苏子降气汤加味治疗缓解期老年慢性阻塞性肺疾病
|
摘要
目的:观察苏子降气汤加味治疗缓解期老年慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)的临床疗效。方法:60例缓解期老年COPD患者随机分为对照组和观察组。对照组给予舒利迭(每次1吸,2次·d~(-1))、氨茶碱片(口服100 mg,2次·d~(-1)),观察组在对照组治疗基础上给予苏子降气汤加味。8周后比较两组患者临床疗效、中医证候评分、CAT评分、血气分析、肺功能及安全性。结果:治疗后,观察组有效率为90.00%,对照组为76.66%,两组有效率比较,差异有统计学意义(χ~2=5.316,P=0.027<0.05)。两组患者治疗后中医证候积分、CAT评分均显著低于治疗前(P<0.05),观察组以上指标治疗后均显著低于对照组(P<0.05)。两组患者治疗后PaO_2均显著高于治疗前(P<0.05),且观察组治疗后高于对照组治疗后(P=0.022);PaCO_2均显著低于治疗前(P<0.05),观察组治疗后低于对照组治疗后(P=0.027)。两组患者治疗后第1秒用力呼气量(forced expiratory volume 1 second,FEV1)、用力肺活量(forced vital capacity,FVC)、FEV1/FVC均显著高于治疗前(P<0.05),且观察组治疗后以上指标均高于对照组治疗后(P<0.05)。两组患者治疗前后尿素氮、肌酐、谷草转氨酶及谷丙转氨酶水平比较,差异均无统计学意义(P>0.05)。结论:苏子降气汤加味治疗缓解期老年COPD疗效显著,可改善患者症状、血气水平,降低CAT评分,提高患者肺功能,且用药安全。
Objective:To observe the clinical efficacy of Suzi Jiangqi Decoction in the treatment of chronic obstructive pulmonary disease(COPD).Methods:Sixty patients with remission COPD were randomly divided into control group and observation group.The control group was given sulidide(1 intake,2 times·d~(-1)),aminophylline tablets(100 mg orally,2 times·d~(-1)),and the observation group was given Suzi Jiangqi Decoction on the basis of the control group.Add flavor.After 8 weeks,the clinical efficacy,TCM syndrome score,CAT score,blood gas analysis,lung function and safety of the two groups were compared.Results:After treatment,the effective rate of the observation group was 90.00%,and that of the control group was 76.66%.The effective rate of the two groups was statistically significant(χ~2=5.316,P=0.027<0.05).The TCM syndrome scores and CAT scores of the two groups were significantly lower than those before treatment(P<0.05).The above indexes of the observation group were significantly lower than the control group(P<0.05).The PaO2 levels in the two groups were significantly higher than those before treatment(P<0.05),and the observation group was higher than the control group after treatment(P=0.022).PaCO_2 was significantly lower than before treatment(P<0.05).That of the observation group was lower than that of the control group after treatment(P=0.027).Forced expiratory volume 1 second(FEV1),forced vital capacity(FVC),FEV1/FVC were significantly higher in the two groups after treatment(P<0.05).After treatment,the above indexes of the observation group were higher than those in the control group(P<0.05).There were no significant differences in the levels of urea nitrogen,creatinine,aspartate aminotransferase and alanine aminotransferase between the two groups before and after treatment(P>0.05).Conclusion:Suzi Jiangqi Decoction has a significant effect on the treatment of elderly patients with COPD.It can improve the symptoms,blood gas level,lower the CAT score,improve the lung function of patients,and safe medication.
Objective:To observe the clinical efficacy of Suzi Jiangqi Decoction in the treatment of chronic obstructive pulmonary disease(COPD).Methods:Sixty patients with remission COPD were randomly divided into control group and observation group.The control group was given sulidide(1 intake,2 times·d~(-1)),aminophylline tablets(100 mg orally,2 times·d~(-1)),and the observation group was given Suzi Jiangqi Decoction on the basis of the control group.Add flavor.After 8 weeks,the clinical efficacy,TCM syndrome score,CAT score,blood gas analysis,lung function and safety of the two groups were compared.Results:After treatment,the effective rate of the observation group was 90.00%,and that of the control group was 76.66%.The effective rate of the two groups was statistically significant(χ~2=5.316,P=0.027<0.05).The TCM syndrome scores and CAT scores of the two groups were significantly lower than those before treatment(P<0.05).The above indexes of the observation group were significantly lower than the control group(P<0.05).The PaO2 levels in the two groups were significantly higher than those before treatment(P<0.05),and the observation group was higher than the control group after treatment(P=0.022).PaCO_2 was significantly lower than before treatment(P<0.05).That of the observation group was lower than that of the control group after treatment(P=0.027).Forced expiratory volume 1 second(FEV1),forced vital capacity(FVC),FEV1/FVC were significantly higher in the two groups after treatment(P<0.05).After treatment,the above indexes of the observation group were higher than those in the control group(P<0.05).There were no significant differences in the levels of urea nitrogen,creatinine,aspartate aminotransferase and alanine aminotransferase between the two groups before and after treatment(P>0.05).Conclusion:Suzi Jiangqi Decoction has a significant effect on the treatment of elderly patients with COPD.It can improve the symptoms,blood gas level,lower the CAT score,improve the lung function of patients,and safe medication.
