基于HRCT小气道参数探讨咳喘停穴位贴敷治疗支气管哮喘的机制

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[Abstract]Objective：Toexplorethemechanismof therapeuticefectofKechuantingacupointappicationonpatientswith chronicasthma basedon HRCTsmallairwayparameters.Methods：Thirty-four patientswithchronicpersistentasthma were randomly dividedintoa Western medicinegroup（16 cases）anda Westernmedicinecombinedwith acupointapplication group（18cases）.Bothgroupsweretreatedwithlow-dose budesonideandformoterolpowder inhalation，andthecombinedgroup wasaddionallytreatedwithKechuantingacupointaplication.Bothgroupsunderwentasthmacontrolquestionnaire（ACQ-7） scoreandchestHRCTexaminationonthedayofenrollmentandwithinoneweekaftertheendof treatment，respectively.The changesof ACQ-7scoreandHRCTsmall airwayparameterswerecomparedbetweenandwithingroupsbeforeandafter treatment.ThequantitativeindicatorsofHRCTsmallairwayparametersincludedwalltickness（WT），irwaydiameteratioof airwaywallthicknesstocross-sectionaldiameter（TDR），ndratioofbronchialwallareatototalcross-sectionalarea（ WA% ） Qualitativeindicatorsincludedend-inspiratorybronchioitisandend-expiratoryairretentionsigns.Results：Therewereno statisticallysignificantdiferencesingenderage，BM，diseaseuration，ACQ-7scoreorHRCTsallairwayparametersbefore treatment between the two groups（all P>0.05 ）.After treatment，there were no statistically significant differences in ACQ-7 score，smallawaydiameterend-inspiratorybronchiolitisorend-expiratoryairretentionsignsbetweenthetwogroups（all P>0.05 ）WT，TDR and WA% in the combined group were lower than those in the Western medicine group （all P <0.01）. Compared with before treatment，there were no statistically significant differences in ACQ-7 score，WT，TDR or WA% inthe Western medicine group after treatment （all P> 0.05），while ACQ-7 score，WT，TDRand WA%in the combined group decreased after treatment（all P <0.05）.ThechangesinWT，TDRandWA%withinthetwogroupsbeforeandaftertreatmentwerestatisticallsignificant（ll P< 0.05）.Conclusions：HRCTsmallairwayparameterscanbeused toevaluatetheeficacyof asthma，andithasbenconfirmed fromtheperspectiveofimagingthat Kechuantingacupointaplicationinthetreatmentofasthmacanimprovesmallairway inflammation anddilate the airway.

[Key words] Asthma;Tomography，X-ray computed;Small airway;Acupoint application；Efficacy

支气管哮喘（哮喘）是我国第二大慢性气道炎性疾病，2008年被列为我国重点防治的慢性呼吸道疾病1，其患病率居全球慢性呼吸系统疾病首位，具有高疾病负担及高致死率的特点，且发病呈低龄化趋势[2]，我国20岁以上人群的哮喘患病率约为 4.2%[3] 。（剩余7890字）