| Bronchial asthma, a refractory respiratory condition, is prevalent among internal medicine diseases. It is a chronic condition closely related to psychosocial effects. While acupuncture treatment on asthma onset is effective, severe attack requires conventional medical management. During remission periods, different acupuncture technics can be applied such as: moxibustion, topical application on acupuncture points and acupuncture point injection. Research about the mechanism of acupuncture in ventilation improvement and immune system strengthening is complex and there are remaining problems that need to be solved. In absence of a complete cure, the present goals of asthma treatment are asthma relapse control and life quality improvement. The present research objective is the observation of the mechanism of mind regulating in the acupuncture treatment of persistent chronic bronchial asthma.Objective:observation of the mind regulating method in the acupuncture treatment of persistent chronic bronchial asthma was implemented in order to obtain a comprehensive evaluation of its mechanism and efficacy.Methods:Subjects were randomly distributed in the treatment group (selection of points for the mind regulation in addition to points for standard asthma treatment) and in the control group (selection of points for standard asthma treatment) with 30 subjects in every group. Point selection criteria:main prescription points for the control group were BL13 Feishu, EX-B1 Dingchuan, CV17 Shanzhong, LU7 Lieque, LU5 Chize and LI4 HeGu. As for the treatment group GV20 BaiHui, EX-HN3 YinTang, PC6 Neiguan and LR3 TaiChong were added to the points prescribed in the control group main prescription. For each group associated points were added:BL20 Pishu (for spleen deficiency pattern), BL23 Shenshu (for kidneys deficiency pattern). LI20 Yingxiang in case of nasal obstruction or rhinorrhea, ST40 Fenglong in case of cough with expectoration, Tian Tu in case of severe dyspnea. Needling techniques:in both groups the points belonging to the main prescription were used systematically, as for the associated points they were selected according to the symptomatology. Points located on the thoracic area were inserted first with the patient lying supine. After the Qi response was obtained on the acupuncture point, a neutral stimulation was applied on each point for about 10 seconds and thereafter the needles were left in situ for 15 minutes. During that interval each needle was manipulated once, combining rotating with the thrusting and pulling technique for about 10 seconds on each point in order to strengthen the Qi response and increase the needle sensation. Afterwards the operation was repeated again for the points located on the dorsal area, following the same protocol as above. Indicators:1) Emotional state indicators:Zung Self-Rating Anxiety Scale (SAS) and Zung Self-Rating Depression Scale (SDS) were used to evaluate the asthmatic patient emotional condition before and after treatment.2) Life quality evaluation:The Asthma Quality of Life Questionnaire (AQLQ) was used to evaluate the asthma patient quality of life before and after treatment.3) Asthma symptoms:the asthma diary was used to evaluate night and day time asthma symptoms.4) Assessment tables:Asthma Control Test (ACT) was used to evaluate the state of asthma control.5) Pulmonary function testing:forced expiratory volume in one second (FEV1) and the ratio of FEV1 to the forced vital capacity (FEV1/FVC) were used to evaluate the pulmonary function before and after treatment.Results:1.Comparing emotional states:1) comparing global level of anxiety with SAS scores in both groups after 3 month of treatment. In the treatment group both SAS and SDS showed an evident drop in scores (P<0.05), as for the control group there was an evident drop in SDS scores (P<0.05). Comparing SAS and SDS scores, between the two groups, showed a significant difference (P<0.05) and both SAS and SDS drop in scores were more evident in the treatment group. The results indicate that there is an evident improvement in the level of anxiety for the patient in the treatment group which is not the case for the control group. Point from both prescriptions can improve depressive symptoms, but the effectiveness in reducing anxiety and depression is superior in the treatment group.2) Comparing patients with anxiety and depression disorders in both groups (SAS积分>45,SDS积分>50) showed a drop in SAS and SDS scores for asthmatic patients with mental disorder belonging to the treatment group (P<0.05). There was no evident drop in the SAS scores in the control group (P>0.05) but the SDS scores did drop significantly (P<0.05). There was a significant difference in SAS and SDS drops after treatment between the two groups (P<0.05), the treatment group showed a significant drop in scores. This indicates that for the patients in the treatment group the anxiety level was reduced significantly, as for the control group there was no significant reduction. Both group point prescription can improve depressive symptoms.This result indicates that the treatment group does have a major improvement in SAS and SDS scores compared to the control group with a higher improvement of the levels of anxiety and depression.2. Evaluating quality of life:1) comparing AQLQ scores within every group after three treatment periods showed an improvement in both groups for overall AQLQ scoring. The treatment group in its AQLQ sub groups:activity reduction (subgroup A), symptoms influence (subgroup B), emotional function (subgroup C) and environment stimuli (subgroup D) showed a significant score increase after treatment (P<0.05). The control group AQLQ subgroups A, B and C showed a significant score increase after treatment (P<0.05). Results were higher in A subgroup with the treatment group compared to the control group. This indicates an improvement of life quality after treatment in both the treatment group and control group patients and that the treatment group had a superior efficacy in improving patient movement limitations compared to the control group.2) comparing AQLQ scores in patients with mental disorders (SDS>50 or SAS>45) in every group showed a rise in overall AQLQ scoring after