参蛤补肺汤治疗肺气亏虚型稳定期慢性阻塞性肺疾病的研究
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摘要
目的探讨观察慢性阻塞性肺疾病(COPD)稳定期肺肾气虚型患者使用参蛤补肺汤的临床治疗效果。方法选取住院的COPD稳定期患者120例,采用随机单盲法均分为2组,对照组对患者进行西医常规用药,如解痉、祛痰、平喘、支气管扩张剂类和糖皮质激素类药物;研究组在对照组的基础上加服参蛤补肺汤。对比2组患者组间及治疗前后与本组的治疗后综合疗效、中医证候积分、COPD评估测试CAT评分以及肺功能指标。结果治疗后综合疗效:对照组总有效率(71.67%)显著低于研究组(95.00%),差异有统计学意义(P<0.01)。中医证候积分:疗程结束后,对照组中医证候积分下降水平低于研究组(P<0.05),2组治疗前后积分均明显降低(P<0.05)。COPD评估测试(CAT):疗程结束后,对照组CAT评分下降水平低于研究组(P<0.05),2组治疗前后,CAT评分明显降低(P<0.05)。肺功能指标:研究组治疗后呼气容积(FEV1)和其占预计值百分比(FEV1%)、其占用力肺活量百分比(FEV1/FVC)均较治疗前有明显改善(P<0.05),治疗后2组肺功能改善效果研究组显著优于对照组(P<0.05)。结论采用参蛤补肺汤治疗COPD稳定期患者的疗效显著、安全、可靠,能明显改善患者肺功能。
Objective To investigate the clinical effect of Shenhabufei Decoction in the treatment of patients with lung and kidney qi deficiency in chronic obstructive pulmonary disease(COPD)stable period.Methods 120 patients with stable COPD hospitalized patients were divided into 2 groups randomly.The control group of patients were given conventional drugs such as bronchial spasm,expectorant,antiasthmatic,expansion agent,and glucocorticoid drugs.The patients in the study group were treated by adding Shenhabufei Decoction on the basis of routine treatment in the control group.Comprehensive efficacy,TCM syndrome score,COPD assessment test CAT score,and lung function index was compared between and in the 2 groups before and after treatment.Results Comprehensive efficacy after treatment:the total effective rate of the control group(71.67%)was significantly lower than that of the study group(95.00%),the difference was significant(P<0.01).TCM syndrome score:after the course of treatment,the decline of TCM syndrome score in the control group was lower than that in the study group(P<0.05),the scores of the 2 groups before and after treatment were significantly decreased(P<0.05).The COPD assessment test(CAT):at the end of treatment,the CAT score of the control group was lower than of the study group(P<0.05),the 2 groups before and after treatment,CAT score decreased significantly(P<0.05).Pulmonary function index:FEV1% of the study group after treatment,FEV1/FVC,FEV1 improved significantly compared with before treatment(P<0.05),the 2 groups after treatment of lung function improvement effect of the study group was significantly better than the control group(P<0.05).Conclusion The curative effect of Shenhabufei Decoction in the treatment of stable COPD patients is significant,safe and reliable,and can significantly improve the pulmonary function of patients.
Objective To investigate the clinical effect of Shenhabufei Decoction in the treatment of patients with lung and kidney qi deficiency in chronic obstructive pulmonary disease(COPD)stable period.Methods 120 patients with stable COPD hospitalized patients were divided into 2 groups randomly.The control group of patients were given conventional drugs such as bronchial spasm,expectorant,antiasthmatic,expansion agent,and glucocorticoid drugs.The patients in the study group were treated by adding Shenhabufei Decoction on the basis of routine treatment in the control group.Comprehensive efficacy,TCM syndrome score,COPD assessment test CAT score,and lung function index was compared between and in the 2 groups before and after treatment.Results Comprehensive efficacy after treatment:the total effective rate of the control group(71.67%)was significantly lower than that of the study group(95.00%),the difference was significant(P<0.01).TCM syndrome score:after the course of treatment,the decline of TCM syndrome score in the control group was lower than that in the study group(P<0.05),the scores of the 2 groups before and after treatment were significantly decreased(P<0.05).The COPD assessment test(CAT):at the end of treatment,the CAT score of the control group was lower than of the study group(P<0.05),the 2 groups before and after treatment,CAT score decreased significantly(P<0.05).Pulmonary function index:FEV1% of the study group after treatment,FEV1/FVC,FEV1 improved significantly compared with before treatment(P<0.05),the 2 groups after treatment of lung function improvement effect of the study group was significantly better than the control group(P<0.05).Conclusion The curative effect of Shenhabufei Decoction in the treatment of stable COPD patients is significant,safe and reliable,and can significantly improve the pulmonary function of patients.
引文
[1]中华医学会呼吸病学会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版)[J].中国医学前沿杂志:电子版,2014,6(2):67-80.
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[3]倪伟,张惠勇,吴定中,等.补肾纳气方结合西药治疗慢性阻塞性肺疾病临床观察[J].上海中医药杂志,2008,42(5):15-17.
[4]徐雯洁,王天芳,王智瑜,等.基于现代文献的慢性阻塞性肺疾病中医证候及证候要素的研究[J].中华中医药杂志,2008,23(1):19-22.
