[Effect of transcutaneous electrical acupoint stimulation on lung function and risks of exacerbation for patients with chronic obstructive pulmonary disease].

To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on lung function, clinical symptoms, exercise tolerance and risk of acute exacerbation in patients with chronic obstructive pulmonary disease (COPD).A total of 49 outpatients with COPD were randomly divided into TEAS group and control group by using a digital table. The clinical trials were conducted by using randomized, single-blinded and placebo-controlled method. Patients in the TEAS group were treated by TEAS of Feishu (BL13), Dingchuan (EX-B1), Zusanli (ST36) and Pishu (BL20) for 40 min, once every other day for 4 weeks, while patients in the control group were treated with placebo TEAS which the electrode plates were adhered to the same acupoints but without electrical current outputs. The treatment was conducted every 3 months in one year. In addition, patients of the two groups had no restriction on their original treatment with conventional western medicines and Chinese Materia medica. The lung function (forced expiratory volume in 1 second predicted，FEV1%, forced vital capacity predicted，FVC%) was detected using a spirometer), clinical symptom scores （CAT） for coughing, phlegm, chest tightness, climbing, family activities, out-door activities, sleeping and energy status were given. The patient's exercise tolerance was assessed using walking distance in 6 min, and the risks of acute exacerbation (times of exacerbation and hospitalization in 1 year) were recorded.Correlative analysis showed a negative correlation between the risks of acute exacerbation and the levels of FEV1% and FVC% (P<0.01) and a positive correlation between the risks of acute exacerbation and CAT score (P<0.01). Self-comparison showed that 1 month after the treatment, the FEV1% and FVC% levels, 6MWD in the control group were significantly decreased (P<0.001, P<0.01), while the CAT score in the control group, and FEV1% and 6MWD in the TEAS group were obviously increased in comparison with their own pretreatment (P<0.05, P<0.001), but FVC% in the TEAS group and the times of exacerbation and hospitalization in the control group had no obvious changes in comparison with their own pre-treatment (P>0.05). One year (1 year) after the treatment, FEV1% and FVC% levels, 6MWD in the control group, and CAT score and times of exacerbations and hospitalization in the TEAS group were significantly decreased (P<0.001, P<0.01, P<0.05), while CAT score in the control group and 6MWD in the TEAS group were markedly increased (P<0.05, P<0.01), but FEV1% in the TEAS group and the times of exacerbation and hospitalization in the control group had no significant change compared with their own pretreatment (P>0.05). Comparison between two groups showed that after the treatment, the FEV1% (1 month) and FVC% (1 month and 1 year), 6MWD (1 month and 1 year) were significantly higher in the TEAS group than in the control group (P<0.05), while the CAT (1 month and 1 year) and times of exacerbation and hospitalization (1 year) were significantly lower in the TEAS group than in the control group (P<0.05, P<0.01, P<0.001), without significant difference in the FEV1% (1 year) level (P>0.05).TEAS can improve the lung function, clinical symptoms, exercise tolerance, and reduce the risks of acute exacerbation in patients with COPD.目的：评估经皮穴位电刺激(TEAS)对慢性阻塞性肺疾病(COPD)稳定期患者肺功能、临床症状、活动耐量和急性加重风险的影响。方法：COPD患者随机分为TEAS组25例及对照组24例。TEAS组患者于双侧肺俞、定喘、足三里、脾俞实施TEAS治疗，每次40 min，隔天1次，4周为1个疗程，每3个月治疗1个疗程，共4个疗程。对照组患者在相同穴位上安置TENS电极但不通电，其余治疗措施与TEAS组相同。分别在治疗前、治疗1个月后及治疗1年后记录患者肺功能(FEV1%、FVC%)、临床症状CAT评分、6 min步行距离(6MWD)和急性加重风险(中重度急性加重次数、住院次数)的变化，并对患者急性加重风险因素进行相关性分析。结果：相关性分析显示，急性加重风险与FEV1%、FVC%呈负相关(P<0.01)，与CAT评分呈正相关(P<0.01)。与治疗前比较，对照组治疗1个月后及治疗1年后的FEV1%、FVC%、6MWD均下降(P<0.001，P<0.01)，CAT评分升高(P<0.05)；TEAS组患者治疗1个月后FEV1%升高(P<0.001)，治疗1个月后及治疗1年后的CAT评分降低(P<0.001，P<0.05)，治疗1个月后及治疗1年后的6MWD明显升高(P<0.001)，治疗1年后中重度急性加重次数、住院次数显著减少(P<0.001)。与同时点对照组比较，TEAS组患者治疗1个月后的FEV1%升高(P<0.05),治疗1个月后及治疗1年后的FVC%升高、6MWD升高(P<0.05)，治疗1个月后及治疗1年后的CAT评分降低(P<0.05)，治疗1年后中重度急性加重次数、住院次数均减少(P<0.001，P<0.01)。结论：TEAS可以改善COPD患者肺功能、临床症状、活动耐量，并降低急性加重风险。.