The Efficacy Of Diarrhea Acupuncture Combined With Tanreqing In The Treatment Of Phlegm-Heat Obstructs Of Lung AECOPD

ObjectiveThis study uses a randomized grouping method to observe the clinical efficacy of acupuncture and diarrhea combined with Tanreqing in the treatment of phlegm-heat congestion type AECOPD and to explore its therapeutic mechanism,so as to provide a new method for the treatment of AECOPD.MethodsOne hundred and fifty-six patients with AECOPD who met the study criteria were randomly divided into three groups using the digital randomization method:conventional AECOPD treatment group(Group A),acupuncture+conventional treatment group(Group B)and acupuncture combined with Tanreqing+conventional treatment group(Group C),of which 53 cases were in Group A,53 cases in Group B and 50 cases in Group C.Western medicine diagnostic criteria can be referred to the AECOPD diagnostic criteria in the 2019 Global GOLD Guidelines,and the Chinese medicine dialectical typing refers to the phlegm-heat congestion lung evidence of pulmonary distension disease in the Guidelines for Clinical Research on New Chinese Medicines.The acupuncture therapy in groups B and C was based on the same basic treatment,and the main acupoints used for treatment in both groups were mainly based on the article on a retrospective study of acupuncture for pulmonary dysfunction and the article on Meridians Acupuncture Points" and "Name and Positioning of Acupoints" GB/T 12346-2006,the standardized acupuncture point selection used in both books were mainly(1)via the Hand Taiyin Lung meridian:LU11(well point);(2)via the Hand Yangming Large Intestine meridian:L14(original point);(3)via the Foot Yangming Stomach meridian:ST25(large intestine collection point),ST40(luo point),and ST36(combined point);(4)via the Foot Solar Bladder meridian:BL13(dorsal lung point),BL20(dorsal spleen point),BL12(dorsal kidney point);(5)through the Directing Vessel:DU14(meeting point of the Hand and Foot Sanyang meridian),GV10;(6)through the Ren Vessel:RN17(pericardium point;qi meeting of the eight meeting points),RN12(stomach point;internal organs meeting of the eight meeting points),RN04(small intestine point;meeting point of the Ren Vessel and the Foot Sanyin meridian);(7)EX-B1 odd points.Ting gas(specific points).In order to avoid injury to the lungs,acupuncture points close to the lungs were treated with a flat acupuncture technique,and the needles were left in place for 30 minutes.The treatment was performed once a day for 4 times(one week),for a total of 2 courses.2 The efficacy and data were collected after the course of treatment.The general clinical data of the three groups of patients were analyzed comparably before the experiment.Pulmonary function of the three groups of patients before and after the treatment was counted:["(first second expiratory volume with force FVE1)/exertional spirometry(FVC)"];arterial blood gas analysis:arterial partial pressure of oxygen(Po2),arterial partial pressure of carbon dioxide(Pco2);subjective rating scales:modified Borg before and after the 6-minute walk dyspnea scale,6-minute walk test;inflammatory factors:"interleukin-8(IL-8),tumor necrosis factor(TNF-α)";length of hospital stay of patients to observe the clinical efficacy of acupuncture and diarrhea combined with Tanreqing in the treatment of phlegm-heat congestion type AECOPD.Results(Ⅰ)Comparison of pulmonary function indexes(FEV1/FVC)in different groupsIn terms of pulmonary function indexes,after the end of treatment,the lung function indexes FEV1/FVC improved in all three groups compared with those before treatment(P<0.05),among which,there was no significant difference in the improvement of lung function indexes between the acupuncture combined with Tanreqing group C and the acupuncture group B after treatment(P>0.05),and the improvement of lung function in the acupuncture group and the acupuncture combined with Tanreqing group after treatment compared with group A(P<0.05).The improvement in lung function in the acupuncture group and the acupuncture combined with Tanreqing group after treatment was significant compared with that in group A(P<0.05);indicating that all three therapies could improve the lung function of AECOPD patients.After treatment,the three groups were compared among the groups,among these three treatment methods,both acupuncture and Tanreqing had the effect of potentially improving the lung function of patients,and acupuncture combined with Tanreqing perhaps had a superimposed effect,and the therapeutic advantage was more obvious in the improvement of pulmonary function FEV1,so the clinical effect of acupuncture and acupuncture combined with Tanreqing therapy to improve lung function was better than that of the conventional treatment group(P<0.05),so the efficacy of Tanreqing combined with acupuncture therapy is worthy of affirmation and promotion.