庞彩苓　厉兆春山东省潍坊市中医院保健科，山东潍坊　261041

耳穴压豆法对COPD合并营养不良患者的影响

庞彩苓厉兆春
山东省潍坊市中医院保健科，山东潍坊261041

目的 探讨传统中医疗法对COPD患者营养状况的影响。方法 选取38例Ⅲ～Ⅳ级COPD稳定期、中医辨证为脾肾亏虚型COPD患者，将其随机分为两组：对照组应用沙美特罗替卡松粉吸入剂，治疗组在此基础上加用耳穴压豆治疗。观察两组治疗前后头三肌皮皱厚度（TSF）、血清白蛋白（ALB）、前白蛋白（Palb）的含量变化。并观察肺功能指标FEV1（第1秒呼气容积）、FEV1/FVC%（第1秒呼气容积占用力肺活量百分比）及FEV1pred%。结果 治疗组在肺功能指标FEV1、FEV1/FVC%及FEV1pred%均较对照组改善明显，差异有统计学意义（P＜0.05），两组在TSF、ALB、Palb方面差异有统计学意义（P＜0.05）。结论在常规治疗的同时加用中医传统疗法如耳穴压豆治疗，对COPD患者营养状况的改善可能会起到更好效果。

耳穴压豆；COPD；营养不良；传统疗法

[Abstract]Objective To investigate the influence of traditional Chinese medical therapy on the nutritional status of COPD patients.Methods 52 cases of COPD patients in grade II-IV stable period with TCM syndrome differentiation of spleen and kidney deficiency type,were randomly divided into two groups,and the control group received salmeterol xinafoate and fluticasone propionate powder for inhalation,and the treatment group received auricular pressure therapy on this basis.The content changes of triceps skinfold thickness(TSF),serum albumin(ALB),prealbumin(Palb)before and after treatment were observed,and lung function indexes such as FEV1(first second expiratory volume),FEV1/ FVC%(the percentage of first second expiratory volume in forced vital capacity)and FEV1pred%were observed.Results There were significant differences in comparing lung function parameters such as FEV1,FEV1/FVC%and FEV1 pred%of the treatment group and the control group(P<0.05),and there were also statistically significant differences in comparing BMI%,TSF,ALB,Palb of the two groups(P<0.05).Conclusion The traditional Chinese medical therapies such as auricular pressure therapy in routine treatment can play a better role in improving the nutritional status of COPD patients.

[Key words]Auricular pressure therapy;COPD;Malnutrition;Conventional therapy

慢性阻塞性肺疾病（chronic obustrctive pulmonary disease，COPD）是一种慢性疾病，其致残和致死率均较高，目前已经成为全球第4大死亡原因[1，2]。COPD后期可出现包括抑郁、焦虑、营养不良等并发症，国外流行病学资料显示，COPD患者发生营养不良的机率介于25%～40%之间[3]，是COPD独立的预后因子[4，5]，且COPD患者的疾病严重程度影响其流行病学资料[6]。我国COPD患者出现营养不良的机率更高，有研究表明营养不良的发生与患者免疫功能下降相关，且COPD患者体重下降与其生存率呈负相关[7，8]。COPD患者营养不良的发生主要与长期胃肠道淤血、缺氧、口服药物对胃黏膜刺激等因素有关。除进行有效的营养支持外，联合应用中医传统疗法辨证施治对患者进行免疫调节，可以获得更好的疗效。……