Summary

En traditionel kinesisk medicin karakteristisk terapi for bronchial astma: Moxibustion

Published: May 12, 2023
doi:

Summary

Denne protokol præsenterer en helbredende procedure for moxibustion til behandling af patienter med bronchial astma.

Abstract

Bronkial astma er en kronisk inflammatorisk sygdom i luftvejene, som kan føre til symptomer såsom tilbagevendende hvæsen, åndenød, trykken for brystet eller hoste som følge af øget luftvejsreaktivitet. Med høj daglig variation forekommer eller forværres disse symptomer ofte om natten eller om morgenen. Ved at brænde og stege den kinesiske medica over humane akupunkter er moxibustion en type behandling, der stimulerer aktiviteten af de menneskelige meridianer gennem medicin og varmestimulering for at forebygge og behandle sygdomme. Ifølge princippet om syndromdifferentiering og behandling af traditionel kinesisk medicin vælges akupunkter på de tilsvarende dele, hvilket har en bestemt virkning. Det betragtes som en karakteristisk traditionel kinesisk medicin terapi for bronchial astma. Denne protokol uddyber metoder og trin til patientbehandling, materialeforberedelse, udvælgelse af akupunkter, operation og postoperativ sygepleje for at sikre sikker og effektiv moxibustionsbehandling for signifikant at forbedre de kliniske symptomer og livskvaliteten hos patienter med bronchial astma.

Introduction

Protokollen, der præsenteres her, demonstrerer driften af moxibustion til behandling af bronchial astma med hensyn til patientbehandling, materialeforberedelse, akupunktvalg, operation og postoperativ sygepleje. Formålet med denne protokol er at kontrollere symptomerne hos patienter med bronchial astma og forbedre lungefunktionen ved moxibustion.

Akupunktur og moxibustion er vigtige komponenter i traditionel kinesisk medicin (TCM). Med hensyn til bronchial astma har akupunktur og moxibustion akkumuleret omfattende klinisk erfaring med behandlinger, og især moxibustion har vist unikke fordele 1,2,3,4. Moderne undersøgelser viser, at virkningerne af den biologiske mekanisme til opvarmningsfremme og tilskud af moxibustion er som følger: moxibustion aktiverer akupunkterne (lokal start), fremmer bevægelsen af qi og blod, regulerer det neuroendokrine-immune netværk (reguleringsvej) og regulerer indvoldenes funktioner (respons fra effektororganet)5,6,7.

Bronkial astma er en kronisk inflammatorisk sygdom i luftvejene, som kan føre til symptomer såsom tilbagevendende hvæsen, åndenød, trykken for brystet eller hoste på grund af den øgede luftvejsreaktivitet. Disse symptomer opstår ofte eller forværres om natten eller om morgenen8. Bronkial astma er en af de mest almindelige kroniske lungesygdomme i verden, der rammer mennesker i alle aldre9. I de senere år har forekomsten af bronchial astma i Kina været stigende årligt. Den seneste epidemiologiske undersøgelse viste, at forekomsten af astma hos voksne over 20 år er 4,2%10. Sygdommen vil føre til luftvejsremodellering og hyperreaktivitet, hvilket alvorligt vil påvirke lungefunktionen hos patienter i det sene stadium. I øjeblikket er de vigtigste kliniske behandlinger for bronchial astma antiinflammatoriske, antispasmodiske og symptomatiske behandlinger. Ikke desto mindre skitserer den høje gentagelsesrate og uhåndterlighed de største ulemper, endsige den dårlige langsigtede lægemiddeleffektivitet og manglen på en ideel terapeutisk tidsplan. Sammenlignet med inhalerede lægemidler alene kunne moxibustion forbedre humoral og cellulær immunitet, som har en signifikant immunmodulerende virkning under behandling11,12,13. Ved at brænde og stege den kinesiske medica over menneskelige akupunkter er moxibustion en type behandling, der virker gennem medicin og varmestimulering. Det har virkninger som at fjerne kolde fornemmelser ved at opvarme meridianerne, fremme qi-cirkulation for at fjerne meridianobstruktionen og eliminere stagnation for at aktivere meridianer. Det betragtes som en TCM karakteristisk terapi for bronchial astma14.