(Ⅱ)Comparison of arterial blood gas analysis indices(arterial partial pressure of oxygen Po2)and(arterial partial pressure of carbon dioxide Pco2)in different groupsIn terms of arterial blood gas analysis indices(arterial oxygen partial pressure(Po2),carbon dioxide arterial partial pressure(Pco2),the differences in(Po2,Pco2)values between the three groups before treatment were not statistically significant(P>0.05),and after the patients finished treatment,the arterial oxygen partial pressure(Po2)and carbon dioxide arterial partial pressure(Pco2)in the three groups improved compared with those before treatment.There was statistical significance(P<0.05),and all three therapy groups had the effect of improving patients’ arterial blood gas values and correcting hypercapnia.Among them,there was no statistically significant difference in the improvement of(Po2)values between groups B and C after treatment(P>0.05),and there was a statistically significant difference in the improvement of(Po2)values between groups B and C compared with group A(P<0.05);there was no significant difference in the improvement of(Pco2)values between groups A and B after treatment(P>0.05);there was a significant improvement in(Pco2)values between groups C compared with groups A and B after treatment(P<0.05),which indicates that there was a statistically significant difference in the improvement of(Po2)values between groups A and B after treatment(P>0.05).P<0.05),indicating that it may be due to the superimposed effect of Tanreqing itself or Tanreqing and acupuncture,which can more effectively correct hypercapnia during AECOPD.(C)Comparison of modified Borg dyspnea rating scale,6-minute walk test(6MWT),before and after transient 6-minute walk in different groupsIn terms of subjective scores:modified Borg dyspnea rating scale before and after the 6-minute walk,6-minute walk test,when baseline measurements were compared with the final end-of-experiment measurements,groups B and C,which used acupuncture,had a significant advantage over the conventional treatment group A in terms of both the Borg dyspnea rating scale and the distance walked in six minutes(P<0.05).group A had no significant improvement in the pre-and post-treatment There was no significant improvement in the 6MWT score(P>0.05),group A had a significant improvement in the Borg score after treatment(P<0.05),and groups B and C had a significant improvement between the two scores of Borg and 6MWT before and after treatment(P<0.05).There was no significant difference in the improvement of 6MWT between groups B and C after treatment(P>0.05),and there was a significant difference in the improvement of Borg score between groups B and C after treatment in group C>group B(P<0.05),indicating that both acupuncture and Tanreqing could improve patients’ dyspnea symptoms and skeletal muscle strength.(Ⅳ)Comparison of inflammatory factors in different groups:"interleukin-8(IL-8),tumor necrosis factor(TNF-α)In terms of inflammatory factors:"interleukin-8(IL-8),tumor necrosis factor(TNF-α)",after the end of treatment,all three groups A,B and C showed improvement compared with before,and there were statistical differences in the changes of serum IL-8 and TNF-αconcentration index(P<0.05),and all three treatment regimens had the effect of reducing inflammatory factors effect.After treatment,when comparing the three groups,the difference between the Tanreqing combined with acupuncture group before and after treatment was more significant in improving serum IL-8(P<0.05),and the improvement in group B was better than that in group A(P<0.05),probably because Tanreqing was more advantageous in anti-serum IL-8 or there was a superimposed effect of the two treatments of Tanreqing and acupuncture.In terms of tumor necrosis factor(TNF-α),there was a statistically significant improvement in all three groups after treatment(P<0.05),indicating that all three groups had efficacy on TNF-α,which was more significant in group C before and after treatment(P<0.05)and better in group B than in group A(P<0.05),indicating that although the inflammatory condition could also be improved by conventional treatment,the use of Tanreqing or the combination of acupuncture was more effective in improving the airway inflammation in AECOPD.(E)Comparison of length of hospitalization for AECOPD among different groups of patientsIn terms of length of hospitalization,group A>group B>group C at the end of treatment,with a statistical difference between the three groups(P<0.05),indicating that group A had a longer length of hospitalization,followed by group B,and group C had the shortest length of hospitalization.Conclusion1.conventional treatment method,acupuncture diarrhea method and acupuncture diarrhea method combined with Tanreqing therapy can effectively treat AECOPD,and all three treatment methods can improve not only patients’lung function(FEV1/FVC),but also patients’arterial blood gas(arterial partial pressure of oxygen(Po(2)),arterial partial pressure of carbon dioxide(Pco(2))index,inflammation index,improve AECOPD patients’ survival quality and shorten the length of hospitalization for AECOPD.2.Adding Tanreqing to conventional acupuncture can enhance the therapeutic effect.Acupuncture is effective in improving dyspnea in patients,and combined with phlegm fever clearing treatment,it may have a superimposed effect on the therapeutic effect,which can significantly improve arterial partial pressure of carbon dioxide(Pco(2))index,pulmonary function(FEV1/FVC),Borg score,serum IL-8,TNF-α and shorten There were better results in terms of length of stay,perhaps due to the superimposed effect generated between Tanreqing and acupuncture.3.All three groups improved airway inflammation and reduced inflammatory factor levels in patients during AECOPD,with the Tanreqing combined with acupuncture group significantly improving serum inflammatory factors IL-8 and TNF-α levels in patients.4.Acupuncture diarrhea combined with Tanreqing therapy has a complementary and adjuvant therapeutic effect on AECOPD patients,providing a clinical basis for the treatment of AECOPD disease.