耳部刮痧对慢性阻塞性肺疾病急性加重期伴胃肠功能紊乱患者胃肠激素水平的影响

陈晟茜; 张盼盼; 陈新鑫; 吴培焱

doi:10.16766/j.cnki.issn.1674-4152.004323

耳部刮痧对慢性阻塞性肺疾病急性加重期伴胃肠功能紊乱患者胃肠激素水平的影响

doi: 10.16766/j.cnki.issn.1674-4152.004323

浙江中医药大学附属第一医院(浙江省中医院)呼吸与危重症医学科，浙江杭州 310018

基金项目:

浙江省中医药科技计划项目 2022ZB136

浙江省中医药科技计划项目 2025ZL040

详细信息

通讯作者:
陈晟茜，E-mail：18005881510@163.com

中图分类号: R563
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出版历程
- 收稿日期: 2025-07-10
- 网络出版日期: 2026-04-01

Effect of auricular scraping on gastrointestinal hormone levels in patients with acute exacerbation of chronic obstructive pulmonary disease complicated with gastrointestinal dysfunction

Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, Zhejiang 310018, China

摘要

摘要: 目的探讨耳部刮痧对慢性阻塞性肺疾病急性加重期(AECOPD)伴胃肠功能紊乱患者胃肠激素水平的作用，为临床治疗提供依据。方法选取2023年3月—2025年3月浙江中医药大学附属第一医院收治的167例AECOPD伴胃肠功能紊乱患者，按照随机数字表法分成A组(83例)与B组(84例)，A组予以药物治疗，B组予以药物治疗联合耳部刮痧刺激迷走神经。观察2组患者胃肠激素水平、胃肠道症状、中医症状积分、临床疗效及不良反应。结果胃泌素(GAS)、胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)在组间、各时点间、组间与时点间存在交互作用(P＜0.05)；2组治疗后第4天(T2)、治疗后第8天(T3)的GAS、PGⅠ、PGⅡ均升高(P＜0.05)，且B组T2、T3的GAS、PGⅠ、PGⅡ高于A组(P＜0.05)。胃肠道症状分级评分量表(GSRS)评分在组间、各时点间、组间与时点间存在交互作用(P＜0.05)；2组T2、T3的GSRS评分均降低(P＜0.05)，且B组T2、T3的GSRS评分低于A组(P＜0.05)。各项中医证候积分在组间、各时点间、组间与时点间存在交互作用(P＜0.05)；2组T2、T3的各项中医证候积分均降低(P＜0.05)，且B组T2、T3的各项中医证候积分低于A组(P＜0.05)。B组总有效率高于A组[91.67%(77/84) vs. 78.31%(65/83), χ²=5.848，P=0.016]。2组不良反应发生率比较差异无统计学意义(P＞0.05)。结论药物治疗联合耳部刮痧刺激迷走神经可改善AECOPD伴胃肠功能紊乱患者的胃肠激素水平，减轻胃肠道症状及中医临床症状，提高疗效，且安全性较高。
- 慢性阻塞性肺疾病急性加重期 /
- 耳部刮痧 /
- 胃肠功能紊乱 /
- 胃肠激素水平
Abstract: Objective To explore the effect of auricular scraping on the levels of gastrointestinal hormones in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with gastrointestinal dysfunction, and to provide evidence for clinical management. Methods A total of 167 patients with AECOPD complicated with gastrointestinal dysfunction admitted to the First Affiliated Hospital of Zhejiang Chinese Medical University from March 2023 to March 2025 were randomly divided into the group A (83 cases) and the group B (84 cases). The group A were given drug treatment, and the group B were given drug treatment combined with auricular scraping to stimulate the vagus nerve. The gastrointestinal hormone levels, gastrointestinal symptoms, TCM symptom scores, clinical efficacy and adverse reactions of the two groups were observed. Results A significant interaction was observed among group, time point, and their interaction (group-by-time) for the levels of gastrin (GAS), pepsinogen Ⅰ (PG Ⅰ), and pepsinogen Ⅱ (PG Ⅱ, P < 0.05). The GAS, PG Ⅰ and PG Ⅱ of T2 and T3 in the two groups were increased (P < 0.05), and the GAS, PG Ⅰ and PG Ⅱ of T2 and T3 in the group B were higher than those in the group A (P < 0.05). A significant interaction was observed for the gastrointestinal symptom rating scale (GSRS) scores between groups, over time points, and for their interaction (group × time, P < 0.05). The GSRS scores of T2 and T3 in the two groups were decreased (P < 0.05), and the GSRS scores of T2 and T3 in the group B were lower than those in the group A (P < 0.05). The TCM syndrome scores of T2 and T3 in the two groups were decreased (P < 0.05), and the TCM syndrome scores of T2 and T3 in the group B were lower than those in the group A (P < 0.05). The total effective rate of group B was higher than that of group A [91.67% (77/84) vs. 78.31% (65/83), χ²=5.848, P=0.016]. There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion The combination of medication and auricular scraping therapy, which stimulates the vagus nerve can improve the gastrointestinal hormone level of AECOPD patients with gastrointestinal dysfunction, reduce gastrointestinal symptoms and clinical symptoms of traditional Chinese medicine, improve the clinical efficacy, and has high safety.
- Acute exacerbation of chronic obstructive pulmonary disease /
- Auricular scraping therapy /
- Gastrointestinal dysfunction /
- Gastrointestinal hormone levels

