利金汤联合临床康复训练对慢性阻塞性肺疾病肺气虚证患者肺功能影响的研究
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摘要
目的:观察利金汤联合临床康复训练对慢性阻塞性肺疾病(COPD)肺气虚证患者肺功能的影响。方法:将129例COPD肺气虚证患者按照随机数字表法分为2组,对照组64例采用康复训练和西药常规治疗,观察组65例在对照组治疗方案的基础上加用利金汤治疗。记录治疗前后2组临床总有效率、中医证候积分、慢性阻塞性肺疾病评分(CAT)、第1秒用力呼气容积(FEV_1)、用力肺活量(FVC)、第1秒用力呼气容积占用力肺活量百分比(FEV_1/FVC)值、动脉血氧分压(PaO_2)和二氧化碳分压(PaCO_2)。结果:临床疗效总有效率观察组93.85%,明显高于对照组84.38%,差异有统计学意义(P <0.05)。治疗后,2组CAT评分均下降,且观察组明显低于对照组,差异均有统计学意义(P <0.05)。治疗后,2组FEV_1、FVC和FEV_1/FVC值均升高,且观察组高于对照组,差异均有统计学意义(P <0.05)。治疗后,2组PaO_2值均升高,且观察组高于对照组;治疗后,2组PaCO_2值均降低,且观察组低于对照组,差异均有统计学意义(P <0.05)。2组治疗后中医证候积分均下降,且观察组各指标均低于对照组,差异均有统计学意义(P <0.05)。结论:利金汤联合临床康复训练能明显提高COPD肺气虚证患者的临床疗效,改善肺功能,提高患者生活质量。
Objective:To observe the effect of Lijin tang combined with clinical rehabilitation training on the lung function of patients with chronic obstructive pulmonary disease(COPD)with lung qi deficiency syndrome. Methods:A total of 129 cases of COPD patients with lung qi deficiency syndrome were divided into two groups according to the random number table method. The control group(64 cases)was treated with rehabilitation training and routine western medicine,and the observation group(65 cases)was additionally treated with Lijin tang based on the treatment of the control group. The total clinical effective rates,Chinese medicine syndrome scores,the scores of COPD Assessment Test(CAT),the forced expiratory volume in one second(FEV_1), the forced vital capacity(FVC), and the values of FEV_1/FVC and partial pressure of oxygen(PaO_2) as well as partial pressure of carbon dioxide(PaCO_2)in the two groups before and after treatment were recorded. Results: The total effective rate was 93.85% in the observation group, significantly higher than that of 84.38% in the control group, the difference being significant(P < 0.05). After treatment,the scores of CAT in the two groups were decreased,and the score in the observation group was significantly lower than that in the control group, differences being significant(P < 0.05). After treatment,the values of FEV_1,FVC and FEV_1/FVC in the two groups were increased,and the values in the observation group were higher than those in the control group,differences being significant(P < 0.05). After treatment,the values of PaO_2 in the two groups were increased,and the value in the observation group was higher than that in the control group;the values of PaCO_2 in the two groups were decreased,and the value in the observation group was lower than that in the control group,differences being significant(P < 0.05). After treatment, the Chinese medicine syndrome scores in the two groups were decreased,and the indexes in the observation group were lower than those in the control group,differences being significant(P < 0.05). Conclusion: The therapy of Lijin tang combined with clinical rehabilitation training can effectively improve the clinical effect,the lung function and quality of life of COPD patients with lung qi deficiency syndrome.
