参苓白术散对慢性阻塞性肺疾病稳定期肺脾两虚患者运动耐力及氧化应激水平的影响
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摘要
目的观察参苓白术散对慢性阻塞性肺疾病稳定期肺脾两虚患者运动耐力及氧化应激水平的影响。方法将58例COPD稳定期患者随机分为对照组29例和治疗组29例。两组均给予常规基础治疗,治疗组在常规基础治疗上加用参苓白术散(党参、茯苓、白术、薏苡仁等)治疗,疗程均为4周,比较两组患者治疗前后的6分钟步行距离、肺功能和氧化应激水平。结果与治疗前相比,治疗组治疗后6MWD明显增加,且与对照组治疗后相比,具有明显差异(P<0.05);治疗组FEV1%和FEV1/FVC治疗后较治疗前有所改善,但无统计学意义,治疗后两组FEV1/FVC间有差异(P<0.05);两组治疗后的SOD含量较治疗前明显升高,而MDA含量显著降低,具有统计学意义(P<0.05);与对照组治疗后比较,治疗组的氧化应激水平明显减轻(P<0.05)。结论参苓白术散可提高慢性阻塞性肺疾病稳定期肺脾两虚患者运动耐力,其作用机制可能与其减轻氧化应激反应有关,具体分子生物机制有待于进一步研究。
Objective Objective to observe the influence of Shenlingbaizhu Powder on exercise tolerance and oxidative stress in patients with chronic obstructive pulmonary disease at stable stage of lung-spleen deficiency syndrome.Methods 58 cases of COPD in stable stage patients, was randomly divided into control group and treatment group, each group contains 29 cases. Both were given the conventional treatments,the treatment group received Shenlingbaizhu Powder based on the basic treatments.The courses of treatment were 4 weeks.The observation indexes included 6 minutes walking distance(6 MWD), lung function and the level of oxidative stress.Results Compared to pre-treatment, there is a significant improvement of 6 MWD in treatment group. Compared to control group, 6 MWD after treatment was obviously better in treatment group(P<0.05),which expressed the same in the FEV1/FVC(P<0.05).There is no difference in FEV1% and FEV1/FVC, compared to pre-treatment, although improvement was found. The levels of SOD in the two groups were significantly higher than before treatment, while the contents of MDA decreased significantly, which was statistically significant(P<0.05). Compared with the control group, the oxidative stress level decreased significantly(P<0.05).Conclusion Shenlingbaizhu Powder has good therapeutic effect on exercise tolerance of patients with chronic obstructive pulmonary disease at stable stage of lung-spleen deficiency syndrome.The mechanism may be revelant to reduction of oxidative stress. However, the specific mechanism remains to be further researched.
Objective Objective to observe the influence of Shenlingbaizhu Powder on exercise tolerance and oxidative stress in patients with chronic obstructive pulmonary disease at stable stage of lung-spleen deficiency syndrome.Methods 58 cases of COPD in stable stage patients, was randomly divided into control group and treatment group, each group contains 29 cases. Both were given the conventional treatments,the treatment group received Shenlingbaizhu Powder based on the basic treatments.The courses of treatment were 4 weeks.The observation indexes included 6 minutes walking distance(6 MWD), lung function and the level of oxidative stress.Results Compared to pre-treatment, there is a significant improvement of 6 MWD in treatment group. Compared to control group, 6 MWD after treatment was obviously better in treatment group(P<0.05),which expressed the same in the FEV1/FVC(P<0.05).There is no difference in FEV1% and FEV1/FVC, compared to pre-treatment, although improvement was found. The levels of SOD in the two groups were significantly higher than before treatment, while the contents of MDA decreased significantly, which was statistically significant(P<0.05). Compared with the control group, the oxidative stress level decreased significantly(P<0.05).Conclusion Shenlingbaizhu Powder has good therapeutic effect on exercise tolerance of patients with chronic obstructive pulmonary disease at stable stage of lung-spleen deficiency syndrome.The mechanism may be revelant to reduction of oxidative stress. However, the specific mechanism remains to be further researched.
引文
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[14] 程正良,王胜.“培土生金法”在慢性阻塞性肺疾病治疗中的应用[J].中医药临床杂志,2015,27(8):1057.
[15] 袁燕芳,金桂兰,张建忠.“培土生金”治疗慢性阻塞性肺疾病理论初探及应用浅析[J].内蒙古中医药,2015,34(11): 159.
[16] 徐升.黄芪建中汤对慢性阻塞性肺疾病稳定期患者呼吸肌疲劳的影响[J].中国中医急症,2011,20(1):31.
