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摘要 目的：探討五虎汤联合穴位贴敷对支气管哮喘患者的疗效及对气道重塑、MMP-9因子的影响。方法：选取2017年1—12月新疆医科大学附属中医医院收治的支气管哮喘患者80例作为研究对象。按照随机数字表法随机分为对照组和观察组，每组40例。对照组采用布地奈德福莫特罗粉吸入剂联合硫酸沙丁胺醇治疗，观察组在对照组基础上给予中药五虎汤联合穴位贴敷治疗。比较2组患者治疗前、治疗后肺功能（FEV1%、PEFR、MMEF）、支气管黏膜基底膜厚度（TRBM）、支气管上皮黏膜肌纤维母细胞计数、MMP-9及TGF-β1水平变化情况及临床疗效。结果：2组治疗前FEV1%、PEFR、MMEF、TRBM、支气管上皮黏膜肌纤维母细胞计数、MMP-9及TGF-β1水平比较，差异无统计学意义（P>0.05）；治疗后2组FEV1%、PEFR及MMEF水平均显著升高，支气管上皮黏膜肌纤维母细胞计数、TRBM、MMP-9及TGF-β1水平显著降低，差异有统计学意义（P<0.05）；观察组FEV1%、PEFR及MMEF水平均显著高于对照组，支气管上皮黏膜肌纤维母细胞计数、TRBM、MMP-9及TGF-β1水平显著低于对照组，差异有统计学意义（P0.05）。结论：五虎汤联合穴位贴敷可显著改善支气管哮喘患者肺功能指标，降低患者支气管上皮黏膜肌纤维母细胞计数、TRBM、MMP-9及TGF-β1水平，疗效显著，且用药安全无不良反应，在临床支气管哮喘的治疗中具有重要的应用价值。
关键词 五虎汤；穴位贴敷；支气管哮喘；气道重塑；临床疗效
Abstract Objective：To investigate the effects of Wuhu Decoction combined with acupoint application on bronchial asthma and its effect on airway remodeling and MMP-9 factor.Methods：A total of 80 patients with bronchial asthma admitted to Affiliated Hospital of Traditional Chinese Medicine，Xinjiang Medical University from January 2017 to December 2017 were selected as the research subjects.The patients were divided into control group and observation group by random number table method，40 cases in each group.The control group was treated with Budesonide and Formoterol Fumarate Powder for Inhalation combined with salbutamol sulfate，and the observation group was treated with the combination of Wuhu Decoction and acupoint application on the basis of the control group.The changes of lung function （FEV1%，PEFR，MMEF），basilar membrane thickness （TRBM） of bronchial mucosa，myofibroblast count of bronchial epithelium，MMP-9 and TGF-β1 were compared between the two groups.Results：There was no significant difference in the levels of FEV1%，PEFR，MMEF，TRBM，myofibroblast count，MMP-9 and TGF-β1 in the two groups before treatment （P>0.05）.After treatment，the levels of FEV1%，PEFR and MMEF in the two groups were significantly increased，and the myofibroblast count，TRBM，MMP-9，and TGF-β1 levels of the bronchial epithelium were significant.The difference was statistically significant （P0.05）.Conclusion：The combination of Wuhu Decoction and acupoint application can significantly improve the pulmonary function index of the bronchial asthma patients，reduce the myofibroblast count，TRBM，MMP-9 and TGF-beta 1 levels in the bronchial epithelium of the patients.The curative effect is significant，and it has important application value in the treatment of clinical bronchial asthma.
Key Words Wuhu Decoction； Acupoint application； Bronchial asthma； Airway remodeling； Clinical efficacy [2]Akiyama K.Bronchial asthma：progress in diagnosis and treatments.Editorial：Progress in diagnosis and treatment of bronchial asthma[J].Nihon Naika Gakkai Zasshi，2013，102（6）：1323-1326.