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表 1 2组AECOPD伴胃肠功能紊乱患者治疗前后胃肠激素水平比较(x±s，pg/mL)

Table 1. Comparison of gastrointestinal hormone levels before and after treatment in two groups of AECOPD patients with gastrointestinal dysfunction(x±s, pg/mL)

组别	例数	GAS			PGⅠ			PGⅡ
组别	例数	T1	T2	T3	T1	T2	T3	T1	T2	T3
A组	83	65.32±10.25	70.56±11.08^a	75.68±12.15^a	78.46±12.38	82.35±13.02^a	86.42±14.16^a	12.63±3.12	14.85±2.98^a	16.92±2.75^a
B组	84	65.87±10.56	78.65±12.56^a	85.32±13.89^a	77.02±12.56	88.56±14.85^a	93.68±15.63^a	12.91±3.25	16.26±2.56^a	18.89±2.34^a
F值		0.342	4.415	4.775	0.746	2.874	3.146	0.568	3.278	4.983
P值		0.733	＜0.001	＜0.001	0.457	0.005	0.002	0.571	0.001	＜0.001
注：与同组T1比较，^aP＜0.05。

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表 2 2组AECOPD伴胃肠功能紊乱患者治疗前后胃肠道症状比较(x±s，分)

Table 2. Comparison of gastrointestinal symptoms before and after treatment in two groups of AECOPD patients with gastrointestinal dysfunction(x±s, points)

组别	例数	GSRS
组别	例数	T1	T2	T3
A组	83	32.16±5.68	28.65±4.89^a	24.32±4.25^a
B组	84	32.89±5.87	24.56±4.23^a	20.19±3.68^a
F值		0.817	5.778	6.710
P值		0.415	＜0.001	＜0.001
注：与同组T1比较，^aP＜0.05。

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表 3 2组AECOPD伴胃肠功能紊乱患者治疗前后中医症状积分比较(x±s，分)

Table 3. Comparison of TCM symptom scores before and after treatment in two groups of patients with AECOPD and gastrointestinal dysfunction(x±s, points)

组别	例数	咳嗽
组别	例数	T1	T2	T3
A组	83	2.15±0.56	1.65±0.48^a	1.23±0.40^a
B组	84	2.09±0.58	1.32±0.42^a	0.89±0.35^a
F值		0.680	4.726	5.843
P值		0.497	＜0.001	＜0.001

组别	例数	咯痰
组别	例数	T1	T2	T3
A组	83	2.23±0.62	1.78±0.55^a	1.32±0.41^a
B组	84	2.27±0.65	1.45±0.48^a	0.98±0.43^a
F值		0.407	4.129	5.230
P值		0.685	＜0.001	＜0.001

组别	例数	喘息
组别	例数	T1	T2	T3
A组	83	2.34±0.65	1.86±0.57^a	1.49±0.53^a
B组	84	2.36±0.64	1.51±0.56^a	1.16±0.47^a
F值		0.204	4.002	4.255
P值		0.839	＜0.001	＜0.001

组别	例数	自汗
组别	例数	T1	T2	T3
A组	83	1.89±0.54	1.47±0.49	1.17±0.41^a
B组	84	1.93±0.51	1.14±0.43^a	0.86±0.37^a
F值		0.492	4.624	5.128
P值		0.623	＜0.001	＜0.001

组别	例数	气短
组别	例数	T1	T2	T3
A组	83	2.01±0.58	1.62±0.50^a	1.28±0.45^a
B组	84	2.04±0.62	1.35±0.48^a	0.98±0.42^a
F值		0.323	3.559	4.453
P值		0.747	＜0.001	＜0.001
注：与同组T1比较，^aP＜0.05。

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