[17] 李航,黄慧婷,詹少锋,等.培土生金法治疗慢性阻塞性肺疾病稳定期疗效的Meta分析[J].广州中医药大学学报,2017,34( 1):132.
[18] 刘淼雄,余春芳,余燕.培土生金化瘀方对慢性阻塞性肺疾病稳定期血清细胞因子和人体测量学的影响[J].新中医,2010,42( 8): 28.
[19] 刘志刚,李泽庚,杨程,等.培土生金法对慢性阻塞性肺疾病稳定期患者低体重指数及预后的影响[J].辽宁中医杂志,2010,37(10):1877.
[20] 席崇.参苓白术散治疗慢性阻塞性肺病呼吸肌疲劳的临床观察[J].临床肺科杂志,2011,16(1):25.
[21] 张新静,沈威,高蔚.6分钟步行试验和圣乔治呼吸问卷与慢性阻塞性肺疾病患者运动能力的相关性研究[J].中国实用医药,2013,8(12):82.
[2] Couillard A,Muir J F,Veale D.COPD recent findings:impact on clinical practice[J].COPD,2010,7(3) 204.
[3] 闫香桂,吴国芳,黄芬,等.中医药治疗稳定期慢性阻塞性肺疾病研究进展[J].中医学报,2016,31( 9): 1284.
[4] 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.
[5] Gagnon P,Saey D,Vivodtzev I. et al.Impact of preinduced quadriceps fatigue on exercise response in chronic obstructive pulmonary disease and healthy subjects[J].J Appl Physiol.2009,107(3):832.
[6] Gosker HR, Hesselink MK, Duimel, H,et al. Reduced mitochondrial density in the vastuslateralis muscle of patients with COPD[J]. Eur Respir J, 2007,30:73.
[7] Picard M,Godin R,Sinnreich M,et al. The mitochondrial phenotype of peripheral muscle in chronic obstructive pulmonary disease;disuse or dysfunction[J].Am J Respir Crit Care Med,2008,178:1040.
[8] Yang S,Wu H,Zhao J,et al.Feasibility of 8-OHdG formation and hOGG1 induction in PBMCs for assessing oxidative DNA damage in the lung of COPD patients[J].Respirology,2014,19(8): 83.
[9] 朱文峰.中医诊断与鉴别诊断学[M].北京:人民卫生出版社,2006:124.
[10] 陈志斌,刘中友,连林辉.等.补肺Ⅰ号方治疗COPD肺气虚证的临床研究[J].中医临床研究,2011,3(19):14.
[11] 谢文英,尚立芝,胡文豪,等.慢性阻塞性肺疾病的发病机制及中医药治疗进展[J].中国实验方剂学杂志,2015,21(9):227.
[12] 于丽丽,王天芳,徐雯洁,等.慢性阻塞性肺疾病稳定期证候及证候要素分布特点的临床研究[J].北京中医药大学学报,2010,10(33):699.
[13] 葛建军.体质指数与COPD患者生存预后关系的回顾性队列研究[J].实用医学杂志,2013,10 (29):1686.
[14] 程正良,王胜.“培土生金法”在慢性阻塞性肺疾病治疗中的应用[J].中医药临床杂志,2015,27(8):1057.
[15] 袁燕芳,金桂兰,张建忠.“培土生金”治疗慢性阻塞性肺疾病理论初探及应用浅析[J].内蒙古中医药,2015,34(11): 159.
[16] 徐升.黄芪建中汤对慢性阻塞性肺疾病稳定期患者呼吸肌疲劳的影响[J].中国中医急症,2011,20(1):31.
[17] 李航,黄慧婷,詹少锋,等.培土生金法治疗慢性阻塞性肺疾病稳定期疗效的Meta分析[J].广州中医药大学学报,2017,34( 1):132.
[18] 刘淼雄,余春芳,余燕.培土生金化瘀方对慢性阻塞性肺疾病稳定期血清细胞因子和人体测量学的影响[J].新中医,2010,42( 8): 28.
[19] 刘志刚,李泽庚,杨程,等.培土生金法对慢性阻塞性肺疾病稳定期患者低体重指数及预后的影响[J].辽宁中医杂志,2010,37(10):1877.
[20] 席崇.参苓白术散治疗慢性阻塞性肺病呼吸肌疲劳的临床观察[J].临床肺科杂志,2011,16(1):25.
[21] 张新静,沈威,高蔚.6分钟步行试验和圣乔治呼吸问卷与慢性阻塞性肺疾病患者运动能力的相关性研究[J].中国实用医药,2013,8(12):82.