[3]Kamimura M，Arimoto Y，Homma C，et al.The effects of daily bathing on symptoms of patients with bronchial asthma[J].Asia Pac Allergy，2016，6（2）：112-119.
[4]栾一鸣，宋小莲，王昌惠.支气管哮喘气道重塑的研究进展[J].中国医药导报，2008，10（18）：26-27.
[5]黄月初，韦晚玉，唐美崇.支气管哮喘急性发作期的舒适护理进展[J].中国医学创新，2013，10（2）：163-164.
[6]中华医学会呼吸病学分会哮喘学组.支气管哮喘防治指南（2016年版）[J].中华结核和呼吸杂志，2016，39（9）：675-697.
[7]国家食品药品监督管理局.中药新药临床研究指南原则（试行）[S].北京：中国医药科技出版社，2002.
[8]Sabry MK，Shahin RY，Sheha DS，et al.Suspected Allergic Bronchopulmonary Aspergillosis Cases in Adult Bronchial Asthma Patients Attending a Tertiary Care Clinic[J].Egypt J Immunol，2016，23（1）：31-37.
[9]Arora P，Ansari SH，Anjum V，et al.Investigation of anti-asthmatic potential of Kanakasava in ovalbumin-induced bronchial asthma and airway inflammation in rats[J].J Ethnopharmacol，2017，197：242-249.
[10]Shimoda T，Obase Y，Nagasaka Y，et al.Lung Sound Analysis and Airway Inflammation in Bronchial Asthma[J].J Allergy Clin Immunol Pract，2016，4（3）：505-511.
[11]李丽，王祖红，栾莎，等.七排针刺结合平衡针法治疗支气管哮喘持续期60例临床观察[J].云南中医学院学报，2016，39（3）：57-60.
[12]赵四林，贲定严，易展.灸药结合治疗支气管哮喘临床缓解期的疗效观察[J].中华中医药杂志，2017，32（08）：3819-3822.
[13]季冬梅，金亞明.固本平哮汤联合舒利迭治疗支气管哮喘缓解期24例临床研究[J].江苏中医药，2016，48（12）：25-27.
[14]付勇，周娟娟，陈日新，等.热敏腧穴穴位敷贴治疗支气管哮喘（慢性持续期）20例[J].江西中医药大学学报，2014，26（3）：43-44，47.
[15]Yu F，Sun Y，Yu J，et al.ORMDL3 is associated with airway remodeling in asthma via the ERK/MMP-9 pathway[J].Mol Med Rep，2017，15（5）：2969-2976.
[16]Lee HY，Kim IK，Yoon HK，et al.Inhibitory Effects of Resveratrol on Airway Remodeling by Transforming Growth Factor-β/Smad Signaling Pathway in Chronic Asthma Model[J].Allergy Asthma Immunol Res，2017，9（1）：25-34.
（2018-06-13收稿 责任编辑：王明）
关键词 五虎汤；穴位贴敷；支气管哮喘；气道重塑；临床疗效
Abstract Objective：To investigate the effects of Wuhu Decoction combined with acupoint application on bronchial asthma and its effect on airway remodeling and MMP-9 factor.Methods：A total of 80 patients with bronchial asthma admitted to Affiliated Hospital of Traditional Chinese Medicine，Xinjiang Medical University from January 2017 to December 2017 were selected as the research subjects.The patients were divided into control group and observation group by random number table method，40 cases in each group.The control group was treated with Budesonide and Formoterol Fumarate Powder for Inhalation combined with salbutamol sulfate，and the observation group was treated with the combination of Wuhu Decoction and acupoint application on the basis of the control group.The changes of lung function （FEV1%，PEFR，MMEF），basilar membrane thickness （TRBM） of bronchial mucosa，myofibroblast count of bronchial epithelium，MMP-9 and TGF-β1 were compared between the two groups.Results：There was no significant difference in the levels of FEV1%，PEFR，MMEF，TRBM，myofibroblast count，MMP-9 and TGF-β1 in the two groups before treatment （P>0.05）.After treatment，the levels of FEV1%，PEFR and MMEF in the two groups were significantly increased，and the myofibroblast count，TRBM，MMP-9，and TGF-β1 levels of the bronchial epithelium were significant.The difference was statistically significant （P0.05）.Conclusion：The combination of Wuhu Decoction and acupoint application can significantly improve the pulmonary function index of the bronchial asthma patients，reduce the myofibroblast count，TRBM，MMP-9 and TGF-beta 1 levels in the bronchial epithelium of the patients.The curative effect is significant，and it has important application value in the treatment of clinical bronchial asthma.
