支气管哮喘的中医特色疗法：艾灸
Summary
该方案提出了治疗支气管哮喘患者的艾灸治疗程序。
Abstract
支气管哮喘是一种慢性气道炎症性疾病，由于气道反应性增加，可导致反复喘息、呼吸急促、胸闷或咳嗽等症状。由于昼夜变化很大，这些症状经常在夜间或早晨发生或加重。艾灸是将中药在人体穴位上方焚烧烘烤，通过药物和热刺激来刺激人体经络活动，以预防和治疗疾病的一种治疗方法。根据中医辨证治的原理，在相应部位选穴位，效果一定。它被认为是支气管哮喘的特色中医治疗方法。该方案详细阐述了患者管理、材料准备、穴位选择、手术和术后护理的方法和步骤，以确保安全有效的艾灸治疗，以显着改善支气管哮喘患者的临床症状和生活质量。
Introduction
这里介绍的方案展示了艾灸在患者管理、材料准备、穴位选择、手术和术后护理方面治疗支气管哮喘的操作。该方案的目的是控制支气管哮喘患者的症状，并通过艾灸改善肺功能。
针灸是中医的重要组成部分。在支气管哮喘方面，针灸治疗积累了丰富的临床经验，尤其是艾灸更显示出独特的优势1,2,3,4。现代研究表明，温暖促进艾灸的生物学机制作用如下：艾灸激活穴位（局部启动），促进气血运动，调节神经内分泌免疫网络（调节通路），调节内脏功能（效应器官的反应）5,6,7。
支气管哮喘是一种慢性气道炎症性疾病，由于气道反应性增加，可导致反复喘息、呼吸急促、胸闷或咳嗽等症状。这些症状经常在夜间或早晨发生或加重8.支气管哮喘是世界上最常见的慢性肺部疾病之一，影响所有年龄段的人9.近年来，我国支气管哮喘的患病率逐年上升。最新的流行病学调查显示，20岁以上成年人哮喘的患病率为4.2%10。该病会导致气道重塑和高反应性，严重影响晚期患者的肺功能。目前，支气管哮喘的主要临床治疗方法是抗炎、解痉和对症治疗。然而，高复发率和顽固性概述了主要缺点，更不用说长期药物疗效差和缺乏理想的治疗方案了。与单纯吸入药物相比，艾灸可增强体液和细胞免疫，在治疗过程中具有显著的免疫调节作用11,12,13。通过将中药在人体穴位上方燃烧和烘烤，艾灸是一种通过药物和热刺激起作用的治疗方法。它具有温热经络祛寒、促进气循环祛除经络、祛停活络络等功效。它被认为是支气管哮喘的中医特色疗法14.
Protocol
该临床试验已获得成都中医药大学附属医院呼吸科审批委员会批准（No.KY2022022）。本研究支气管哮喘的诊断标准参考《支气管哮喘防治指南（2020年版）》8 ，中医药操作参考《中医疾病和证候诊断及治疗效果标准》15。典型病例为成都中医药大学附属医院呼吸科收治的确诊支气管哮喘患者。已获得患者的知情同意。可以获得协议中使用的所有材料来源（参见 <str…
Representative Results
8例符合标准的支气管哮喘患者接受艾灸治疗。所有患者支气管哮喘的诊断标准相同，艾灸治疗前后患者的肺功能FEV1比值、PEF比值（实际/预期百分比）和哮喘控制试验（ACT）评分均采用相同的方法进行测量。1个疗程后，所有患者肺功能FEV1比值、PEF比值、ACT评分均有所改善。治疗前肺功能FEV1比值为68.23%±4.35%，PEF比值为65.91%±4.34%，ACT评分为16.13±2.30分。治疗后肺功能FEV1比值为77.33%±5.53%，PEF比值为7…
Discussion
支气管哮喘引起的气道炎症是一种级联免疫反应，涉及各种免疫细胞、细胞因子和炎症介质19。哮喘患者的支气管活检显示存在嗜酸性粒细胞、活化的肥大细胞和基于 Th2 细胞的 T 细胞浸润20。肺功能指标FEV1和PEF反映了气道阻塞的严重程度，是客观判断和评价哮喘病情最常用的指标8。支气管哮喘的西医治疗方法是糖皮质激素、β2受体激动剂、?…
Divulgations
The authors have nothing to disclose.
