| Objective:To observe the symptom scores,the improvement of lung function,and compare the percentage of the CD3+,CD4+,CD8+,CD4+/CD8+ in peripheral blood of patients before and after treatment by surveying the "winter disease treated in summer" acupoint application of different application time.To explore the correlation between the curative effect of different application time of the "winter disease treated in summer" acupoint application in the treatment of stable COPD and its effect on the immune regulation of blood T lymphocyte subsets.Methods:Patients who met the inclusion criteria were randomly divided into three groups:the treatment group A,the treatment group B,and the control group C.The patients in the control group maintained their original Western medicine treatment plan unchanged.The patients in the two treatment groups were given the"winter disease treated in summer"acupointapplication on the basis of the conventional treatment of western medicine.According to the time of application,the two treatment groups were randomly divided into the treatment group A for 8 hours and the treatment group A for 4 hours.The acupoint application of the drug were independently developed by Dongzhimen Hospital.The application time was the first three days of the early,middle,run and end of the "Dog days" in every summer.And the application time of the treatment group A was 8 hours,and the treatment group B was 4h.The end of the three periods of the hot season means a course of treatment,everyone needs a total of 1 courses of application,the apply acupoints were Feishu(BL13),Shenshu(BL23),Dingchuan(EX-B1).The observation period was one year.Fill in the mMRC table and CAT form on the day of enrollment and treatment for half a year and one year later.On the day of enrollment and one year after treatment,flow cytometry was used to detect T lymphocyte subsets in peripheral blood and lung function was measured.After the end of each course of the treatment,the patients with skin reactions were followed up until the skin lesions healed.The observation indicators mainly include:①general situation:age,gender,etc.② the number of acute exacerbations,mMRC score,CAT score.③pulmonary function test FEV1/FVC,FEV1/Pred%.④CD3+%,CD4+%,CD8+%,CD4+/CD8+ in peripheral blood.⑤skin reaction.Results:A total of 70 patients were included in the clinical observation,including 7 cases of shedding and 4 cases of exclusion.In the end,a total of 59 patients were completed,including 20 patients in the 8h treatment group,20 patients in the 4h treatment group,and 19patients in the control group.Before the treatment,the baseline data(age,gender,acute exacerbation,CAT score,mMRC score,lung function index,peripheral blood CD3+%,CD4+%,CD8+%,CD4+/CD8+)were not statistically significantly difference between the two treatment groups and the control group(P>0.05),and the three groups were comparable.1.Comparison among the three groups of acute exacerbation,mMRC scores and CAT scores:After one year’s treatment,the number of acute exacerbations and mMRC scores in patients with stable COPD in the two treatment group were significantly lower than those before treatment(P<0.05).There was no significant difference of mMRC scores in the treatment group for 8h after six months and one year(P>0.05),and so was the treatment group for 4h when compared with before treatment and six months after treatment.No matter before treatment,half a year or one year after treatment,the number of acute exacerbations and mMRC scores in the control group patients had no significant change(P>0.05).The CAT scores of the three groups were significantly different from those before treatment and half a year after treatment.There was no significant difference in the CAT score between the three groups after treatment for half a year and one year(P>0.05).However,this study did not prove the correlation between the different sticking time of application and the number of acute exacerbations,mMRC scores,CAT scores(P>0.05),nor did it indicate that the application of the treatment can improve the patient’s CAT.2.Comparison of lung function in three groups:only the 8h group could significantly increase FEV1/FVC,and the FEV1/Pred%could be improved by the application.The FEV1/Pred%in the 8h group was better than that in the 4h group(P<0.05),indicating that FEV1/Pred%was positively correlated with the different sticking time of application.3.Comparison of blood T lymphocyte subsets in three groups:there was no significant change in CD3+%in the three groups,while CD4+%,CD4+/CD8+ were increased and CD8+%were decreased in the 8h group(P<0.05).In the 4h group,CD3+%,CD4+%,CD4+/CD8+showed no significant change compared with that before treatment(P>0.05),and CD8+%was significantly reduced(P<0.05).The CD3+%,CD4+%and CD8+%of the control group showed no significant changes(P>0.05),and their CD4+/CD8+ levels decreased(P<0.05),suggesting that the changes of T lymphocyte subsets were correlated with the different sticking time of application.The improvement rate of T lymphocyte subsets after application for 8h was better than that of the 4h group and the control group.4.skin reactions in two treatment groups:during the application,there were only 1 patient had large blisters in the 8h group of all the 59 patients.Conclusion:1.On the basis of conventional treatment,acupoint application with "winter disease treated in summer" is better in improving the number of acute exacerbation,mMRC score,FEV1/Pred%.and the duration of application and FEV1/Pred%,There is a certain correlation between changes in the different sticking time of application and FEV1/Pred%.The certain correlation is also applied to the changes between the different sticking time of application and T lymphocyte subsets.2.For the stable phase of chronic obstructive pulmonary disease,the”winter disease treated in summer " acupoint application can treat stable COPD by affecting T lymphocyte immunity including CD3+%,CD4+%,CD8+%and CD4+/CD8+,thus improving the immune function of the body.3.The application time of 8h is better than 4h,and the "winter disease treated in summer"acupoint application is simple,safe and effective,it is well worth further clinical promotion. |
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