CAJ | 학술논문

目的：观察粗针透刺膻中穴对慢性阻塞性肺疾病急性加重期患者C反应蛋白（CRP）的影响。方法将90例慢性阻塞性肺疾病急性加重期患者按随机原则分为对照组、传统毫针组、粗针透刺组，每组30例。对照组只常规抗感染、雾化吸入平喘、抗炎、化痰药物及支持、对症治疗；传统毫针组在对照组治疗基础上加毫针（直径0.4 mm）紫宫穴透刺膻中穴，每次进针100 mm，留针3 h；粗针透刺组在对照组治疗基础上加用粗针（直径0.8 mm）紫宫穴透刺膻中穴，每次进针100 mm，留针3 h；3组均治疗10 d。观察3组患者治疗前与治疗10 d后血清CRP的变化情况。使用SPSS13.0软件进行统计分析，3组患者血清CRP检测结果为计量资料，呈正态分布，以均数±标准差（±s）表示，多组间均数差异比较采用单因素方差分析，组间均数的两两比较采用LSD-t检验，治疗前后比较采用配对设计t检验，以P<0.05为差异有统计学意义。结果对照组患者治疗前、治疗10 d后的血清CRP分别为（2.111±0.207）mg/L和（1.676±0.321）mg/L，差异有统计学意义（t=-12.157， P<0.01）；传统毫针组患者治疗前、治疗10 d后血清CRP分别为（2.033±0.204）mg/L和（1.255±0.193） mg/L，差异有统计学意义（t=-67.206，P<0.01）；粗针透刺组患者治疗前、治疗10 d后血清CRP分别为（2.096±0.230）mg/L和（0.601±0.097）mg/L，差异有统计学意义（t=-60.242，P<0.01）。治疗前，3组患者血清CRP比较差异无统计学意义（F=1.603，P>0.05）；治疗10 d后经方差分析，3组患者血清CRP比较，差异有统计学意义（F=176.705，P<0.01），经两两比较，传统毫针组和对照组相比，差异有统计学意义（t=7.303，P<0.01）；粗针透刺组和对照组相比，差异有统计学意义（t=18.653， P<0.01）；粗针透刺组和毫针组相比，差异有统计学意义（t=11.350，P<0.01）。结论穴位透刺膻中穴比对照组能降低慢性阻塞性肺疾病急性加重期患者的血清CRP，改善患者呼吸系统及全身症状，粗针透刺法比传统毫针透刺法降低的更明显，为慢性阻塞性肺疾病急性加重期患者临床治疗提供新的治疗方法。目的：觀察粗針透刺膻中穴對慢性阻塞性肺疾病急性加重期患者C反應蛋白（CRP）的影響。方法將90例慢性阻塞性肺疾病急性加重期患者按隨機原則分為對照組、傳統毫針組、粗針透刺組，每組30例。對照組隻常規抗感染、霧化吸入平喘、抗炎、化痰藥物及支持、對癥治療；傳統毫針組在對照組治療基礎上加毫針（直徑0.4 mm）紫宮穴透刺膻中穴，每次進針100 mm，留針3 h；粗針透刺組在對照組治療基礎上加用粗針（直徑0.8 mm）紫宮穴透刺膻中穴，每次進針100 mm，留針3 h；3組均治療10 d。觀察3組患者治療前與治療10 d後血清CRP的變化情況。使用SPSS13.0軟件進行統計分析，3組患者血清CRP檢測結果為計量資料，呈正態分佈，以均數±標準差（±s）錶示，多組間均數差異比較採用單因素方差分析，組間均數的兩兩比較採用LSD-t檢驗，治療前後比較採用配對設計t檢驗，以P<0.05為差異有統計學意義。結果對照組患者治療前、治療10 d後的血清CRP分彆為（2.111±0.207）mg/L和（1.676±0.321）mg/L，差異有統計學意義（t=-12.157， P<0.01）；傳統毫針組患者治療前、治療10 d後血清CRP分彆為（2.033±0.204）mg/L和（1.255±0.193） mg/L，差異有統計學意義（t=-67.206，P<0.01）；粗針透刺組患者治療前、治療10 d後血清CRP分彆為（2.096±0.230）mg/L和（0.601±0.097）mg/L，差異有統計學意義（t=-60.242，P<0.01）。治療前，3組患者血清CRP比較差異無統計學意義（F=1.603，P>0.05）；治療10 d後經方差分析，3組患者血清CRP比較，差異有統計學意義（F=176.705，P<0.01），經兩兩比較，傳統毫針組和對照組相比，差異有統計學意義（t=7.303，P<0.01）；粗針透刺組和對照組相比，差異有統計學意義（t=18.653， P<0.01）；粗針透刺組和毫針組相比，差異有統計學意義（t=11.350，P<0.01）。結論穴位透刺膻中穴比對照組能降低慢性阻塞性肺疾病急性加重期患者的血清CRP，改善患者呼吸繫統及全身癥狀，粗針透刺法比傳統毫針透刺法降低的更明顯，為慢性阻塞性肺疾病急性加重期患者臨床治療提供新的治療方法。
목적：관찰조침투자단중혈대만성조새성폐질병급성가중기환자C반응단백（CRP）적영향。방법장90례만성조새성폐질병급성가중기환자안수궤원칙분위대조조、전통호침조、조침투자조，매조30례。대조조지상규항감염、무화흡입평천、항염、화담약물급지지、대증치료；전통호침조재대조조치료기출상가호침（직경0.4 mm）자궁혈투자단중혈，매차진침100 mm，류침3 h；조침투자조재대조조치료기출상가용조침（직경0.8 mm）자궁혈투자단중혈，매차진침100 mm，류침3 h；3조균치료10 d。관찰3조환자치료전여치료10 d후혈청CRP적변화정황。사용SPSS13.0연건진행통계분석，3조환자혈청CRP검측결과위계량자료，정정태분포，이균수±표준차（±s）표시，다조간균수차이비교채용단인소방차분석，조간균수적량량비교채용LSD-t검험，치료전후비교채용배대설계t검험，이P<0.05위차이유통계학의의。결과대조조환자치료전、치료10 d후적혈청CRP분별위（2.111±0.207）mg/L화（1.676±0.321）mg/L，차이유통계학의의（t=-12.157， P<0.01）；전통호침조환자치료전、치료10 d후혈청CRP분별위（2.033±0.204）mg/L화（1.255±0.193） mg/L，차이유통계학의의（t=-67.206，P<0.01）；조침투자조환자치료전、치료10 d후혈청CRP분별위（2.096±0.230）mg/L화（0.601±0.097）mg/L，차이유통계학의의（t=-60.242，P<0.01）。치료전，3조환자혈청CRP비교차이무통계학의의（F=1.603，P>0.05）；치료10 d후경방차분석，3조환자혈청CRP비교，차이유통계학의의（F=176.705，P<0.01），경량량비교，전통호침조화대조조상비，차이유통계학의의（t=7.303，P<0.01）；조침투자조화대조조상비，차이유통계학의의（t=18.653， P<0.01）；조침투자조화호침조상비，차이유통계학의의（t=11.350，P<0.01）。결론혈위투자단중혈비대조조능강저만성조새성폐질병급성가중기환자적혈청CRP，개선환자호흡계통급전신증상，조침투자법비전통호침투자법강저적경명현，위만성조새성폐질병급성가중기환자림상치료제공신적치료방법。
