张善芳 汤杰

摘   要：目的  觀察穴位注射黄芪注射液联合沙美特罗替卡松粉吸入剂（舒利迭）治疗慢性阻塞性肺疾病（COPD）稳定期的临床疗效。方法  选取2016年8月～2018年2月上海市宝山区中西医结合医院呼吸内科门诊慢性阻塞性肺病临床缓解期的患者66例，随机分为试验组和对照组，各33例。对照组予以舒利迭治疗，试验组予以穴位注射黄芪注射液联合舒利迭治疗，疗程均2个月。观察两组治疗前后中医证候积分主证分、CAT评分、血清IL-8变化。结果  治疗后，两组中医证候主证分均改变，试验组与治疗前比较差异有统计学意义（P<0.05），对照组与治疗前比较差异无统计学意义（P>0.05），且试验组与对照组主证分改变比较，差异有统计学意义（P<0.05）;治疗后，试验组CAT评分下降优于对照组，差异有统计学意义（P<0.05）;治疗后，试验组IL-8水平下降优于对照组，差异有统计学意义（P<0.05）。结论  穴位注射能改善慢性阻塞性肺疾病患者的中医证候主证分，降低患者的炎症介质，提高患者的生活质量。

关键词：穴位注射;慢性阻塞性肺疾病;肺胀病;CAT评分

中图分类号： R563.9                                 文献标识码：A                                DOI：10.3969/j.issn.1006-1959.2018.16.041

文章编号：1006-1959（2018）16-0131-04

Clinical Observation of Acupoint Injection Combined with Salmeterol and Fluticasone Powder Inhalation in the Treatment of Chronic Obstructive Pulmonary Disease

ZHANG Shan-fang1，TANG Jie2

（1.Baoshan Branch of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine/Department of Respiratory Medicine，Shanghai Baoshan Hospital of Integrated Traditional Chinese and Western Medicine，Shanghai 20199，China;

2.Department of Respiratory Medicine，Yueyang Hospital of Integrated Chinese and Western Medicine，Shanghai University of Traditional Chinese Medicine，Shanghai 200000，China）

Abstract：Objective  To observe the clinical efficacy of acupoint injection of Astragalus injection combined with salmeterol and fluticasone powder inhalation（Sulidide）in the treatment of chronic obstructive pulmonary disease（COPD）.Methods  A total of 66 patients with clinical remission of chronic obstructive pulmonary disease in the Department of Respiratory Medicine，Shanghai Baoshan District Hospital of Integrated Traditional Chinese and Western Medicine from August 2016 to February 2018 were randomly divided into the experimental group and the control group，33 cases each.The control group was treated with sulidide，and the experimental group was treated with acupoint injection of astragalus injection combined with sullidide for 2 months.The scores of the main syndrome，CAT score and serum IL-8 of TCM syndromes before and after treatment were observed.Results  After treatment，the scores of TCM syndromes in the two groups were changed，there was significant difference between the experimental group and the pre-treatment（P<0.05）.There was no significant difference between the control group and the pre-treatment（P>0.05），the test group and the control group were compared with the main syndrome scores，the difference was statistically significant（P<0.05）.After treatment，the CAT score of the experimental group was lower than that of the control group，and the difference was statistically significant（P<0.05）.After treatment，the IL-8 level of the test group was lower than that of the control group，the difference was statistically significant（P<0.05）.Conclusion  Acupoint injection can improve the syndrome of TCM syndromes in patients with chronic obstructive pulmonary disease， reduce the inflammatory mediators and improve the quality of life of patients.

Key words：Acupoint injection;Chronic obstructive pulmonary disease;Lung bloating;CAT score

慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）的高发病率、高致残率、高死亡率使其成为我国主要慢性病之一[1]。其临床表现为气道炎症呈进行性加重，肺功能的不可逆转使患者的生活质量进行性下降。目前，中西医结合治疗COPD成为一个新的方向[2]。本实验在原有西医治疗的基础上，增加了中医穴位注射治疗，旨在通过中西医结合治疗减少患者的发病率、降低死亡率，现报告如下。

1 资料与方法

1.1一般资料  选取2016年8月～2018年2月上海市宝山区中西医结合医院呼吸内科门诊慢性阻塞性肺病临床缓解期的患者66例，按照随机数字表法分为试验组及对照组，各33例。试验组入组33例，脱落3例（主动退出），完成30例，男20例，女10例，年龄60～80岁，平均年龄（70.83±6.37）岁，病程6～23年，平均病程（9.40±3.78）年。……