Protocol

Det kliniske forsøg er godkendt af godkendelsesudvalget for respiratorisk afdeling på det tilknyttede hospital i Chengdu University of Traditional Chinese Medicine (nr. KY2022022). I denne undersøgelse henviser de diagnostiske kriterier for bronchial astma til retningslinjerne for forebyggelse og styring af bronchial astma (2020-udgave)8 , og TCM-operationer henviser til kriterierne for diagnose og terapeutisk virkning af sygdomme og syndromer i traditionel kinesisk medicin15<…

Representative Results

Otte patienter med bronchial astma, som opfyldte kriterierne, blev behandlet med moxibustion. Alle patienter havde de samme diagnostiske kriterier for bronchial astma, og patienternes lungefunktion FEV1-forhold, PEF-ratio (faktisk/forventet; procentdel) og astmakontroltest (ACT) score blev målt før og efter moxibustionsbehandlingen på samme måde. Efter et behandlingsforløb havde alle patienter forbedret lungefunktion FEV1-forhold, PEF-ratio og ACT-score. Før behandling var lungefunktionen FEV1-forholdet 68,23 % ± …

Discussion

Luftvejsbetændelsen forårsaget af bronchial astma er et kaskadeimmunrespons, der involverer forskellige immunceller, cytokiner og inflammatoriske mediatorer19. Bronkial biopsier af astmatiske patienter viser tilstedeværelsen af eosinofiler, aktiverede mastceller og Th2-cellebaseret T-celleinfiltration20. Lungefunktionsindekserne FEV1 og PEF afspejler sværhedsgraden af luftvejsobstruktion og er de mest almindeligt anvendte indekser til objektivt at bedømme og evaluere a…

Divulgations

The authors have nothing to disclose.

Acknowledgements

Vi sætter pris på den økonomiske støtte fra Science and Technology Development Fund Project of Hospital of Chengdu University of Traditional Chinese Medicine (nr. 20ZL10). Forfatterne vil gerne takke Mr. Yang Yang for at deltage i vores undersøgelse som model.

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

  1. 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).
  2. 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).
  3. 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).
  4. 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&#34. World Journal of Integrated Traditional and Western Medicine. 16 (10), 1783-1786 (2021).
  5. 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).
  6. Huang, K. Y., et al. From biological effects of local cutaneous thermal stimulation to moxibustion therapy. Acupuncture Research. 40 (6), 504-509 (2015).
  7. 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).
  8. 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).
  9. 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).
  10. Dixon, A. E., Carr, T. F., Que, L. G. Advances in Asthma. Semin Respir Crit Care Med. 43 (5), 593-594 (2022).
  11. 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).
  12. 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).
  13. 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).
  14. 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).
  15. 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).
  16. Shen, X. Y. . Meridians and Acupoints. 61, 178-179 (2016).
  17. . Nomenclature and location of meridian points Available from: https://openstd.samr.gov.cn/bzgk/gb/newGbinfo?hcno=397548AE7248D3D87DD15E0AB8107185 (2023)
  18. 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).
  19. Fei, F., Ji, Y. F., Huang, M. New understanding of pathogenesis of bronchial asthma. International Journal of Respiration. 38 (12), 955-960 (2018).
  20. 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).
  21. 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).
  22. 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).
  23. 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).
  24. 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).
  25. 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).
  26. 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).
  27. 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).
  28. 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).
  29. 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).
  30. 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).
  31. 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).
  32. 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).
  33. Li, C. X., et al. Advances in the clinical research on acupuncture in treatment of respiratory diseases. Acupuncture Research. 45 (2), 169-172 (2020).
  34. 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).
  35. 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).
  36. 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).
  37. 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).
  38. 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).
  39. 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).
  40. 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).
  41. 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).
  42. 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).
  43. 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).
  44. 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).
  45. 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).
  46. 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).
  47. 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).
  48. 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).
  49. 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).
  50. Wang, W., Yang, D. H. Research progress of Dingchuan point. Journal of Chinese Physician. 16 (11), 1581-1583 (2014).
  51. 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).
check_url/fr/65119?article_type=t

Play Video

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).

View Video