| 引用本文: |
陈代平, 赵婕, 赵丽华, 陆喜珍.基于“冬病夏治”理论观察隔药饼灸对COPD稳定期患者肺功能及CAT评分的影响[J].湖南中医药大学学报,2026,46(9):1834-1839[点击复制] |
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| 基于“冬病夏治”理论观察隔药饼灸对COPD稳定期患者肺功能及CAT评分的影响 |
| 陈代平,赵婕,赵丽华,陆喜珍 |
| (上海市第六人民医院金山分院中医内科, 上海 201599) |
| 摘要: |
| 目的 基于“冬病夏治”理论，观察隔药饼灸对慢性阻塞性肺疾病（COPD）稳定期患者肺功能及COPD评估测试问卷（CAT）评分的影响。方法 选取2023年7月至2025年9月于上海市第六人民医院金山分院就诊的COPD稳定期患者150例，采用随机数字表法分为观察组与对照组（各75例），研究期间观察组脱落3例、对照组脱落2例，最终观察组72例、对照组73例纳入统计分析。对照组给予西医常规治疗，治疗周期为12周；观察组在对照组西医常规治疗的基础上，于三伏期间加用隔药饼灸治疗，治疗频率为隔日治疗1次，共治疗12次。以肺功能[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）]为主要指标，以CAT评分、血清炎症因子[肿瘤坏死因子-α（TNF-α）、髓过氧化物酶（MPO）、白细胞介素-6（IL-6）]、膈肌超声参数[膈肌增厚分数（DTF）、深呼吸膈肌移动度（DE-DB）]、急性加重次数为次要指标，观察比较两组患者治疗前、治疗后及治疗后6个月随访时上述各指标的变化，并观察治疗后的临床疗效。结果 治疗后及治疗后6个月随访时，两组患者FEV1% pred、FEV1/FVC均较治疗前升高（P<0.05），且观察组均高于对照组（P<0.05）；两组患者CAT评分及TNF-α、MPO、IL-6水平均较治疗前降低（P<0.05），且观察组均低于对照组（P<0.05）；两组患者DTF、DE-DB均较治疗前升高（P<0.05），且观察组均高于对照组（P<0.05）。观察组总有效率为90.3%，高于对照组的75.3%（P<0.05）。治疗后6个月内随访，观察组急性加重次数少于对照组（P<0.05）。结论 基于“冬病夏治”理论的隔药饼灸可有效改善COPD稳定期患者肺功能，降低CAT评分，其作用机制可能与抑制全身炎症反应、改善膈肌功能有关，并能降低急性加重风险，值得临床推广应用。 |
| 关键词: 慢性阻塞性肺疾病|冬病夏治|隔药饼灸|肺功能|COPD评估测试问卷评分|血清炎症因子|膈肌超声 |
| DOI：10.3969/j.issn.1674-070X.2026.09.011 |
| 投稿时间：2026-05-13 |
| 基金项目:上海市金山区科学技术委员会医药卫生科技创新资金项目(2023-WS-39);上海市医疗服务与保障能力提升项目(Z15080004-03)。 |
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| Moxibustion on herbal cake guided by the theory of “treating winter diseases in summer” for patients with stable COPD: effects on pulmonary function and CAT scores |
| CHEN Daiping, ZHAO Jie, ZHAO Lihua, LU Xizhen |
| (Department of Chinese Internal Medicine, Jinshan Branch of Shanghai Sixth People's Hospital, Shanghai 201599, China) |
| Abstract: |
| Objective To evaluate the effects of moxibustion on herbal cake, guided by the theory of "treating winter diseases in summer," on pulmonary function and COPD assessment test (CAT) scores in patients with stable chronic obstructive pulmonary disease (COPD). Methods A total of 150 patients with stable COPD treated at Jinshan Branch of Shanghai Sixth People's Hospital from July 2023 to September 2025 were enrolled and randomly divided into observation group and control group using a random number table, with 75 patients in each group. During the study, three patients in observation group and two in control group dropped out. Ultimately, 72 patients in observation group and 73 in control group were included in the statistical analysis. The control group received conventional Western medical treatment for 12 weeks. In addition to the same conventional treatment, the observation group received moxibustion on herbal cake during the Sanfu period, once every other day for a total of 12 sessions. The primary outcomes were pulmonary function parameters, including forced expiratory volume in 1 s as a percentage of the predicted value (FEV1%pred) and the ratio of FEV1 to forced vital capacity (FEV1/FVC). Secondary outcomes included CAT scores; serum inflammatory markers, including tumor necrosis factor-α (TNF-α), myeloperoxidase (MPO), and interleukin-6 (IL-6); diaphragmatic ultrasonographic parameters, including diaphragmatic thickening fraction (DTF) and diaphragmatic excursion during deep breathing (DE-DB); and the number of acute exacerbations. Changes in these outcomes were compared between the two groups at baseline, immediately after treatment, and at the 6-month post-treatment follow-up. Clinical efficacy after treatment was also evaluated. Results After treatment and at the 6-month post-treatment follow-up, FEV1%pred and FEV1/FVC increased from baseline in both groups (P<0.05) and were higher in observation group than in control group (P<0.05). CAT scores and serum TNF-α, MPO, and IL-6 levels decreased from baseline in both groups (P<0.05) and were lower in the observation group than in the control group (P<0.05). At both post-treatment assessment points, DTF and DE-DB increased from baseline in both groups(P<0.05). and were higher in the observation group than in the control group (P<0.05). The overall response rate was 90.3% in the observation group, higher than 75.3% in the control group (P<0.05). During the 6-month post-treatment follow-up, the observation group experienced fewer acute exacerbations than the control group (P<0.05). Conclusion Moxibustion on herbal cake guided by the theory of "treating winter diseases in summer" may effectively enhance pulmonary function and reduce CAT scores in patients with stable COPD. Its mechanism of action may be associated with suppression of systemic inflammation and enhancement of diaphragmatic function. It may also reduce the risk of acute exacerbations, supporting its wider clinical application. |
| Key words: chronic obstructive pulmonary disease|treating winter diseases in summer|moxibustion on herbal cake|pulmonary function|COPD assessment test score|serum inflammatory markers|diaphragmatic ultrasonography |
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