three treatment periods within either the treatment group and the control group (P<0.05). This indicates an improvement of life quality, in patient with mental disorders, after treatment in both the treatment group and control group. As for evaluating AQLQ subgroups within the treatment and control group, scoring rose significantly (P<0.05) for A, B, C and D subgroup in the treatment group indicating an improvement in movement limitation, symptom influence, emotional function and environment stimuli in patients with mental disorders. As for the control group there was a significant score rise in subgroup A. B and D (P<0.05) with no significant score rise in the C subgroup (P>0.05). This indicates that there was an improvement in all areas, for patients with mental disorders, except for emotional function area. Comparing the difference between the two groups after treatment showed that there was a significant difference for overall scoring as well as A, B and C subgroups (P<0.05), as for D subgroup there was no significant difference (P>0.05) which indicates that the treatment group has major efficacy in improving the patient movement limitation, symptoms influence and emotional function compared to the control group.3. Comparing clinical symptoms:1) comparing night time and day time overall symptoms scores in both groups. Comparing the results before and after a 3 month treatment course, scores dropped significantly in both the treatment group and the control group (P<0.05), there was no significant difference in night time and day time symptom scoring between the two groups (P>0.05). This indicates that both group point prescription can improve significantly asthma related night time or day time symptoms.2) Comparing scores changes in patients with anxiety and depression disorders in both groups (SAS>45,SDS>50) before and after treatment. The treatment group showed an evident drop in scores in night time and day time symptoms after treatment (P<0.05), among the patients with mental disorders, which was not the case with the control group (P>0.05). Comparing the results between the two groups after treatment showed an evident major drop of scores in the treatment group compared to the control group. 4. Asthma control evaluation:Asthma Control Test was used to evaluate overall score changes in each group. After three treatment periods there was a significant rise in ACT scores in both the treatment group and the control group (P<0.05) which indicates that prescription points from both groups have a positive effect in the control of asthma symptoms. As for patients with mental disorders, both groups also showed evident rise in overall scores after treatment (P<0.05) with a higher scoring in the control group compared to the control group.5. Comparing pulmonary function:1) comparing pulmonary function changes in every group before and after treatment showed that, after three treatment periods, there was an index increase in pulmonary function FEV1%,FEV1/FVC% in both the treatment group and the control group (P<0.05). Comparing pulmonary function results after treatment between the treatment group and the control group as well as the difference in each group before and after the treatment, did not show any significant difference (P>0.05). This indicates that acupuncture points from both groups can improve asthmatic patient's pulmonary function.2) Pulmonary function index FEV1%, FEV1/FVC% showed significant increase after treatment (P<0.05), within each group, in patients with mental disorders (SDS>50 or SAS>45) in the treatment group as well as the control group. Comparing FEV1%,FEV1/FVC% after treatment, between the two groups, as well as the difference in each group before and after the treatment did not show any significant difference (P>0.05). This result indicates that there is a significant improvement in pulmonary ventilation, in asthmatic patients with mental disorders (SDS>50 or SAS>45), after acupuncture treatment with points from both groups and that the difference in pulmonary ventilation improvement between the two groups is not significant.Discussion:1. Acupuncture treatment with the method of regulating the mind can improve anxiety and depression symptoms in patients suffering from anxiety and depression condition, but acupuncture points belonging to the control group can only improve depression symptoms in depressed patients. This indicates that there is a major efficacy in improving anxiety and depression symptoms, in asthmatic patients suffering from anxiety and depression condition, when applying the mind regulating method in acupuncture treatment.2. The acupuncture method of regulating the mind can improve the movement limitations, the symptoms influence, the emotional function and environment stimuli in the asthmatic patients with mental disorders, thus improving his overall quality of life. Major efficacy in improving movement limitations, symptoms influence and emotional function was shown when applying the mind regulating points compared to the standard asthma group of points.3. The acupuncture method of regulating the mind is efficient in reducing night time and day time symptoms in patients with mental disorders. Using the acupuncture method of regulating the mind has a major efficacy, compared to the standard asthma acupuncture treatment, in reducing day time and night time symptoms in patients with mental disorders.4. The acupuncture method of regulating the mind and the standard asthma acupuncture treatment both can improve asthma control levels in asthmatic patients whether they suffer from mental disorders or not, but the improvement is more evident in patients with mental disorders when using points from the treatment group. The improvement of asthma control was correlated with the improvement of the pulmonary function.5. The acupuncture method of regulating the mind and the standard asthma acupuncture treatment both can improve the ventilatory function and reduce airway resistance in overall patients and patients with mental disorders. In fact, there was no significant difference in ventilatory function improvement when selecting points from these two different prescriptions.
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