目的 观察吐纳呼吸操联合穴位贴敷治疗哮喘慢性持续期的临床疗效。方法 将60例哮喘慢性持续期患者随机分成对照组和观察组，每组30例；对照组予常规西药治疗配合穴位贴敷，观察组在对照组基础上加用吐纳呼吸操，疗程均为6周；治疗后3个月随访时，记录两组哮喘急性发作次数及呼吸道感染次数；治疗前、治疗后及随访时，采用哮喘控制测试问卷（asthma control test，ACT）评价哮喘控制水平，采用肺功能中用力肺活量（forced vital capacity，FVC）、第1秒用力呼气容积（forced expiratory flow in one second，FEV1）、呼气峰值流量（peak expiratory flow，PEF）占预计值的百分比（FVC%、FEV1%、PEF%）和呼出气一氧化氮（fractional exhaled nitric oxide，FeNO）检测仪评估患者气道通气功能及炎症程度，采用哮喘生活质量量表（asthma quality of life questionnaire，AQLQ）评估患者生活质量。结果 治疗后3个月，观察组哮喘急性发作次数和呼吸道感染次数均低于对照组（P<0.05）。治疗后、随访时，两组ACT评分、FVC%、FEV1%、PEF%、FeNO及AQLQ中活动受限、哮喘状况、心理状况和对刺激原的反应4个维度评分均优于治疗前（P<0.05），且治疗后观察组各项均显著优于对照组（P<0.05），随访时观察组ACT评分、FEV1%、FeNO及AQLQ中活动受限、哮喘状况、心理状况3个维度评分优于对照组（P<0.05）。结论 采用吐纳呼吸操联合穴位贴敷治疗能显著提高哮喘慢性持续期患者症状控制水平和肺功能水平，缓解哮喘气道炎症，改善生活质量。
Objective To investigate the clinical effect of expiration- inspiration breathing exercise combined with acupoint application in the treatment of chronic persistent bronchial asthma. Methods A total of 60 patients with chronic persistent bronchial asthma were randomly divided into control group and observation group, with 30 patients in each group. The patients in the control group were given conventional Western medicine treatment combined with acupoint application, and those in the observation group were given expiration- inspiration breathing exercise in addition to the treatment in the control group; the course of treatment was 6 weeks for both groups. The number of acute asthma attacks and respiratory tract infections were recorded at 3 months after treatment. Before treatment, after treatment, and during follow- up, Asthma Control Test (ACT) was used to evaluate the level of asthma control; percentage of forced vital capacity in predicted value (FVC%), percentage of forced expiratory volume in 1 second in predicted value (FEV1%), percentage of peak expiratory flow in predicted value (PEF%), and fractional exhaled nitric oxide (FeNO) were used to evaluate airway ventilation function and degree of inflammation; Asthma Quality of Life Questionnaire (AQLQ) was used to evaluate quality of life. Results At 3 months after treatment, the observation group had significantly lower numbers of acute asthma attacks and respiratory tract infections than the control group (P<0.05). After treatment and during follow- up, both groups had significantly better ACT score, FVC%, FEV1%, PEF%, FeNO, and scores of activity limitation, asthma status, psychological status, and response to stimuli of AQLQ (P<0.05), and the observation group had significantly better results of these items than the control group (P<0.05). Compared with the control group during follow- up, the observation group had significantly better ACT score, FEV1%, FeNO, and scores of activity limitation, asthma status, and psychological status of AQLQ (P<0.05). Conclusion For patients with chronic persistent bronchial asthma, expiration- inspiration breathing exercise combined with acupoint application can significantly improve the levels of symptom control and lung function, alleviate airway inflammation, and improve quality of life.