Acknowledgements
感谢成都中医药大学附属医院科技发展基金项目（第20ZL10号）的财政支持。作者要感谢杨洋先生作为模特参与我们的研究。
Materials
| Forceps | Shandong Weigao Group MEDICAL Polymer Co., Ltd. | Shandong Medical Device Registration Certificate: No.20182640148 | |
| Gauze | Shandong Angyang Medical Co.,Ltd | Shandong Medical Device Registration Certificate: No.20152140569 | |
| Lighter | Ningbo Qiant Technology Co., Ltd | Chaofan-CF-1 | |
| Moxa Stick | Nanjing Tongrentang Lejialaopu Health Technology Co., Ltd | 10028859806337 | |
| Surgical Curved Plate | Yuekang Hardware Medical Instrument Factory, Caitang Town, Chao'an District, Chaozhou City | Medium Size |
References
- Yin, L. M. Basic strategy of acupuncture translational medicine research: acupuncture prevention and treatment of asthma as an example. Chinese Acupuncture & Moxibustion. 42 (12), 1327-1330 (2022).
- Li, D. M., Li, Q., Chen, X. J., Zhu, X. Y., Luo, X. Z. Therapeutic effect of smokeless moxibustion on children with acute attack of bronchial asthma. Journal of Emergency in Traditional Chinese Medicine. 31 (12), 2159-2162 (2022).
- Zhou, J. Y., et al. Effect of "joint treatment of lung and intestine" with moxibustion on lung function and airway inflammation in asthmatic rats. Acupuncture Research. 47 (11), 969-974 (2022).
- Bai, L., Chen, H., Zhang, X. Effect of moxibustion on lung function and serum inflammatory factors in patients with asthma attack stage heat syndrome based on "heat syndrome being treated with moxibustion". World Journal of Integrated Traditional and Western Medicine. 16 (10), 1783-1786 (2021).
- Chang, X., et al. Research on mechanisms and principles of warm-unblock and warm-tonic effects on moxibustion. World Chinese Medicine. 8 (8), 875-879 (2013).
- Huang, K. Y., et al. From biological effects of local cutaneous thermal stimulation to moxibustion therapy. Acupuncture Research. 40 (6), 504-509 (2015).
- Tang, Y. N., et al. Research progress of mechanism of moxibustion heat, light and smoke. Chinese Journal of Information on TCM. 29 (11), 148-151 (2022).
- Asthma group of Chinese Thoracic Society. Guidelines for bronchial asthma prevent and management (2020 edition). Chinese Journal of Tuberculosis and Respiratory Diseases. 43 (12), 1023-1048 (2020).
- Reddel, H. K., et al. Global Initiative for Asthma Strategy 2021: executive summary and rationale for key changes. The European Respiratory Journal. 59 (1), 2102730 (2021).
- Dixon, A. E., Carr, T. F., Que, L. G. Advances in Asthma. Semin Respir Crit Care Med. 43 (5), 593-594 (2022).
- Zhang, W., Chen, M. R., Xiong, J. Effects of different quantity of moxibustion at "Dazhui" (GV 14) on cellular immunity in asthma rats. Acupuncture Research. 37 (3), 202-205 (2012).
- Lei, J., Luo, L. Y., Sun, Y., Qiao, S. Mechanism of acupuncture at "Feishu" (BL13) to correct Th1/Th2 immune balance in asthma model rats based on IL-27/STAT1 pathway. Journal of Hunan University of Chinese Medicine. 42 (6), 986-993 (2022).
- Hua, J. S., et al. Effects of Shao’s five needle method on GATA-3/T-bet expression in rats with chronic asthma. Journal of Basic Chinese Medicine. 26 (8), 1084-1087 (2020).
- Ogbu, C. E., et al. Trends in the use of complementary and alternative therapies among US adults with current asthma. Epidemiologia. 4, 94-105 (2023).
- Department of Medical Affairs, National Administration of Traditional Chinese Medicine. Criteria of diagnosis and therapeutic effect of disease and syndromes in traditional Chinese medicine. Department of Medical Affairs, National Administration of Traditional Chinese Medicine. , 2 (2020).
