利卿,马建岭,等.慢性阻塞性肺疾病气道黏液高分泌脏腑相关病机及证治探讨[J].世界中医药,2022,17(9):1316-1321.DOI:10.3969/j.issn.1673-7202.2022.09.021.
[15] 马妍.中医治疗慢性阻塞性肺疾病急性加重期研究进展[J].光明中医,2022,37(21):4008-4011.DOI:10.3969/j.issn.1003-8914.2022.21.057.
[16] 刘方,刁素梅,严瑾,等.火龙罐辅治慢性阻塞性肺疾病急性发作期临床观察[J].实用中医药杂志,2023,39(9):1793-1794.
[17] 罗艳,孙朝辉,龙渊.中医外治疗法在慢性阻塞性肺疾病稳定期的应用研究进展[J].云南中医中药杂志,2022,43(12):84-88.DOI:10.3969/j.issn.1007-2349.2022.12.021.
[18] 李璞,贺生霞.探讨不同灸量的脐灸疗法治疗慢阻肺稳定期患者的临床效果及对SGRQ评分、肺功能的影响[J].贵州医药,2023,47(9):1360-1361.DOI:10.3969/j.issn.1000- 744X.2023.09.007.
[19] 杨桥清,钟慧霞,黄欣怡,等.抗阻加间歇有氧运动配合火龙罐疗法在慢性心力衰竭病人心脏康复的护理研究[J].内蒙古中医药,2023,42(11):82-83.DOI:10.16040/j.cnki.cn15-1101.2023.11.057.
[20] 陈赞,任肖敬,钟远,等.火龙罐疗法的临床应用进展[J].光明中医,2023,38(11):2224-2227.DOI:10.3969/j.issn.1003- 8914.2023.11.057.
[21] 王向丽,张留巧,马孟婕.火龙罐疗法在临床护理中的应用进展[J].光明中医,2022,37(17):3259-3260.DOI:10.3969/j.issn.1003-8914.2022.17.061.
[22] 任蕾元,唐荣欣,李新诺,等.火龙罐在气滞血瘀型胸痹心痛伴不寐护理中的应用[J].护理研究,2024,38(11):2053-2057.DOI:10.12102/j.issn.1009-6493.2024.11.031.
[23] 韩文聪,陈晓英,郑小芬,等.火龙罐疗法联合常规治疗在AECOPD患者中的应用效果[J].中外医学研究,2024,22(6):143-146.DOI:10.14033/j.cnki.cfmr.2024.06.036.
[24] 戴倩,佘峥娣,洪文静,等.火龙罐疗法在患者症状管理中的应用进展[J].湖南中医杂志,2023,39(2):198-200.DOI:10.16808/j.cnki.issn1003-7705.2023.02.043.
[25] 陈水珍,方勇.火龙罐疗法在慢性病患者症状管理中的应用进展[J].中国乡村医药,2024,31(15):77-78.DOI:10.19542/j.cnki.1006-5180.2308-379.
[26] 房华瑞,乔双,沈晓明,等.火龙罐治疗患者体验的质性研究[J].光明中医,2023,38(9):1634-1638.DOI:10.3969/j.issn.1003-8914.2023.09.006.