引文
[1]牛宏涛,杨汀,王辰.慢性阻塞性肺疾病的临床表型和治疗策略[J].中国临床医生杂志,2017,45(9):1-4.
[2]RABE KF,HURD S,ANZUETO A,et al.Global Strategy for the Diagnosis,Management,and Prevention of Chronic Obstructive Lung Disease 2017 Report:GOLD Executive Summary[J].Am J Respir Crit Care Med,2007,176(6):532-555.
[3]WHO.World Health Statistics 2017:Monitoring health for the SDGs[J].PLoS One,12(5):e0176195.
[4]慢性阻塞性肺疾病诊治指南(2013年修订版)[J].中华结核和呼吸杂志,2013,43(4):1-10.
[5]陈明.固本祛痰化瘀汤对慢性阻塞性肺疾病稳定期患者生活质量的影响[J].中国药师,2012,15(7):1007-1009.
[6]宋丽华,祝建材,王枫.补肾益金汤对慢性阻塞性肺疾病稳定期患者免疫功能的影响[J].中医学报,2017,32(9):1613-1615.
[7]陆麒,姜柏生.谈《涉及人的生物医学研究伦理审查办法》的修订对我国伦理审查工作的影响[J].医学与哲学,2017,38(21):1-4.
[8]Global initiative for chronic obstmctive lung di8ease.GlobaJ strategy for the diagnosis,management,and prevemion of chmnjc obstmc6ve pul-monary disease 2017 report[EB/OL].[2016-12-09].http://www.goldopd.org.
[9]陈云坤,冯英凯.GOLD 2017新版指南要点解读[J].现代医药卫生,2017,33(4):481-486.
[10]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(2013年修订版)[J].中国医学前沿杂志(电子版),2014,6(2):67.
[11]周仲瑛.中医内科学[M].北京:中国中医药出版社,2007:112-115.
[12]庞才双,龙虹羽,吴艳秋,等.CAT评分在慢性阻塞性肺疾病中的临床应用[J].临床肺科杂志,2015,20(12):2173-2176.
[13]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:233-237.
[14]胡瑞霞,胡瑞华,秦淑芳.中西医结合治疗Ⅲ-Ⅳ级慢性阻塞性肺疾病临床研究[J].中医学报,2013,28(10):1464-1465.
[15]OVERBEEK S A,BRABER S,KOELINK P J,et al.Cigarette smoke-induced collagen destruction;key to chronic neutrophilic airway inflammation[J].PLoS One,2013,8(1):e55612.
[16]CRISTOVAO C,CRISTOVAO L,NOGUEIRA F,et al.Evaluation of the oxidant and antioxidant balance in the pathogenesis of chronic obstructive pulmonary disease[J].Rev Port Pneumol,2013,19(2):70-75.
[17]李琳琳,田燕歌,李亚,等.中医外治法治疗稳定期慢性阻塞性肺疾病研究进展[J].中医学报,2015,30(11):1583-1585.
[18]邓丽.慢性阻塞性肺疾病稳定期虚证中医药治疗进展[J].中医学报,2011,26(1):29-31.
[19]孙丽.老年病的用药体会[J].光明中医,2012,27(2):390-391.
[20]马屏南.紫苏子镇咳、祛痰、平喘作用的药理研究[J].中国实用医药,2015,10(10):159-160.
[21]肖琦,阳文武,张德伟,等.半夏总生物碱含量影响因素及药理作用研究进展[J].中国药物,2016,25(3):123-126.
[22]王秀枝,王迪,迟戈夫,等.改善急性肺损伤的中药有效成分研究进展[J].中国药房,2016,27(34):4868-4871.
[23]鞠康,赵利敏.前胡化学成分及其药理作用研究进展[J].内蒙古中医药,2017(3):142-143.
[24]夏其乐,王涛,陆胜民,等.苦杏仁苷的分析、提取纯化及药理作用研究进展[J].食品科学,2013,34(21):403-407.
[25]杨娥,钟艳梅,冯毅凡.白术化学成分和药理作用的研究进展[J].广东药学院学报,2012,28(2):218-221.
[26]刘医辉,杨世英,马伟林,等.当归药理作用的研究进展[J].中国当代医药,2014,21(22):192-194.
[27]刘明淑美,刘云,邢爱萍.运用虫类药治疗气道痉挛性疾病验案举隅[J].国际中医中药杂志,2017,39(11):1035-1036.
[28]邵明珅.虫类中药在哮喘治疗中的应用[J].中国文献杂志,2013(3):55-57.
[29]吴修富.肉桂提取物的主要化学成分及药理活性研究进展[J].中国药房,2015,26(24):3454-3456.
[30]张俊清,王勇,陈峰,等.益智的化学成分与药理作用研究进展[J].天然产物研究与开发,2013,25(2):280-287.
[31]马思田.学仲景《金匮要略》中生姜大枣甘草三药功效浅见[J].健康周刊,2016(7):51-52.