Key Words Wuhu Decoction； Acupoint application； Bronchial asthma； Airway remodeling； Clinical efficacy [2]Akiyama K.Bronchial asthma：progress in diagnosis and treatments.Editorial：Progress in diagnosis and treatment of bronchial asthma[J].Nihon Naika Gakkai Zasshi，2013，102（6）：1323-1326.
[3]Kamimura M，Arimoto Y，Homma C，et al.The effects of daily bathing on symptoms of patients with bronchial asthma[J].Asia Pac Allergy，2016，6（2）：112-119.
[4]栾一鸣，宋小莲，王昌惠.支气管哮喘气道重塑的研究进展[J].中国医药导报，2008，10（18）：26-27.
[5]黄月初，韦晚玉，唐美崇.支气管哮喘急性发作期的舒适护理进展[J].中国医学创新，2013，10（2）：163-164.
[6]中华医学会呼吸病学分会哮喘学组.支气管哮喘防治指南（2016年版）[J].中华结核和呼吸杂志，2016，39（9）：675-697.
[7]国家食品药品监督管理局.中药新药临床研究指南原则（试行）[S].北京：中国医药科技出版社，2002.
[8]Sabry MK，Shahin RY，Sheha DS，et al.Suspected Allergic Bronchopulmonary Aspergillosis Cases in Adult Bronchial Asthma Patients Attending a Tertiary Care Clinic[J].Egypt J Immunol，2016，23（1）：31-37.
[9]Arora P，Ansari SH，Anjum V，et al.Investigation of anti-asthmatic potential of Kanakasava in ovalbumin-induced bronchial asthma and airway inflammation in rats[J].J Ethnopharmacol，2017，197：242-249.
[10]Shimoda T，Obase Y，Nagasaka Y，et al.Lung Sound Analysis and Airway Inflammation in Bronchial Asthma[J].J Allergy Clin Immunol Pract，2016，4（3）：505-511.
[11]李丽，王祖红，栾莎，等.七排针刺结合平衡针法治疗支气管哮喘持续期60例临床观察[J].云南中医学院学报，2016，39（3）：57-60.
[12]赵四林，贲定严，易展.灸药结合治疗支气管哮喘临床缓解期的疗效观察[J].中华中医药杂志，2017，32（08）：3819-3822.
[13]季冬梅，金亞明.固本平哮汤联合舒利迭治疗支气管哮喘缓解期24例临床研究[J].江苏中医药，2016，48（12）：25-27.
[14]付勇，周娟娟，陈日新，等.热敏腧穴穴位敷贴治疗支气管哮喘（慢性持续期）20例[J].江西中医药大学学报，2014，26（3）：43-44，47.
[15]Yu F，Sun Y，Yu J，et al.ORMDL3 is associated with airway remodeling in asthma via the ERK/MMP-9 pathway[J].Mol Med Rep，2017，15（5）：2969-2976.
[16]Lee HY，Kim IK，Yoon HK，et al.Inhibitory Effects of Resveratrol on Airway Remodeling by Transforming Growth Factor-β/Smad Signaling Pathway in Chronic Asthma Model[J].Allergy Asthma Immunol Res，2017，9（1）：25-34.
（2018-06-13收稿 责任编辑：王明）