Moxibustion plus montelukast for cough variant asthma with wind cold

OBJECTIVE: To observe the clinical efficacy of modified painless wheat-grain blistering moxibustion combined with western medication for cough variant asthma (CVA) of wind cold attacking the lung. METHODS: Ninety-four patients with CVA of wind cold attacking the lung were randomly divided into a wheat-grain blistering moxibustion group and a montelukast sodium group, 47 cases in each group. The montelukast sodium group was treated with oral montelukast sodium tablets, 10 mg each time, once a day for 8 weeks. The wheat-grain blistering moxibustion group was treated with modified painless wheat-grain blistering moxibustion at Dingchuan (EX-B1), Fengmen (BL12), Gaohuang (BL43) and Zusanli (ST36) on the basis of the treatment in the montelukast sodium group, the acupoints on both sides were selected alternately for moxibustion, once every other day, three times a week for 8 weeks. The TCM syndrome score before and after treatment, as well as after 1 month of treatment completion (follow-up) was observed, the pulmonary function indexes (forced expiratory volume in 1 second [FEV1], peak expiratory flow [PEF] and FEV1/forced vital capacity[FVC]%), and serum levels of immunoglobulin E (IgE)and interleukin-6 (IL-6) were detected before and after treatment, the clinical efficacy was evaluated in the two groups. RESULTS: After treatment and in follow-up, the TCM syndrome scores in both groups were decreased compared with those before treatment (<0.05), and the scores in the wheat-grain blistering moxibustion group were lower than those in the montelukast sodium group (<0.01). After treatment, the FEV1, PEF and FEV1/FVC% were increased compared with those before treatment (<0.05), while serum levels of IgE and IL-6 were decreased compared with those before treatment (<0.05) in both groups; the FEV1, PEF and FEV1/FVC% in the wheat-grain blistering moxibustion group were higher than those in the montelukast sodium group (<0.01, <0.05), the serum levels of IgE and IL-6 in the wheat-grain blistering moxibustion group were lower than those in the montelukast sodium group (<0.01). After treatment, the total effective rate was 100.0% (47/47) in the wheat-grain blistering moxibustion group and 93.6% (44/47) in the montelukast sodium group, with no statistically significant difference between the two groups (>0.05). In follow-up, the total effective rate was 95.7% (45/47) in the wheat-grain blistering moxibustion group and 42.6% (20/47) in the montelukast sodium group, total effective rate in the wheat-grain blistering moxibustion group was superior to that in the montelukast sodium group (<0.01). CONCLUSION: Modified painless wheat-grain blistering moxibustion combined with montelukast sodium tablets can alleviate cough symptoms and improve lung function in patients with CVA of wind cold attacking the lung. Its mechanism may be related to regulating the serum levels of IgE and IL-6, thereby inhibiting airway inflammatory responses.