Objective To observe effects of thick needle puncturing Danzhong (RN 17) on C-reactive protein ( CRP ) in patients with acute exacerbation of chronic obstructive pulmonary disease ( AECOPD ). Methods Ninety AECOPD patients were selected and randomly divided into control group, traditional needle puncturing group and thick needle puncturing group ( n=30 for each group ). Patients in control group received symptomatic treatment, those in traditional needle puncturing group received symptomatic treatment plus acupuncture subcutaneously 100 mm deep from Zigong ( RN 19 ) to Danzhong ( RN 17 ) by a traditional needle puncturing, and retaining for 3 hours. Patients in thick needle puncturing group received symptomatic therapy plus puncturing subcutaneously 100 mm deep from Zigong ( RN 19 ) to Danzhong ( RN 17 ) by a thick stainless steel needle and retaining for 3 hours. Patients were treated for 10 days in three groups. The Serum Changes of CRP were observed before and after 10-day treatment. All data were processed by SPSS13.0 for windows. Results were demonstrated by mean±standard deviation. The single factor analysis of variance was used for comparing mean difference between groups. Data of three groups were compared using LSD-t test. The paired t test was used in data before and after treatment. WhenP<0.05, it shows that the difference was statistically significant.Results Before and after 10-day treatment, the serum levels of CRP were ( 2.111±0.207 ) mg/L and ( 1.676±0.321 ) mg/L in control group respectively. The difference was statistically significant (t=-12.157, P<0.01). The serum levels of CRP were ( 2.033±0.204 ) mg/L and ( 1.255±0.193 )mg/L before and after 10-day treatment in traditional needle puncturing group respectively. The difference was statistically significant (t=-67.206,P<0.01 ). The serum levels of CRP were ( 2.096±0.230)mg/L and ( 0.601±0.097 ) mg/L in thick needle puncturing group before and after 10-day treatment. There was a significant difference before and after 10-day treatment (t=-60.242,P<0.01 ). Before treatment, there were no significant differences in serum levels of CRP between three groups (F=1.603,P>0.05 ). After 10-day treatment, there were significant differences in the serum levels of CRP (F=176.705,P<0.01 ). There was a significant difference in the serum level of CRP between traditional needle puncturing group and control group(t=7.303,P<0.01 ). Compared thick needle puncturing group and control group, there as a significant difference in the serum level of CRP between thick needle puncturing group and control group (t=18.653,P<0.01). There was also a significant difference in the serum level of CRP between thick needle puncturing group and traditional needle puncturing group (t=11.350,P<0.01 ).Conclusion The needle puncturing ( RN 17 ) point through can significantly reduce the serum level of CRP in patients with AECOPD, which is more significant in thick needle puncturing group than that of traditional needle puncturing group.