Chinese General Practice ›› 2025, Vol. 28 ›› Issue (11): 1367-1375.DOI: 10.12114/j.issn.1007-9572.2024.0044

• Original Research·Combination of Chinese and Western Medicine • Previous Articles     Next Articles

Acupoint Application with Tianjiu Powder for Pre-asthma: a Randomized Controlled Trial

  

  1. 1. The Second Clinic Medical College, Guangzhou University of Chinese Medicine/State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangzhou 510120, China
    2. Guangdong-Hong Kong-Macao Joint Laboratory for Research of Traditional Chinese Medicine and Immune Diseases/The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
    3. Guangdong Provincial Key Laboratory of Clinical Research on TCM Syndromes/The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
  • Received:2024-02-25 Revised:2024-06-10 Published:2025-04-15 Online:2025-02-06
  • Contact: CHEN Yuanbin

天灸散穴位贴敷治疗支气管哮喘前期的随机对照研究

  

  1. 1.510120 广东省广州市,广州中医药大学第二临床医学院/省部共建中医湿证国家重点实验室
    2.510120 广东省广州市,粤港澳中医药与免疫疾病研究联合实验室 广州中医药大学第二附属医院
    3.510120 广东省广州市,广东省中医证候临床研究重点实验室 广州中医药大学第二附属医院
  • 通讯作者: 陈远彬
  • 作者简介:

    作者贡献:

    郭鑫收集数据,进行表格的绘制与展示,撰写论文;周明娟、范斐婷筛选病例,对患者进行随访管理;郭鑫、肖晶旻负责统计学处理;郭鑫、池逸和进行数据的收集与整理;吴蕾、陈远彬进行论文的修订;林琳负责研究监督与质控;陈远彬提出研究思路,负责研究设计,筛选病例,对文章整体负责,监督管理。

  • 基金资助:
    省部共建中医湿证国家重点实验室项目(SZ2021ZZ42,SZ2023ZZ11); 2020广东省科技创新战略专项资金(粤港澳联合实验室)项目(2020B1212030006); 广东省科技计划项目(2016A020215187,2023B1212060063); 广州市中医药防治慢性咳喘病重点实验室(2023A03J0226); 广东省中医药局科研项目(20221175,20233020); 广东省中医院中医药科学技术研究专项(YN2022MS02); 广东省中医院周仲瑛学术经验传承工作室(中医二院[2014]89号); 广东省中医药局林琳省名中医传承工作室(粤中医办函[2023]108号)

Abstract:

Background

Pre-asthma is a pre-disease state of asthma. However, effective interventions against pre-asthma at currently scant.

Objective

To assess the clinical efficacy and safety of acupoint application with Tianjiu Powder on treating pre-asthma, aiming to develop a traditional Chinese medicine (TCM) preventive therapy regimen for external treatment of pre-asthma.

Methods

This was a randomized, double-blind, placebo-parallel controlled trial. A total of 123 pre-asthma patients treated in the Guangdong Provincial Hospital of Chinese Medicine from August 1, 2016 to December 31, 2019 were recruited and randomly assigned into the treatment group (n=62) and control group (n=61) at a ratio of 1∶1. During the experimental period, 12 cases were dropped off in the treatment group and finally 50 patients who completed the experiments were involved in. In the control group, 38 cases were finally involved in after excluding 22 cases of drop-off and 1 with bronchiectasis. Acupoint application of Tianjiu Powder and placebo was respectively given to patients of the treatment group (n=50) and control group (n=38). After 24 weeks of treatment, patients were followed up for another 24 weeks. Primary and secondary outcomes before the treatment (V1 visit), at 12 weeks (V2 visit), 24 weeks (V3 visit) and 48 weeks of treatment (end of the follow-up, V4 visit) were compared between groups. The primary outcome was the negative conversion rate of the bronchial provocation test (BPT) /bronchial dilation test (BDT). Secondary outcomes included the positive rate of BPT/BDT, forced expiratory volume in one second (FEV1), small airway function indicators, TCM syndrome score, the 36-item Short-Form (SF-36) score, serum eosinophil cationic protein (ECP), eosinophil percentage (EOS%) and total serum immunoglobulin E (IgE). Adverse events were recorded during treatment.