[5]韩佳.慢性阻塞性肺疾病肺与肾相关的实质研究[D].济南:山东中医药大学,2013:12-13.
[6]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:54-66.
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[9]董薇.全真一气汤对慢性阻塞性肺疾病稳定期肺肾气虚证BODE指数及呼吸肌疲劳的影响[D].福州:福建中医药大学,2014:17-19.
[10]张惠勇,鹿振辉,吴定中,等.慢性阻塞性肺疾病中医辨证分型模式研究初探[J].中国中医药信息杂志,2007,14(8):23-25.
[11]刘永琦,王文.虚证的免疫学本质[J].中国中医基础医学杂志,2003,9(5):7-10,13.
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[13]金中义.《景岳全书》治疗内科杂病补益方剂配伍规律的研究[D].哈尔滨:黑龙江中医药大学,2013.
[14]薛福辰,孙中国.重广补注黄帝内经素问:影宋本[M].北京:学苑出版社,2009:25-774.
[15]朱鹏举,陈士玉.顾本《黄帝内经·素问》王冰注语"瘦于玄府中"考误[J].光明中医,2009,24(10):1861-1862.
[16]张红.多索茶碱对慢性阻塞性肺病患者气道重塑与炎性指标的影响[J].西北药学杂志,2015,30(5):628-630.
[17]王兴,罗纯清,贺竞敏.参蛤胶囊干预慢性阻塞性肺疾病模型大鼠的实验研究[J].中医药导报,2016,22(17):20-23.
[18]韩林华,邹华丽.加减参蛤散对肺肾气虚型慢性阻塞性肺疾病稳定期BODE指数的影响[J].现代中医药,2016,36(3):21-23.
[19]尚悦.加味补肺汤治疗慢性阻塞性肺疾病稳定期(肺肾气虚痰瘀阻络)的临床观察[D].长春:长春中医药大学,2015:3-6.
[20]刘文兵,黄立搜,丁学军,等.平喘固本汤合补肺汤治疗COPD患者的临床观察[J].中华全科医学,2015,13(2):292-294.
[2]中华中医药学会内科分会肺系病专业委员会.慢性阻塞性肺疾病中医诊疗指南(2011版)[J].中医杂志,2012,53(1):80-84.
[3]倪伟,张惠勇,吴定中,等.补肾纳气方结合西药治疗慢性阻塞性肺疾病临床观察[J].上海中医药杂志,2008,42(5):15-17.
[4]徐雯洁,王天芳,王智瑜,等.基于现代文献的慢性阻塞性肺疾病中医证候及证候要素的研究[J].中华中医药杂志,2008,23(1):19-22.
[5]韩佳.慢性阻塞性肺疾病肺与肾相关的实质研究[D].济南:山东中医药大学,2013:12-13.
[6]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:54-66.
[7]Rabe K F,Hurd S,Anzueto A,et al.Global strategy for the diagnosis,management,and prevention of chronic obstructive pulmonary disease[J].Am J Resp Crit Care Med,2007,176:532-555.
[8]高鸿彬,傅芃,王晓君,等.HPLC法测定养阴清肺口服液中芍药苷的含量[J].西北药学杂志,2016,31(3):254-256.
[9]董薇.全真一气汤对慢性阻塞性肺疾病稳定期肺肾气虚证BODE指数及呼吸肌疲劳的影响[D].福州:福建中医药大学,2014:17-19.
[10]张惠勇,鹿振辉,吴定中,等.慢性阻塞性肺疾病中医辨证分型模式研究初探[J].中国中医药信息杂志,2007,14(8):23-25.
[11]刘永琦,王文.虚证的免疫学本质[J].中国中医基础医学杂志,2003,9(5):7-10,13.
[12]张学文.《景岳全书》论治内科急症初探[J].贵阳中医学院学报,1984,(2):1-5.
[13]金中义.《景岳全书》治疗内科杂病补益方剂配伍规律的研究[D].哈尔滨:黑龙江中医药大学,2013.
[14]薛福辰,孙中国.重广补注黄帝内经素问:影宋本[M].北京:学苑出版社,2009:25-774.
[15]朱鹏举,陈士玉.顾本《黄帝内经·素问》王冰注语"瘦于玄府中"考误[J].光明中医,2009,24(10):1861-1862.
[16]张红.多索茶碱对慢性阻塞性肺病患者气道重塑与炎性指标的影响[J].西北药学杂志,2015,30(5):628-630.
[17]王兴,罗纯清,贺竞敏.参蛤胶囊干预慢性阻塞性肺疾病模型大鼠的实验研究[J].中医药导报,2016,22(17):20-23.
[18]韩林华,邹华丽.加减参蛤散对肺肾气虚型慢性阻塞性肺疾病稳定期BODE指数的影响[J].现代中医药,2016,36(3):21-23.
[19]尚悦.加味补肺汤治疗慢性阻塞性肺疾病稳定期(肺肾气虚痰瘀阻络)的临床观察[D].长春:长春中医药大学,2015:3-6.
[20]刘文兵,黄立搜,丁学军,等.平喘固本汤合补肺汤治疗COPD患者的临床观察[J].中华全科医学,2015,13(2):292-294.