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Randomized Controlled Trial
. 2024 Mar 12;44(3):261-265.
doi: 10.13703/j.0255-2930.20230509-0001.

Effect of the modified painless blistering moxibustion with wheat-grain sized moxa cone on cough variant asthma of pathogenic wind attacking the lung: a randomized controlled trial

[Article in English, Chinese]
Zhiyu Shao  1 , Jinyi Guo  1 , Xueqing Lu  2 , Jun Cao  2 , Yiwen Chen  2 , Jing Li  3 , Xiuzhen Su  4
Affiliations
Randomized Controlled Trial

Effect of the modified painless blistering moxibustion with wheat-grain sized moxa cone on cough variant asthma of pathogenic wind attacking the lung: a randomized controlled trial

[Article in English, Chinese]
Zhiyu Shao et al. Zhongguo Zhen Jiu. .

Abstract
in English, Chinese

Objectives: To observe the clinical effect of the modified painless blistering moxibustion with wheat-grain sized moxa cone on cough variant asthma (CVA) differentiated as pathogenic wind attacking the lung and explore the influences on eosinophil count (EOS) in the peripheral blood and the content of interleukin-4 (IL-4) and tumor necrosis factor-α (TNF-α) in the serum of patients.

Methods: Ninety-two patients with CVA of pathogenic wind attacking the lung were randomly divided into an observation group and a control group, 46 cases in each group. In the observation group, the modified painless blistering moxibustion with wheat-grain sized moxa cone was applied to the unilateral Feishu (BL 13), Gaohuang (BL 43) and Zusanli (ST 36) in each session of treatment, once every 3 days. In the control group, budesonide and formoterol powder inhaler was delivered, 4.5 μg per inhalation, once every half an hour after breakfast and dinner; one more time of inhalation needed if the symptoms were not well controlled, but less than 6 times of inhalation per day. The duration of treatment was 8 weeks in both groups. Separately, before and after treatment, and during the 1-month follow-up after treatment completion, the score of the symptoms of traditional Chinese medicine (TCM) was observed in the two groups; using the lung function detector, the indexes of pulmonary function (forced expiratory volume in one second [FEV1], FEV1/forced vital capacity [FVC] and peak expiratory flow [PEF]) were determined, and the count of EOS in the peripheral blood and the content of IL-4 and TNF-α in the serum were determined before and after treatment; and the clinical effect was compared between the two groups.

Results: After treatment and in follow-up, the TCM symptom scores were decreased compared with those before treatment in the two groups (P<0.05), and the score in the observation group was lower than that of the control group in follow-up (P<0.05). After treatment, FEV1, FEV1/FVC and PEF were increased when compared with those before treatment in the two groups (P<0.05), and the count of EOS in the peripheral blood and the content of IL-4 and TNF-α in the serum were reduced (P<0.05); there was no statistical difference in these indexes between the two groups (P>0.05). After treatment, the total effective rate of the observation group was 95.7% (44/46), which was not different statistically in comparison with the control group (93.5% [43/46], P>0.05). In the follow-up, the total effective rate of the observation group was 95.7% (44/46), which was higher than that of the control group (78.3% [36/46], P<0.05).

Conclusions: The modified painless blistering moxibustion with wheat-grain sized moxa cone may ameliorate the symptoms of CVA of pathogenic wind attacking the lung and improve the pulmonary functions, which is probably related to the regulation of the count of EOS in the peripheral blood and the content of IL-4 and TNF-α in the serum, thereby, reducing the inflammatory response.

目的: 观察改良无痛麦粒化脓灸治疗风邪犯肺型咳嗽变异性哮喘（CVA）的临床疗效及对患者外周血嗜酸性粒细胞计数（EOS）和血清白细胞介素-4（IL-4）、肿瘤坏死因子-α（TNF-α）含量的影响。方法: 将92例风邪犯肺型CVA患者随机分为观察组和对照组，每组46例。观察组于肺俞、膏肓、足三里穴行改良无痛麦粒化脓灸治疗，每次治疗取一侧腧穴，每3天施灸1次；对照组予布地奈德福莫特罗粉吸入剂，4.5 μg/吸，每日早晚餐后半小时吸入1次，若症状控制不佳，可再加1吸，每日不能超过6吸。两组均治疗8周。观察两组患者治疗前后和治疗后1个月随访时中医证候评分；采用肺功能检测仪检测两组患者治疗前后肺功能指标［第1秒用力呼气容积（FEV1）、FEV1/用力肺活量（FVC）、最大呼气流量（PEF）］；检测两组患者治疗前后外周血EOS和血清IL-4、TNF-α含量；比较两组患者临床疗效。结果: 治疗后及随访时，两组患者中医证候评分均较治疗前降低（P<0.05）；随访时，观察组患者中医证候评分低于对照组（P<0.05）。治疗后，两组患者FEV1、FEV1/FVC、PEF较治疗前升高（P<0.05），外周血EOS和血清IL-4、TNF-α含量均较治疗前降低（P<0.05），两组间比较差异无统计学意义（P>0.05）。治疗后，观察组总有效率为95.7%（44/46），与对照组93.5%（43/46）比较，差异无统计学意义（P>0.05）；随访时，观察组总有效率为95.7%（44/46），高于对照组的78.3%（36/46，P<0.05）。结论: 改良无痛麦粒化脓灸治疗可以改善风邪犯肺型CVA患者的临床症状及肺功能，其作用机制可能与调节外周血EOS和血清IL-4、TNF-α含量，进而降低炎性反应有关。.

Keywords: cough variant asthma; eosinophil; interleukin-4; modified painless blistering moxibustion with wheat-grain sized moxa cone; tumor necrosis factor-α.

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