- Shen, X. Y. . Meridians and Acupoints. 61, 178-179 (2016).
- . Nomenclature and location of meridian points Available from: https://openstd.samr.gov.cn/bzgk/gb/newGbinfo?hcno=397548AE7248D3D87DD15E0AB8107185 (2023)
- Chen, Y. F., et al. Advances in immune imbalance in airway inflammatory injury in bronchial asthma. Journal of China Medical University. 52 (4), 371-374 (2023).
- Fei, F., Ji, Y. F., Huang, M. New understanding of pathogenesis of bronchial asthma. International Journal of Respiration. 38 (12), 955-960 (2018).
- Asthma group of Chinese Thoracic Society. Guidelines for the prevention and treatment of bronchial asthma. Chinese Journal of Tuberculosis and Respiratory Diseases. 39 (9), 675-697 (2016).
- Chang, X., Zhang, T., Sui, Y. Y., Zhang, Q. X. Research on the pathological mechanism of bronchial asthma and progress in clinical treatment with traditional Chinese and Western medicine. Journal of Shandong University of Traditional Chinese Medicine. 42 (3), 272-275 (2018).
- Xu, Y. D., et al. Proteomic analysis reveals the deregulation of inflammation-related proteins in acupuncture-treated rats with asthma onset. Evidence-Based Complementary and Alternative Medicine. 2012, 850512 (2012).
- Xu, Y. D., et al. Exogenous S100A8 protein inhibits PDGF-induced migration of airway smooth muscle cells in a RAGE-dependent manner. Biochemical and Biophysical Research Communications. 472 (1), 243-249 (2016).
- Wang, Y., et al. Influence of acupuncture on expression of T-type calcium channel protein in airway smooth muscle cell in airway remodeling rats with asthma. Chinese Acupuncture & Moxibustion. 32 (6), 534-540 (2012).
- Li, L., Cao, Z. D., Yan, L., Huang, B. J., Zhu, Y. M. Effects of Du moxibustion on asthmatic mice and TRPV1-related neuroimmune inflammation. Shanxi Journal of Traditional Chinese Medicine. 38 (1), 60-64 (2022).
- Mao, J. X. Research progress on immunomodulatory mechanism of acupuncture-moxibustion in prevention and treatment of bronchial asthma. Shanghai Journal of Acupuncture and Moxibustion. 39 (1), 110-115 (2020).
- Wang, K., Gu, M. E., Wu, H. G., Zhang, J. B., Liu, H. R. Discussion on the direction of moxibustion. Chinese Acupuncture & Moxibustion. 38 (3), 281-283 (2018).
- Zhao, H. Y., et al. Inhibiting ATG5 mediated autophagy to regulate endoplasmic reticulum stress and CD4+ T lymphocyte differentiation: Mechanisms of acupuncture’s effects on asthma. Biomedicine & Pharmacotherapy. 142, 112045 (2021).
- Liu, Y. L., et al. Feishu acupuncture inhibits acetylcholine synthesis and restores muscarinic acetylcholine receptor M2 expression in the lung when treating allergic asthma. Inflammation. 41 (3), 741-750 (2018).
- Wang, M. H., Chen, C., Yeh, M. L., Lin, J. G. Using traditional Chinese medicine to relieve asthma symptoms: a systematic review and meta-analysis. The American Journal of Chinese Medicine. 47 (8), 1659-1674 (2019).
- Yang, Y. Q., et al. Considerations for use of acupuncture as supplemental therapy for patients with allergic asthma. Clinical Reviews in Allergy & Immunology. 44 (3), 254-261 (2013).
- Li, M., Zhang, X., Bao, H. P., Li, C. L., Zhang, P. T. Acupuncture for asthma: Protocol for a systematic review. Médecine. 96 (26), e7296 (2017).
- Li, C. X., et al. Advances in the clinical research on acupuncture in treatment of respiratory diseases. Acupuncture Research. 45 (2), 169-172 (2020).
- Zhang, M. R. Clinical study on treatment of bronchial asthma with ginger separated moxibustion and western medicine. Asia-Pacific Traditional Medicine. 11 (16), 110-111 (2015).
