加味黄芪六君子汤联合针灸及穴位敷贴治疗肺脾气虚型咳嗽变异性哮喘临床研究
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R562.25

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浙江省中医药科技计划项目(2025ZX373)


Clinical Study on Modified Huangqi Liujunzi Decoction Combined with Acupuncture,Moxibustion,and Acupoint Application for Cough Variant Asthma of Lung-Spleen Qi Deficiency Type
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    摘要:

    目的:观察加味黄芪六君子汤联合针灸及穴位敷贴治疗肺脾气虚型咳嗽变异性哮喘(CVA) 的临 床疗效。方法:选取2024年8月—2025年6月仙居县人民医院收治的60例肺脾气虚型CVA患者,按随机数字 表法分为对照组和观察组各30例。2组均给予常规对症治疗,在此基础上对照组予以布地奈德福莫特罗吸入粉 雾剂治疗,观察组予以加味黄芪六君子汤联合针灸及穴位敷贴治疗。2组均以10天为1个疗程,治疗1个疗程 后休息3天,治疗3个疗程。评价2组临床疗效,比较2组治疗前后中医证候积分、咳嗽症状积分、肺功能[呼 气流量峰值(PEF) 平均昼夜变异率、第1秒用力呼气容积占预计值百分比(FEV1%pred)、FEV1/用力肺活 量(FVC)]、FEV1改善率、嗜酸性粒细胞数(EOS)、咳嗽频率、免疫应答指标[辅助性T细胞(Th) 1/Th2、 干扰素-γ (IFN-γ)、白细胞介素-4 (IL-4) ]。结果: 观察组总有效率为90.00% (27/30), 对照组为 76.67%(23/30),2组总有效率比较,差异无统计学意义(P>0.05)。治疗后,2组中医证候积分、咳嗽症状积 分较治疗前降低(P<0.05),且观察组中医证候积分、咳嗽症状积分低于对照组(P<0.05)。治疗后,2组 FEV1%pred、FEV1/FVC较治疗前升高,PEF平均昼夜变异率较治疗前降低(P<0.05);且观察组FEV1%pred、 FEV1/FVC 高于对照组,PEF 平均昼夜变异率低于对照组(P<0.05)。治疗后,2 组EOS 水平较治疗前降 低(P<0.05);且观察组EOS水平低于对照组(P<0.05)。治疗后,2组咳嗽频率较治疗前降低(P<0.05), 且观察组咳嗽频率低于对照组(P<0.05)。治疗后,2 组Th1/Th2、IFN-γ 较治疗前升高,IL-4 较治疗前降 低(P<0.05);且观察组Th1/Th2、IFN-γ高于对照组,IL-4低于对照组(P<0.05)。2组不良反应发生率比 较,差异无统计学意义(P>0.05)。结论:在“培土生金”理论指导下,采用加味黄芪六君子汤联合针灸及穴 位敷贴能降低肺脾气虚型CVA患者的咳嗽频率,有助于控制咳嗽症状,提高肺功能,促进CVA患者康复。

    Abstract:

    Abstract: Objective: To observe the clinical efficacy of modified Huangqi Liujunzi Decoction combined with acupuncture, moxibustion, and acupoint application in treating cough variant asthma (CVA) of lung-spleen qi deficiency type. Methods: A total of 60 patients with CVA of lung-spleen qi deficiency type admitted to Xianju People's Hospital from August 2024 to June 2025 were selected and randomly divided into a control group and an observation group according to a random number table method, with 30 cases in each group. Both groups received conventional symptomatic treatment. In addition, the control group was treated with Budesonide and Formoterol Fumarate Powder for Inhalation, while the observation group was treated with modified Huangqi Liujunzi Decoction combined with acupuncture, moxibustion, and acupoint application. Both groups were treated for 10 days as one course,with a 3-day break between courses,and a total of 3 consecutive courses. Clinical efficacy was evaluated,and traditional Chinese medicine syndrome scores, cough symptom scores, pulmonary function [peak expiratory flow (PEF) mean diurnal variation rate, forced expiratory volume in 1 second as a percentage of predicted value (FEV1%pred),FEV1/forced vital capacity (FVC)],FEV1 improvement rate,eosinophil count (EOS),cough frequency, and immune response indicators [helper T cell (Th)1/Th2 ratio, interferon-γ (IFN-γ), interleukin- 4 (IL-4)] were compared between the two groups before and after treatment. Results: The total effective rate was 90.00% (27/30) in the observation group and 76.67% (23/30) in the control group, with no significant difference between the two groups (P>0.05). After treatment,traditional Chinese medicine syndrome scores and cough symptom scores decreased in both groups compared to before treatment (P<0.05),and the observation group had lower scores than the control group (P<0.05). The FEV1%pred and FEV1/FVC increased in both groups compared to before treatment, while the PEF mean diurnal variation rate decreased (P<0.05). Moreover, the observation group had higher FEV1%pred and FEV1/FVC and a lower PEF mean diurnal variation rate than the control group (P<0.05). The EOS levels decreased in both groups compared to before treatment (P<0.05), and the observation group had lower EOS levels than the control group (P<0.05). Cough frequency decreased in both groups compared to before treatment (P<0.05), and the observation group had lower cough frequency than the control group (P<0.05). The Th1/Th2 ratio and IFN- γ levels increased in both groups compared to before treatment, while IL-4 levels decreased (P<0.05). The observation group showed higher Th1/Th2 ratio and IFN-γ levels and lower IL-4 levels than the control group (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Guided by the theory of "reinforcing earth to generate metal," modified Huangqi Liujunzi Decoction combined with acupuncture,moxibustion,and acupoint application can reduce cough frequency,help control cough symptoms,improve pulmonary function,and promote recovery in patients with CVA of lung-spleen qi deficiency type.

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郭婷婷,李倩倩,应一.加味黄芪六君子汤联合针灸及穴位敷贴治疗肺脾气虚型咳嗽变异性哮喘临床研究[J].新中医,2026,58(7):8-14

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  • 在线发布日期: 2026-04-20
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