背俞穴埋线治疗支气管哮喘的临床观察及对血清IL-13的影响

发布时间：2018-05-01 16:37

本文选题：支气管哮喘 + 背俞穴　；参考：《广西中医药大学》2016年硕士论文

【摘要】：目的:通过背俞穴埋线法治疗支气管哮喘患者,观察该疗法对患者症状体征、哮喘控制情况、血清白介素13(IL-13)水平的影响,探讨背俞穴埋线治疗支气管哮喘的有效性,为支气管哮喘的临床治疗提供方法及理论依据。方法:本课题病例来源于广西中医药大学附属瑞康医院针灸科门诊及呼吸内科门诊从2014年6月至2015年6月期间就诊的患者。研究对象符合:(1)第8版《内科学》[1]中的支气管哮喘的诊断标准;(2)2002年版《中药新药临床研究指导原则》[2]中哮病的中医诊断标准。采用统计学随机数字表的方法,将符合纳入标准的支气管哮喘患者74例随机分组,治疗组37例,对照组37例。治疗组采用背俞穴埋线法,取穴肺俞、脾俞、肾俞,每10天做1次治疗,3个月为1疗程。对照组采用口服氨茶碱缓释片的方法,每日2次,每次0.1g,连续服用3个月。观察比较两组患者治疗前后的中医症候积分、哮喘控制测试(ACT)评分、血清IL-13水平的变化。血清IL-13的含量检测采用酶联免疫吸附法检测。所有数据统计采用统计软件SPSS17.0处理。结果:本课题实际完成病例71例,其中治疗组完成35例,脱落2例,对照组完成36例,脱落1例。治疗前,比较两组患者的年龄、性别、病程,差异无统计学意义(P0.05),两组具有可比性。对两组患者治疗前的中医症候积分、ACT评分、血清IL-13水平进行比较,差异无统计学意义(P0.05),两组治疗前中医症候积分、ACT评分、血清IL-13水平具有可比性。治疗完成后,分别比较两组组内治疗前后疗效评定,差异具有统计学意义(P0.05),两组治疗均有效果;两组之间比较,治疗组总有效率80.00%,对照组总有效率77.80%,差异无统计学意义(P0.05),两组疗效相当。治疗前后两组组内ACT评分比较,差异具有统计学意义(P0.05),两组治疗对哮喘控制均有效;治疗后两组之间ACT评分比较,差异有显著统计学意义(P0.05),治疗组为22.37±2.51分,对照组为20.61±3.12分,治疗组哮喘控制情况优于对照组。治疗前后两组组内IL-13水平比较,差异有统计学意义(P0.05),两组治疗后均能降低IL-13水平;治疗后两组之间IL-13水平比较,差异具有显著统计学意义(P0.05),治疗组为42.54±4.39pg/ml,对照组为50.51±4.72 pg/ml,治疗组在降低IL-13水平方面优于对照组。结论:背俞穴埋线治疗能改善支气管哮喘患者的临床症状体征,总体疗效与公认的口服氨茶碱缓释片疗效相当;背俞穴埋线治疗可有效控制哮喘发作,可降低血清IL-13水平,且优于口服氨茶碱缓释片;背俞穴埋线后可降低机体血清IL-13水平,可能与抑制白介素炎症因子分泌或提高清除炎症细胞水平相关,提高机体免疫力,是背俞穴防治支气管哮喘的作用机理之一。
[Abstract]:Objective: to observe the effect of this therapy on symptoms and signs, asthma control and serum interleukin-13 (IL-13) level in patients with bronchial asthma. To provide the method and theoretical basis for the clinical treatment of bronchial asthma. Methods: the cases were collected from patients in Department of Acupuncture and Respiratory Medicine of Ruikang Hospital affiliated to Guangxi University of traditional Chinese Medicine from June 2014 to June 2015. The subjects were in accordance with the diagnostic criteria of bronchial asthma in the eighth edition of "Internal Medicine" [1] and the 2002 edition of "guiding principles of Clinical Research on New drugs of traditional Chinese Medicine" [2]. 74 patients with bronchial asthma were randomly divided into treatment group (n = 37) and control group (n = 37). The treatment group was treated once every 10 days, 3 months as a course of treatment. The control group was treated with aminophylline sustained release tablets twice a day for 3 months. To observe and compare the TCM symptom score, asthma control test score and serum IL-13 level between the two groups before and after treatment. The content of serum IL-13 was detected by enzyme-linked immunosorbent assay (Elisa). All data statistics are processed by SPSS17.0. Results: there were 71 cases completed in this study, including 35 cases in the treatment group, 2 cases in the control group, 36 cases in the control group and 1 case in the control group. Before treatment, there was no significant difference in age, sex, course of disease between the two groups (P 0.05), and the two groups were comparable. The scores of TCM symptom score and serum IL-13 were compared between the two groups before treatment. There was no significant difference between the two groups (P 0.05). The scores of TCM symptom score and serum IL-13 were comparable between the two groups before treatment. After the treatment, the curative effect of the two groups were compared before and after treatment, the difference was statistically significant (P 0.05). The total effective rate was 80.00g in the treatment group and 77.80 in the control group. There was no significant difference between the two groups (P 0.05). Before and after treatment, the ACT scores of the two groups were significantly different (P 0.05), the two groups were effective in asthma control, the difference of ACT scores between the two groups was statistically significant (22.37 卤2.51), and that of the control group was 20.61 卤3.12 (P < 0.05), and that of the control group was 20.61 卤3.12 (P < 0.05). The control of asthma in the treatment group was better than that in the control group. Before and after treatment, the level of IL-13 in the two groups was significantly higher than that in the control group (P 0.05). After treatment, the level of IL-13 was decreased in both groups, and the level of IL-13 was compared between the two groups after treatment. The difference was statistically significant (42.54 卤4.39pg / ml in the treatment group and 50.51 卤4.72pg / ml in the control group). The treatment group was superior to the control group in lowering the level of IL-13. Conclusion: the clinical symptoms and signs of patients with bronchial asthma can be improved by catgut embedding at Bushu point, and the overall curative effect is similar to that of oral aminophylline sustained-release tablets, and the catgut embedding therapy at Beshu point can effectively control the attack of asthma and reduce the level of serum IL-13. It was better than oral aminophylline sustained-release tablets, the serum IL-13 level was decreased after catgut implantation, which may be related to inhibiting the secretion of interleukin inflammatory factors or increasing the level of clearance of inflammatory cells, so as to improve the immunity of the body. It is one of the mechanisms of prevention and treatment of bronchial asthma at Bushu point.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.1

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