【摘要】 目的 观察改良无痛麦粒化脓灸与布地奈德福莫特罗粉吸入剂联合治疗肺气虚型咳嗽变异性哮喘（CVA）患者的效果及对肺功能、免疫炎症相关因子水平的影响。方法 将2023年9月—2024年9月在潍坊市中医院治疗且符合入组标准的91例肺气虚型CVA患者随机分为2组，最终观察组与对照组各45例完成研究。对照组予布地奈德福莫特罗粉吸入剂治疗，观察组在对照组治疗基础上予改良无痛麦粒化脓灸治疗，2组均治疗8周。比较2组患者治疗前、治疗8周后和治疗结束后1个月时的中医证候积分，治疗前、治疗8周后肺功能指标[第1秒用力呼气容积（FEV₁）、FEV₁/用力肺活量（FVC）、最大呼气流量（PEF）]与血清免疫炎症相关指标[嗜酸性粒细胞计数（EOS）及免疫球蛋白E（IgE）、白细胞介素-4（IL-4）、干扰素-γ（IFN-γ）水平],治疗8周后和治疗结束1个月后的治疗总有效率。结果 观察组治疗8周后及治疗结束后1个月时中医证候积分均明显低于治疗前及同期对照组（P均<0.05）,治疗结束后1个月时中医证候积分与治疗8周后比较差异无统计学意义（P>0.05）;对照组治疗8周后及治疗结束后1个月时中医证候积分均明显低于治疗前（P均<0.05）,但治疗结束后1个月时中医证候积分明显高于治疗8周后（P<0.05）。治疗8周后2组患者3项肺功能指标及血清IFN-γ水平均明显高于治疗前（P均<0.05）,EOS计数及血清IgE、IL-4水平均明显低于治疗前（P均<0.05）,且观察组各指标明显高于或低于对照组（P均<0.05）。观察组治疗8周后和治疗结束后1个月时总有效率均明显高于对照组[95.6%（43/45）比82.2%（37/45）,93.3%（42/45）比62.2%（28/45）,P均<0.05]。结论 改良无痛麦粒化脓灸与布地奈德福莫特罗粉吸入剂联用治疗肺气虚型CVA患者效果优于吸入剂单用，在持续缓解症状、改善肺功能、减轻炎症反应和调节免疫平衡方面均有明显优势。更多还原

【Abstract】 Objective It is to evaluate the efficacy of modified painless grain-sized scarring moxibustion combined with budesonide/formoterol powder inhalation in the treatment of cough-variant asthma（CVA） patients with syndrome of lung Qi deficiency, as well as its effects on lung function and levels of immune and inflammatory-related factors. Methods A total of 91 CVA patients with syndrome of lung Qi deficiency treated at Weifang Hospital of Traditional Chinese Medicine from September 2023 to September 2024, who met the inclusion criteria were randomly divided into two groups. Finally, 45 patients in each of the observation and control groups completed the study. The control group was treated with budesonide/formoterol powder inhalation, while the observation group was treated with modified painless grain-sized scarring moxibustion on the basis of therapy in the control group, both groups were treated for 8 weeks. The following indexes of patients were compared between the two groups: TCM syndrome scores before treatment, after 8 weeks of treatment, and at 1 month after the end of treatment, pulmonary function indicators（FEV₁, FEV₁/FVC, PEF）, as well as serum levels of immune and inflammatory markers [EOS, IgE, IL-4, and IFN-γ] before treatment and after 8 weeks of treatment, and the total effective rates after 8 weeks of treatment, and at 1 month after the end of treatment. Results In the observation group, the TCM syndrome scores after 8 weeks of treatment and at 1 month after the end of treatment were significantly lower than those before treatment and in the control group during the same periods（all P<0.05）, there was no statistically significant difference in the TCM syndrome score between 1 month after treatment and after treatment for 8 weeks（P>0.05）. In the control group, the TCM syndrome scores were significantly lower after 8 weeks of treatment and at 1 month after treatment than those before treatment（both P<0.05）, but the score at 1 month after treatment was significantly higher than that after 8 weeks of treatment（P<0.05）. After 8 weeks of treatment, FEV₁, FEV₁/FVC, PEF and serum level of IFN-γ levels of patients in both groups were significantly higher, while eosinophil counts and serum levels of IgE and IL-4 were significantly lower than those before treatment（all P<0.05）, all these parameters in the observation group were significantly higher or lower than those in the control group（all P<0.05）. The overall response rates in the observation group were significantly higher than those in the control group both after 8 weeks of treatment and at 1 month after the end of treatment [95.6%（43/45） vs 82.2%（37/45）, and 93.3%（42/45） vs 62.2%（28/45）, both P<0.05]. Conclusion The efficacy of scarring moxibustion combined with budesonide/formoterol inhalation powder is more effective than inhalation therapy alone in the treatment of CVA patients with syndrome of lung Qi deficiency, it has significant advantages in continuously alleviating symptoms, improving lung function, attenuating inflammatory responses and regulating immune balance.更多还原