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Title: [Therapeutic effect on chronic obstructive pulmonary disease of lung qi deficiency at the stable stage treated with ginger-separated moxibustion and Chinese herbal medicine atomization].
Author: Zhang Q, Shi Y.
Journal: Zhongguo Zhen Jiu; 2020 Sep 12; 40(9):933-8. PubMed ID: 32959586.
Abstract:
OBJECTIVE: To compare the clinical effect on chronic obstructive pulmonary disease (COPD) of lung qi deficiency at the stable stage treated with ginger-separated moxibustion and Chinese herbal medicine atomizaiton. METHODS: A total of 90 patients with COPD of lung qi deficiency at the stable stage were randomized into an observation group (45 cases, 1 case dropped off) and a control group (45 cases, 2 cases dropped off). In the observation group, the ginger-separated moxibustion was applied to Dazhui (GV 14), Feishu (BL 13) and Gaohuangshu (BL 43), 2 moxa cones at each acupoint in each treatment. Additionally, the atomized inhalation with bufei decoction and erchen decoction was combined for 20 min, once every two days. The treatment for 10 times was taken as one course and 2 courses of treatment were required for 20 min. In the control group, ambroxol hydrochloride oral solution (10 mL) and compound methoxynamine capsules (2 capsules), were taken orally. Additionally, salbutamol aerosol was combined, 1 spray each time, three times a day, consecutively for 40 days. Before treatment and in 1-year followup after treatment, percentage of the forced expiratory volume in the first second predicated value (FEV1%) and its ratio to the forced vital capacity (FVC) (FEV1/FVC%) were determined in patients of the two groups. Before and after treatment, and in 3 months, 6 months and 1 year of followup after treatment, the score of COPD assessment test (CAT) and the score of traditional Chinese medicine (TCM) symptom were observed in the two groups separately. The clinical effect was assessed in 3-month followup after treatment and the frequency of the acute attack of COPD was followed up in 1 year after treatment in patients of the two groups. RESULTS: In 1-year followup, FEV1% and FEV1/FVC% were increased in patients of the two groups (P<0.05). After treatment and in the followup of 3 months, 6 months and 1 year after treatment, CAT scores were reduced as compared with thoes before treatment in the two groups successively (P<0.01, P<0.05). In 1-year followup after treatment, CAT score in the observation group was lower than the control group (P<0.05). After treatment and in the followup of 3 months, 6 months and 1 year after treatment, the TCM symptom scores of cough, asthma, lassitude and spontaneous sweating were all reduced as compared with those before treatment in the observation group (P<0.01), and the scores of cough and asthma were reduced as compared with those before treatment in the control group successively (P<0.01, P<0.05). After treatment and in the followup of 3 months, 6 months and 1 year after treatment, the scores of lassitude and spontaneous sweating in the observation group were lower than the control group successively (P<0.01). In the followup of 6 months and 1 year after treatment, the scores of cough in the observation group were lower than the control group (P<0.05). The total effective rates were 88.6% (39/44) in the observation group and 93.0% (40/43) in the control group, without significance difference (P>0.05). In 1-year followup, the acute recurrence rate of COPD was 20.5% (9/44) in the observation group, lower than 32.6% (14/43) in the control group (P<0.05). CONCLUSION: As compared with western medication, the combination of ginger-separated moxibustion and Chinese herbal medicine atomizaiton achieves the superior effects of improving the lung functions, reducing the clinical symptoms and decreasing the frequency of acute attack in patients with COPD of lung qi deficiency at the stable stage. 目的：比较隔姜灸联合中药雾化与常规西药治疗稳定期肺气虚型慢性阻塞性肺疾病（COPD）的临床疗效。方法：将90例稳定期肺气虚型COPD患者随机分为观察组（45例，脱落1例）和对照组（45例，脱落2例）。观察组于大椎、肺俞、膏肓俞行隔姜灸，每次每穴灸2壮，配合补肺汤合二陈汤雾化吸入20 min，隔日治疗1次，10次为一疗程，治疗2个疗程；对照组口服盐酸氨溴索口服液10 mL、复方甲氧那明胶囊2粒，配合吸入沙丁胺醇气雾剂1喷，均每日3次，连续治疗40 d。于治疗前、治疗后1年随访检测两组患者第1秒用力呼气量占预计值百分比（FEV1%）、FEV1占用力肺活量百分比（FEV1/FVC%）；于治疗前后，治疗后3、6个月及1年随访时，观察两组慢性阻塞性肺疾病评估测试（CAT）评分、中医症状评分变化；于治疗后3个月随访时评定两组临床疗效，并于治疗后1年随访统计两组COPD急性发作次数。结果：1年随访，两组患者FEV1%和FEV1/FVC%均升高（P<0.05）。治疗后，治疗后3、6个月及1年随访时，两组患者CAT评分较治疗前降低（P<0.01，P<0.05）；治疗后1年随访时，观察组CAT评分低于对照组（P<0.05）。治疗后，治疗后3、6个月及1年随访时，观察组咳嗽、喘、乏力、自汗中医症状评分较治疗前降低（P<0.01），对照组咳嗽、喘中医症状评分较治疗前降低（P<0.01， P<0.05）；治疗后，治疗后3、6个月及1年随访时，观察组乏力、自汗中医症状评分低于对照组（P<0.01）；治疗后6个月及1年随访时，观察组咳嗽中医症状评分低于对照组（P<0.05）。观察组总有效率为88.6%（39/44），对照组为93.0%（40/43），差异无统计学意义（P>0.05）。1年随访，观察组COPD急性复发率为20.5%（9/44），低于对照组的32.6%（14/43，P<0.05）。结论：隔姜灸联合中药雾化在改善稳定期肺气虚型COPD患者肺功能、临床症状及减少急性发作次数方面均优于西药治疗。.

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