Results

The negative conversion rate of BPT/BDT at V2 (66.1% vs. 47.5%), V3 (64.5% vs. 44.3%) and V4 (58.1% vs. 36.1%) was significantly higher in the treatment group than that of control group (P<0.05). The main effect of grouping on FEV1 change was significant in BDT (Pgrouping<0.05). The change in FEV1 of BDT at V4 was significantly less in the treatment group than that of the control group (P<0.05). The changes in the peak expiratory flow (PEF) before and after treatment at V2 and V3 were significantly larger in the treatment group than those of control group (P<0.05). Physical Functioning (PF) and Role Physical (RP) scores of the SF-36 at V4 were significantly higher in the treatment group than those of the control group (P<0.05). The General Health (GH) score of the SF-36 before the treatment was significantly lower in the treatment group than that of control group (P<0.05), but no significant difference after treatment was detected between groups (P>0.05). TCM syndrome scores at V2, V3 and V4 were significantly lower in the treatment group than those of the control group, but no significant differences were detected between the two groups (P>0.05). There was no significant difference in ECP at V1 between the two groups (P>0.05), which, at V3 was significantly higher in the treatment group than control group (P<0.05). There were no significant differences in EOS% and its difference, ECP difference and serum total IgE and its difference at V1 and V3 between the two groups (P>0.05). There was no significant difference in the incidence of adverse events between the two groups (P>0.05) .

Conclusion

Acupoint application with Tianjiu Powder can enhance the rate of negative conversion rate of BPT/BDT, increase PEF, and reduce the change in FEV1 of BDT. It improves the quality of life and offers a high safety in treating pre-asthma.

Key words: Bronchial asthma, External application of Chinese medicine, Acupoint application of Chinese medicine, Randomized controlled trial

摘要:

背景

支气管哮喘(以下简称哮喘)前期是哮喘的疾病前状态,研究表明此类患者可能更易发展为哮喘,然而目前尚缺乏有效的干预手段。

目的

评价天灸散穴位贴敷治疗哮喘前期的临床疗效与安全性,形成哮喘前期的中医治未病外治方案。

方法

本研究采用随机、双盲、安慰剂平行对照试验设计。病例来源于2016-08-01—2019-12-31在广东省中医院就诊的123例哮喘前期患者,随机分配为试验组62例和对照组61例。观察期间试验组完成50例,脱落12例;对照组完成38例,脱落22例,剔除1例(合并支气管扩张症)。试验组(50例)给予天灸散穴位贴敷,对照组(38例)给予安慰剂穴位贴敷。疗程24周,治疗结束后随访24周。比较两组患者治疗前(V1访视)、治疗第12周(V2访视)、第24周(V3访视)及第48周随访结束(V4访视)时的主要结局指标(支气管激发/舒张试验转阴率)及次要结局指标[支气管激发/舒张试验阳性率,肺功能第1秒用力呼气末容积(FEV1)和小气道功能指标,中医症状积分,健康状况调查问卷(SF-36)评分,血清嗜酸细胞阳离子蛋白(ECP)和嗜酸性粒细胞比例(EOS%),血清总免疫球蛋白IgE(总IgE)水平]。治疗期间观察不良事件发生情况。

结果

V2访视、V3访视、V4访视时试验组支气管激发/舒张试验转阴率(66.1%、64.5%、58.1%)高于对照组(47.5%、44.3%、36.1%)(P<0.05);组别对支气管舒张试验FEV1变化值主效应显著(P组间<0.05),V4访视时试验组支气管舒张试验FEV1变化值小于对照组(P<0.05);V2访视、V3访视时试验组呼气峰值流量(PEF)治疗前后差值大于对照组(P<0.05);V4访视时试验组SF-36的生理机能(PF)、生理职能(RP)维度评分高于对照组(P<0.05);治疗前试验组总体健康(GH)维度评分低于对照组(P<0.05),治疗后两组GH维度评分比较,差异无统计学意义(P>0.05);V2访视、V3访视、V4访视时试验组中医证候总积分低于对照组,但组间差异无统计学意义(P>0.05);V1访视两组血清ECP水平组间比较,差异无统计学意义(P>0.05),V3访视时试验组血清ECP高于对照组(P<0.05),V1访视、V3访视时两组血清EOS%水平及差值、ECP差值和血清总IgE水平及差值组间比较,差异无统计学意义(P>0.05)。两组不良事件发生率比较,差异无统计学意义(P>0.05)。

结论

天灸散穴位贴敷有效提高哮喘前期患者的支气管激发/舒张试验转阴率,增加PEF,减少支气管舒张试验后FEV1变化值,改善生活质量,且安全性好。

关键词: 支气管哮喘, 中医外治法, 中药穴位贴敷, 随机对照试验