[32]刘志刚,孙宜芬,孟红旗.苏子降气汤治疗慢性阻塞性肺病急性加重疗效观察[J].临床肺科杂志,2016,21(8):1442-1445.
[2]RABE KF,HURD S,ANZUETO A,et al.Global Strategy for the Diagnosis,Management,and Prevention of Chronic Obstructive Lung Disease 2017 Report:GOLD Executive Summary[J].Am J Respir Crit Care Med,2007,176(6):532-555.
[3]WHO.World Health Statistics 2017:Monitoring health for the SDGs[J].PLoS One,12(5):e0176195.
[4]慢性阻塞性肺疾病诊治指南(2013年修订版)[J].中华结核和呼吸杂志,2013,43(4):1-10.
[5]陈明.固本祛痰化瘀汤对慢性阻塞性肺疾病稳定期患者生活质量的影响[J].中国药师,2012,15(7):1007-1009.
[6]宋丽华,祝建材,王枫.补肾益金汤对慢性阻塞性肺疾病稳定期患者免疫功能的影响[J].中医学报,2017,32(9):1613-1615.
[7]陆麒,姜柏生.谈《涉及人的生物医学研究伦理审查办法》的修订对我国伦理审查工作的影响[J].医学与哲学,2017,38(21):1-4.
[8]Global initiative for chronic obstmctive lung di8ease.GlobaJ strategy for the diagnosis,management,and prevemion of chmnjc obstmc6ve pul-monary disease 2017 report[EB/OL].[2016-12-09].http://www.goldopd.org.
[9]陈云坤,冯英凯.GOLD 2017新版指南要点解读[J].现代医药卫生,2017,33(4):481-486.
[10]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(2013年修订版)[J].中国医学前沿杂志(电子版),2014,6(2):67.
[11]周仲瑛.中医内科学[M].北京:中国中医药出版社,2007:112-115.
[12]庞才双,龙虹羽,吴艳秋,等.CAT评分在慢性阻塞性肺疾病中的临床应用[J].临床肺科杂志,2015,20(12):2173-2176.
[13]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:233-237.
[14]胡瑞霞,胡瑞华,秦淑芳.中西医结合治疗Ⅲ-Ⅳ级慢性阻塞性肺疾病临床研究[J].中医学报,2013,28(10):1464-1465.
[15]OVERBEEK S A,BRABER S,KOELINK P J,et al.Cigarette smoke-induced collagen destruction;key to chronic neutrophilic airway inflammation[J].PLoS One,2013,8(1):e55612.
[16]CRISTOVAO C,CRISTOVAO L,NOGUEIRA F,et al.Evaluation of the oxidant and antioxidant balance in the pathogenesis of chronic obstructive pulmonary disease[J].Rev Port Pneumol,2013,19(2):70-75.
[17]李琳琳,田燕歌,李亚,等.中医外治法治疗稳定期慢性阻塞性肺疾病研究进展[J].中医学报,2015,30(11):1583-1585.
[18]邓丽.慢性阻塞性肺疾病稳定期虚证中医药治疗进展[J].中医学报,2011,26(1):29-31.
[19]孙丽.老年病的用药体会[J].光明中医,2012,27(2):390-391.
[20]马屏南.紫苏子镇咳、祛痰、平喘作用的药理研究[J].中国实用医药,2015,10(10):159-160.
[21]肖琦,阳文武,张德伟,等.半夏总生物碱含量影响因素及药理作用研究进展[J].中国药物,2016,25(3):123-126.
[22]王秀枝,王迪,迟戈夫,等.改善急性肺损伤的中药有效成分研究进展[J].中国药房,2016,27(34):4868-4871.
[23]鞠康,赵利敏.前胡化学成分及其药理作用研究进展[J].内蒙古中医药,2017(3):142-143.
[24]夏其乐,王涛,陆胜民,等.苦杏仁苷的分析、提取纯化及药理作用研究进展[J].食品科学,2013,34(21):403-407.
[25]杨娥,钟艳梅,冯毅凡.白术化学成分和药理作用的研究进展[J].广东药学院学报,2012,28(2):218-221.
[26]刘医辉,杨世英,马伟林,等.当归药理作用的研究进展[J].中国当代医药,2014,21(22):192-194.
[27]刘明淑美,刘云,邢爱萍.运用虫类药治疗气道痉挛性疾病验案举隅[J].国际中医中药杂志,2017,39(11):1035-1036.
[28]邵明珅.虫类中药在哮喘治疗中的应用[J].中国文献杂志,2013(3):55-57.
[29]吴修富.肉桂提取物的主要化学成分及药理活性研究进展[J].中国药房,2015,26(24):3454-3456.
[30]张俊清,王勇,陈峰,等.益智的化学成分与药理作用研究进展[J].天然产物研究与开发,2013,25(2):280-287.
[31]马思田.学仲景《金匮要略》中生姜大枣甘草三药功效浅见[J].健康周刊,2016(7):51-52.
[32]刘志刚,孙宜芬,孟红旗.苏子降气汤治疗慢性阻塞性肺病急性加重疗效观察[J].临床肺科杂志,2016,21(8):1442-1445.