摘要
目的 观察冬病夏治对雾霾暴露下支气管哮喘患者的临床疗效和炎性因子影响,为防治雾霾暴露下致哮喘急性发作提供思路。方法 选取2020年5月1日—2020年7月10日期间就诊于河北省中医院呼吸一科门诊的68例支气管哮喘患者,采用随机数字法分为对照组和贴敷组,每组各34例。对照组予基础治疗,贴敷组在对照组基础上予冬病夏治贴敷治疗。以低浓度雾霾月份7月为暴露前,高浓度雾霾月份12月为暴露后,观察比较两组患者临床疗效,暴露前后急性发作次数、哮喘控制测试问卷评分(Asthma Control Test questionnaire, ACT)、肺功能[第1秒用力呼气容积(Forced expiratory volume in 1 sec, FEV1)、第1秒用力呼气容积/用力肺活量(Forced expiratoryvolume in one second to forced vital capacity ratio, FEV1/FVC)、最大呼气流量(Peak Expiratory Flow, PEF)]、外周血嗜酸性粒细胞计数(Eosinophil count, EOS)及炎性因子[白细胞介素-4(Interleukin-4,IL-4)、白细胞介素-8(Interleukin-8,IL-8)]水平。结果 治疗后贴敷组总有效率91.18%(31/34)明显高于对照组70.59%(24/34),差异有统计学意义(P<0.05)。暴露后两组患者急性发作次数较暴露前降低,ACT评分较暴露前升高,差异有统计学意义(P<0.05);且贴敷组急性发作次数明显低于对照组,ACT评分明显高于对照组,差异有统计学意义(P<0.05)。暴露后两组患FEV1、FEV1/FVC、PEF均较暴露前升高,差异有统计学意义(P<0.05);且贴敷组FEV1、FEV1/FVC、PEF明显高于对照组,差异有统计学意义(P<0.05)。暴露后两组患者IL-4、IL-8、EOS水平均较暴露前降低,差异有统计学意义(P<0.05);且贴敷组IL-4、IL-8、EOS水平明显低于对照组,差异有统计学意义(P<0.05)。结论 冬病夏治穴位贴敷治疗雾霾暴露下哮喘临床疗效显著,可改善哮喘患者急性发作次数、肺功能、ACT评分,降低血清EOS、IL-4、IL-8水平,减轻炎性反应,值得进一步推广。
Objective To observe the clinical efficacy of summer treatment in bronchial asthma patients exposed to haze in winter and to provide ideas for preventing and treating asthma exacerbation caused by haze exposure.Methods Sixty-eight patients with bronchial asthma treated in the Department of Pneumology,Hebei Provincial Hospital of Tradi-tional Chinese Medicine from May 1 to July 10 in 2020 were selected and randomly assigned into a control group(n=34)and an observation group(n=34)according to the random number table method.The control group received conventional treatment and the observation group additionally received external application in summer.July with a low concentration of haze was taken as the pre-exposure month,and December with a high concentration of haze as the post-exposure month.The clinical efficacy was compared between the two groups.The number of acute exacerbations,asthma control test(ACT)score,lung function indicators[(forced expiratory volume in 1 s,FEV1),forced expiratory volume in one second to forced vital capacity ratio(FEV1/FVC),and peak expiratory flow(PEF)],and the eosinophil count(EOS)and levels of inflammatory cytokines[interleukin-4(IL-4)and IL-8]in the peripheral blood were compared between the two groups as well as between before and after haze exposure.Results The total effective rate in the observation group was 91.18%(31/34),which was higher than that(70.59%,24/34)in the control group(P<0.05).The number of acute exacerba-tions declined in both groups after exposure compared with that before exposure(P<0.05)and was lower in the observa-tion group than in the control group(P<0.05).The ACT score increased after exposure compared with that before expo-sure(P<0.05)and was higher in the observation group than in the control group(P<0.05).After exposure,the FEV1,FEV1/FVC,and PEF increased compared with those before exposure(P<0.05),and the values in the observation group were higher than those in the control group(P<0.05).The serum levels of EOS,IL-4,and IL-8 declined after expo-sure compared with those before exposure(P<0.05)and were lower in the observation group than in the control group(P<0.05).Conclusion The external application in summer for treating asthma under haze exposure in winter demonstrates significant clinical efficacy.This therapy can reduce acute exacerbations,improve lung function and ACT score,and lower ser-um levels of EOS,IL-4,and IL-8 to mitigate inflammatory response in asthma patients,being worthy of further promotion.
作者
李方
耿立梅
马蕴蕾
闫红倩
宿英豪
于向艳
LI Fang;GENG Li-mie;MA Yun-lei;YAN Hong-qian;SU Ying-hao;YU Xiang-yan(Graduate School of Hebei University of Chinese Medicine,Shijiazhuang Hebei 050011;The First Affiliated Hospital of Hebei University of Chinese Medicine,Shijiazhuang Hebei 050011;Hebei Key Laboratory of Integrated Chinese and Western Medicine for Lung Disease Research,Shijiazhuang Hebei 050011)
出处
《世界中西医结合杂志》
2023年第4期747-751,755,共6页
World Journal of Integrated Traditional and Western Medicine
基金
河北省财政厅项目(361-0402-YSN-ULZ6)
河北省科技厅计划项目(14277798D)
河北省中医药管理局科研计划项目(2019029)。
关键词
哮喘
雾霾
冬病夏治
Asthma
Haze
Summer Treatment of a Disease Occurred in Winter