Objective:To observe the effect of Lijin tang combined with clinical rehabilitation training on the lung function of patients with chronic obstructive pulmonary disease(COPD)with lung qi deficiency syndrome. Methods:A total of 129 cases of COPD patients with lung qi deficiency syndrome were divided into two groups according to the random number table method. The control group(64 cases)was treated with rehabilitation training and routine western medicine,and the observation group(65 cases)was additionally treated with Lijin tang based on the treatment of the control group. The total clinical effective rates,Chinese medicine syndrome scores,the scores of COPD Assessment Test(CAT),the forced expiratory volume in one second(FEV_1), the forced vital capacity(FVC), and the values of FEV_1/FVC and partial pressure of oxygen(PaO_2) as well as partial pressure of carbon dioxide(PaCO_2)in the two groups before and after treatment were recorded. Results: The total effective rate was 93.85% in the observation group, significantly higher than that of 84.38% in the control group, the difference being significant(P < 0.05). After treatment,the scores of CAT in the two groups were decreased,and the score in the observation group was significantly lower than that in the control group, differences being significant(P < 0.05). After treatment,the values of FEV_1,FVC and FEV_1/FVC in the two groups were increased,and the values in the observation group were higher than those in the control group,differences being significant(P < 0.05). After treatment,the values of PaO_2 in the two groups were increased,and the value in the observation group was higher than that in the control group;the values of PaCO_2 in the two groups were decreased,and the value in the observation group was lower than that in the control group,differences being significant(P < 0.05). After treatment, the Chinese medicine syndrome scores in the two groups were decreased,and the indexes in the observation group were lower than those in the control group,differences being significant(P < 0.05). Conclusion: The therapy of Lijin tang combined with clinical rehabilitation training can effectively improve the clinical effect,the lung function and quality of life of COPD patients with lung qi deficiency syndrome.
引文
[1]刘洋,汤万权.补肺活血汤联合常规西医治疗可降低气道炎症并改善肺功能从而提高COPD的疗效[J].中国免疫学杂志,2016,32(7):992-995.
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[4]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南[J].中华内科杂志,2002,25(8):453-460.
[5]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,2002:390.
[6] JONES P W,HARDING G,BERRY P,et al.Development and first validation of the COPD Assessment Test[J].European Respiratory Journal,2009,34(3):648-654.
[7]周胜利,童佳兵,李泽庚,等.八珍汤联合肺俞埋针对脾肺气虚型COPD的疗效及生活质量的影响[J].中医药信息,2016,33(5):68-71.
[8] MCIVOR R A, TASHKIN D P.Underdiagnosis of chronic obstructive pulmonary disease:a rationale for spirometry as a screening tool[J].Canadian Respiratory Journal, 2016, 8(3):153.
[9]杨中良,杨秀云,黄飞华,等.清气化痰汤对COPD急性加重患者肺功能和动脉血氧分压影响的Meta分析[J].中医学报,2017,32(1):26-29.
[10] CASADO B, IADAROLA P, PANNELL L K, et al.Protein Expression in Sputum of Smokers and Chronic Obstructive Pulmonary Disease Patients:A Pilot Study by CapLC-ESI-Q-TOF[J].Journal of Proteome Research,2016,6(12):4615-23.
[11]熊新军,熊龙军.COPD稳定期患者接受健脾补肾汤后PARC/CCL-18含量、气道重塑程度以及MAPKs通路功能的评估[J].海南医学院学报,2016,22(17):1954-1957.
[12] HARTH L,STUART J,MONTGOMERY C,et al.Physical therapy practice patterns in acute exacerbations of chronic obstructive pulmonary disease[J].Canadian Respiratory Journal,2016,16(3):86-92.
[13]矫翠婷,邵玉霞.保肺康汤对COPD合并肺间质纤维化患者血气、肺功能指标与胸部影像学的影响[J].四川中医,2017,35(11):77-80.
[14] CHEN Y H,SUN Y C.Bronchiectasis as a Comorbidity of Chronic Obstructive Pulmonary Disease:Implications and Future Research[J].Chin Med J(Engl), 2016, 129(17):2017-2019.
[15]李磊,倪正义,汤中文,等.血浆中生长分化因子-15在慢性阻塞性肺疾病中的表达和临床应用价值[J].实用医学杂志,2017,33(15):2443-2447.