- Ma, C. Y. Comparative study on treatment of bronchial asthma by Sanfu days moxibustion combined with western medicine. Cardiovascular Disease Electronic Journal of Integrated Traditional Chinese and Western Medicine. 6 (35), 183 (2018).
- Li, J. Effect of ginger partitioned moxibustion in Sanfu days combined with auricular point pressing beans on lung function in patients with bronchial asthma. Journal of External Therapy of Traditional Chinese Medicine. 29 (4), 38-39 (2020).
- Qin, S., et al. Clinical therapeutic effect on bronchial asthma by the observation of skin reaction after acupoint application based on chronic disease management platform of asthma. Chinese Acupuncture & Moxibustion. 41 (11), 1221-1224 (2021).
- Zhou, J. Y. Effects of acupuncture and moxibustion on lung function and airway inflammation in asthmatic. Chinese Journal of Integrated Traditional and Western Medicine. , (2023).
- Liu, Y. L., et al. Acupuncture therapy for bronchial asthma: an overview of systematic reviews. Chinese Journal of Evidence-Based Medicine. 22 (8), 955-963 (2022).
- Liu, Q., et al. Clinical observation on the correlation between moxibustion sensation and distance of moxa stick. Journal of Acupuncture and Tuina Science. 15 (4), 237-241 (2017).
- Zhang, G. S., et al. An analysis of acupoint selection rule of moxibustion for asthma based on literature. Journal of Hunan University of Chinese Medicine. 38 (11), 1278-1282 (2018).
- Zhang, G. S., et al. Effect of moxibustion on respiratory function and cutaneous histamine and neuropeptide contents of "Feishu" (BL 13) in asthmatic rats. Acupuncture Research. 45 (2), 117-121 (2020).
- Chen, X. H., He, H. M. Effects of moxibustion at "Feishu" (BL 13) and "Shenshu" (BL 23) on peripheral blood T cells and serum interleukin in asthmatic rats. Acupuncture Research. 42 (2), 159-162 (2017).
- Zhang, G. S., et al. Effect of moxibustion at Feishu (BL 13) on airway inflammation in asthma model rats. Journal of Acupuncture and Tuina Science. 18 (3), 165-173 (2020).
- Zhang, G. S., et al. Commonality and pattern analysis of acupoint selection in moxibustion treatment of asthma. Journal of Acupuncture and Tuina Science. 17 (6), 451-456 (2019).
- Dong, J., Wu, L. G. R. L., Sun, F. Treatment of asthma syndrome of lung and kidney deficiency type with Shu- And Mu- point combination. Nei Mongol Journal of Traditional Chinese Medicine. 27 (1), 36 (2008).
- Qiao, Y., et al. Effect of moxa-cone moxibustion at lung’s back-shu points and front-mu points on Th17/Treg balance in mice with asthma. Chinese Acupuncture & Moxibustion. 40 (11), 1217-1222 (2020).
- Wei, W., Ou, Q. W., Lin, J. Efficacy observation of acupuncture at back-Shu and front-Mu acupoints group combined with medication for cough variant asthma and its impact on macrophage polarization. Shanghai Journal of Acupuncture and Moxibustion. 41 (7), 644-649 (2022).
- Zhang, Q., Qiao, Y. Research progress on antiasthmatic effect and mechanism of Dingchuan and Tiantu acupoints. Journal of Guangxi University of Chinese Medicine. 23 (3), 64-66 (2020).
- Wang, W., Yang, D. H. Research progress of Dingchuan point. Journal of Chinese Physician. 16 (11), 1581-1583 (2014).
- Zhao, G. Y., Wang, W. Interventional effect of acupoint injection of Dingchuan point on the expression of GM-CSF mRNA in asthmatic guinea pigs. Journal of Clinical Acupuncture and Moxibustion. 25 (6), 38-40 (2009).
Citer Cet Article
Sun, W., Liu, K., Yang, R., Guo, L., Gao, P. A Traditional Chinese Medicine Characteristic Therapy for Bronchial Asthma: Moxibustion. J. Vis. Exp. (195), e65119, doi:10.3791/65119 (2023).