気管支喘息に対する漢方薬の特徴的な治療法:灸
Summary
このプロトコルは気管支喘息の患者を治療するお灸の治癒的なプロシージャを示す。
Abstract
気管支喘息は気道の慢性炎症性疾患であり、気道反応性が高まった結果、喘鳴、息切れ、胸の圧迫感、咳などの症状が再発する可能性があります。日内変動が大きいため、これらの症状は夜間や朝に発生または悪化することがよくあります。お灸は、漢方薬を人間のツボの上で燃やして焙煎することで、薬や熱刺激によって人間の経絡の活動を刺激し、病気の予防や治療を行う治療法の一種です。伝統的な中国医学の症候群の分化と治療の原則に従って、対応する部分で経穴が選択され、明確な効果があります。気管支喘息の特徴的な漢方薬とされています。このプロトコルは、患者管理、材料の準備、経穴の選択、手術、および術後看護の方法と手順を詳しく説明し、安全で効果的な灸治療を保証して、気管支喘息患者の臨床症状と生活の質を大幅に改善します。
Introduction
ここで紹介するプロトコルは、気管支喘息の治療における灸の操作を、患者管理、材料の準備、経穴の選択、手術、および術後看護の観点から実証しています。このプロトコルの目的は、気管支喘息患者の症状を制御し、灸によって肺機能を改善することです。
鍼灸は、伝統的な中国医学(TCM)の重要な要素です。気管支喘息に関しては、鍼灸は治療において豊富な臨床経験を蓄積しており、特に灸は独自の利点を示しています1,2,3,4。現代の研究では、灸の温暖化促進と補給の生物学的メカニズムの効果は、灸がツボを活性化し(局所的な開始)、気と血液の動きを促進し、神経内分泌免疫ネットワークを調節する(調節経路)、内臓の機能を制御する(エフェクター器官の応答)5,6,7。
気管支喘息は気道の慢性炎症性疾患であり、気道反応性が高まるため、喘鳴の再発、息切れ、胸の圧迫感、咳などの症状を引き起こす可能性があります。これらの症状は、夜間や朝に発生することが多く、悪化する8。気管支喘息は、世界で最も一般的な慢性肺疾患の1つであり、9歳のすべての人々が罹患しています。近年、中国における気管支喘息の有病率は年々増加しています。最新の疫学調査では、20歳以上の成人における喘息の有病率は4.2%であることが示されています10。この疾患は気道リモデリングおよび過敏性につながり、後期の患者の肺機能に深刻な影響を及ぼします。現在、気管支喘息の主な臨床治療は、抗炎症薬、鎮痙薬、対症療法です。それにもかかわらず、高い再発率と難治性は、長期的な薬効の悪さや理想的な治療スケジュールの欠如は言うまでもなく、主な欠点を概説しています。吸入薬単独と比較して、灸は体液性免疫と細胞性免疫を高める可能性があり、治療中に有意な免疫調節効果があります11,12,13。お灸は、人間のツボの上で漢方薬を燃やして焙煎することで、薬と熱刺激によって作用する治療法の一種です。経絡を温めることで冷え感を払拭したり、気の循環を促進して経絡の障害を解消したり、淀みを解消して経絡を活性化させるなどの効果があります。気管支喘息14のTCM特徴的な治療法と見なされています。
Protocol
臨床試験は、成都中医薬大学付属病院の呼吸器科の承認委員会によって承認されています。KY2022022)です。本研究では、気管支喘息の診断基準は気管支喘息の予防と管理に関するガイドライン(2020年版)8 を参照し、中医学の手術は漢方における疾患および症候群の診断基準と治療効果の基準15を参照しています。典型的な症例は、成都中医薬大学付属病院の?…
Representative Results
基準を満たした気管支喘息の患者8人がお灸で治療されました。気管支喘息の診断基準は全患者で、肺機能FEV1比、PEF比(実測値/予想値)、喘息コントロール検査(ACT)スコアを灸治療前後で同様に測定した。1コースの治療後、すべての患者は肺機能FEV1比、PEF比、およびACTスコアを改善しました。.治療前の肺機能FEV1比は68.23%±4.35%、PEF比は65.91%±4.34%、ACTスコアは16.13±2.30ポイントでした。治療後、?…
Discussion
気管支喘息によって引き起こされる気道炎症は、さまざまな免疫細胞、サイトカイン、および炎症性メディエーターが関与するカスケード免疫応答です19。喘息患者の気管支生検は、好酸球、活性化肥満細胞、およびTh2細胞ベースのT細胞浸潤の存在を示しています20。肺機能指標FEV1およびPEFは、気道閉塞の重症度を反映しており、喘息の状態を客観的に判?…
Declarações
The authors have nothing to disclose.
Acknowledgements
成都中医薬大学病院の科学技術開発基金プロジェクト(No.20ZL10)からの財政的支援に感謝します。著者らは、モデルとして私たちの研究に参加してくれたYang Yang氏に感謝します。
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 |
Referências
- 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. Medicina. 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).
Citar este artigo
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).