[16] AU D H.Screening for Chronic Obstructive Pulmonary Disease:D Is the New F[J].Jama Internal Medicine,2016,176(5):1372-1377.
[17]潘敏,林晓阳,陈霞,等.补肺益肾化瘀汤对COPD稳定期患者气道功能的影响及其机制研究[J].中华全科医学,2018,6(4):146-149.
[18]周佳佳,林呼,古威.清金化痰汤合麻杏石甘汤治疗COPD急性加重期痰热郁肺证型临床观察[J].陕西中医,2017,38(11):1532-1533.
[2] WONG A W,GAN W Q,BURNS J,et al.Acute exacerbation of chronic obstructive pulmonary disease:influence of social factors in determining length of hospital stay and readmission rates[J].Canadian Respiratory Journal,2016,15(7):361-364.
[3] WATZ H, TETZLAFF K, WOUTERS E F, et al.Blood eosinophil count and exacerbations in severe chronic obstructive pulmonary disease after withdrawal of inhaled corticosteroids:a post-hoc analysis of the WISDOM trial[J].Lancet Respiratory Medicine,2016,4(5):390-398.
[4]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南[J].中华内科杂志,2002,25(8):453-460.
[5]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,2002:390.
[6] JONES P W,HARDING G,BERRY P,et al.Development and first validation of the COPD Assessment Test[J].European Respiratory Journal,2009,34(3):648-654.
[7]周胜利,童佳兵,李泽庚,等.八珍汤联合肺俞埋针对脾肺气虚型COPD的疗效及生活质量的影响[J].中医药信息,2016,33(5):68-71.
[8] MCIVOR R A, TASHKIN D P.Underdiagnosis of chronic obstructive pulmonary disease:a rationale for spirometry as a screening tool[J].Canadian Respiratory Journal, 2016, 8(3):153.
[9]杨中良,杨秀云,黄飞华,等.清气化痰汤对COPD急性加重患者肺功能和动脉血氧分压影响的Meta分析[J].中医学报,2017,32(1):26-29.
[10] CASADO B, IADAROLA P, PANNELL L K, et al.Protein Expression in Sputum of Smokers and Chronic Obstructive Pulmonary Disease Patients:A Pilot Study by CapLC-ESI-Q-TOF[J].Journal of Proteome Research,2016,6(12):4615-23.
[11]熊新军,熊龙军.COPD稳定期患者接受健脾补肾汤后PARC/CCL-18含量、气道重塑程度以及MAPKs通路功能的评估[J].海南医学院学报,2016,22(17):1954-1957.
[12] HARTH L,STUART J,MONTGOMERY C,et al.Physical therapy practice patterns in acute exacerbations of chronic obstructive pulmonary disease[J].Canadian Respiratory Journal,2016,16(3):86-92.
[13]矫翠婷,邵玉霞.保肺康汤对COPD合并肺间质纤维化患者血气、肺功能指标与胸部影像学的影响[J].四川中医,2017,35(11):77-80.
[14] CHEN Y H,SUN Y C.Bronchiectasis as a Comorbidity of Chronic Obstructive Pulmonary Disease:Implications and Future Research[J].Chin Med J(Engl), 2016, 129(17):2017-2019.
[15]李磊,倪正义,汤中文,等.血浆中生长分化因子-15在慢性阻塞性肺疾病中的表达和临床应用价值[J].实用医学杂志,2017,33(15):2443-2447.
[16] AU D H.Screening for Chronic Obstructive Pulmonary Disease:D Is the New F[J].Jama Internal Medicine,2016,176(5):1372-1377.
[17]潘敏,林晓阳,陈霞,等.补肺益肾化瘀汤对COPD稳定期患者气道功能的影响及其机制研究[J].中华全科医学,2018,6(4):146-149.
[18]周佳佳,林呼,古威.清金化痰汤合麻杏石甘汤治疗COPD急性加重期痰热郁肺证型临床观察[J].陕西中医,2017,38(11):1532-1533.