三伏贴联合补肺活血胶囊治疗COPD稳定期的临床疗效观察

发布时间：2018-04-27 14:41

  本文选题：三伏贴 + 补肺活血胶囊　； 参考：《湖北中医药大学》2017年硕士论文

【摘要】：目的采用中医外敷三伏贴联合补肺活血胶囊内服治疗慢性阻塞性肺疾病(COPD)稳定期,通过观察其治疗后总疗效、中医症候积分等的改变,评价三伏贴联合补肺活血胶囊治疗慢性阻塞性肺疾病的临床疗效,以期在探讨其内在作用理论的同时,为中医药防治COPD提供新的思路和方向。方法1.选取符合COPD稳定期诊断标准患者70例,肺功能分级为I~III级,病情分期为稳定期。患者均来自于2015年-2016年2年期间在湖北省中医院呼吸科门诊或住院部治疗的病例,按就诊的先后顺序将患者分为2组,治疗组及对照组各35例。两组患者在年龄、性别、病程、病情分级、治疗前中医症状积分、生活质量评分、6分钟步行距离等资料经统计学分析无明显差异,具有可比性(P0.05)。2.对照组予以噻托溴铵粉雾剂18ug(商品名:思力华勃林格殷格翰公司)治疗,每天1粒。治疗组予以中药三伏贴联合补肺活血胶囊治疗。三伏贴外敷:药物由白芥子、延胡索、细辛、甘遂、肉桂等按一定的比例研磨成细粉,再以生姜汁搅拌调匀,制成膏状;时间为2015年至2016年初伏、中伏、末伏的第一天进行敷贴;取穴为双侧大杼、肺俞、厥阴俞、肾俞,若喘气明显者加定喘,咳痰量多者加丰隆;每次敷贴时间为2-4小时,若敷贴后皮肤刺痒难忍,灼热疼痛则应立即取下,对敷贴无特殊不适者可适当延长时间,但不宜超过6小时。补肺活血胶囊(由黄芪、赤芍、补骨脂组成,广东远大药业有限公司)内服:每天3次,每次4粒。2组均以2年为1个疗程,1疗程结束后评定其临床疗效。两组患者在治疗期间需戒烟酒,避风寒,禁食辛辣刺激食物,以免影响观察效果。3.疗效标准:显效:主要临床症状改善,疗效指数≥70%;有效:主要临床症状改善,疗效指数≥30%,而70%;无效:临床症状无改善,疗效指数30%。4.统计学分析方法:数据采用SPSS19.0统计学软件进行分析。计数资料使用X2检验,计量资料使用t检验。结果1.本次研究中治疗组显效8例,有效19例,无效8例,总有效率为77.14%;对照组中显效8例,有效17例,无效10例,总有效率为71.43%。两组总有效率对比无明显差异(P0.05),疗效相当。2.两组患者治疗后中医症候积分和治疗前相比均有差异(P0.05),且治疗组优于对照组(P0.05)。3.两组患者治疗后生活质量积分和治疗前相比均有差异(P0.05),且治疗组生活质量高于对照组(P0.05)。4.两组患者治疗后一年内感冒次数均较前减少(P0.05),治疗组年感冒次数少于对照组(P0.05)。5.两组患者治疗后6分钟步行距离均较前有所增加(P0.05),治疗组步行距离增加明显高于对照组(P0.05)。结论此次研究表明外敷三伏贴联合内服补肺活血胶囊治疗慢性阻塞性肺疾病稳定期有其优势,可明显改善患者临床症状,减少一年内感冒次数,提高运动耐力及生活质量,与西药比较,通过内外同治调节机体免疫功能,调和经络气血,增强人体正气,提高抵御外邪的能力,治疗效果显著,值得在临床上进一步推广使用。
[Abstract]:Objective to observe the changes of the total curative effect and TCM symptom score after the treatment of chronic obstructive pulmonary disease (COPD) with external application of Sanfu plaster and internal administration of Bufei Huoxue capsule in chronic obstructive pulmonary disease (COPD). To evaluate the clinical efficacy of Sanfu tie combined with Bufei Huoxue capsule in the treatment of chronic obstructive pulmonary disease (COPD) in order to provide new ideas and directions for the prevention and treatment of COPD by traditional Chinese medicine (TCM). Method 1. Seventy patients with COPD stable stage were selected. The pulmonary function grade was I~III grade and the disease stage was stable stage. The patients were all from the outpatient department or inpatient department of respiratory department of Hubei traditional Chinese Medicine Hospital from 2015 to 2016. The patients were divided into two groups according to the order of treatment, 35 cases in the treatment group and 35 cases in the control group. There was no significant difference between the two groups in age, sex, course of disease, grade of illness, score of TCM symptom before treatment, quality of life score and 6-minute walking distance. There was no significant difference between the two groups by statistical analysis, and there was no significant difference in comparison between the two groups. The control group was treated with thiotropium bromide powder (18ugg). The treatment group was treated with Sanfu paste and Bufei Huoxue capsule. External application of three volts: the medicine is ground into fine powder by white mustard, corydalis, asarum, kansui and cinnamon in a certain proportion, and then mixed with ginger juice to make a paste. The time is from 2015 to early 2016. At the end of the first day, the points were applied on both sides of the loom, Feshu, Jueyin Yu, Shenshu, if the breath was obvious, and the expectoration was much more. The time of each application was 2-4 hours, and if the skin prickled after the application, it was hard to bear itching. Burn pain should be removed immediately, the application of no special discomfort can be extended appropriately, but not more than 6 hours. Bufei Huoxue capsule (composed of Radix Astragali, Radix Paeoniae Paeoniae Alba, psoralen, Guangdong Broad Pharmaceutical Co., Ltd.) was taken orally: 3 times a day, 4 tablets per day, 2 years as a course of treatment and 1 course of treatment were used to evaluate its clinical effect. Two groups of patients in the treatment period should quit smoking and alcohol, avoid cold, fasting spicy food, so as not to affect the observation effect. 3. Efficacy standard: significant effect: main clinical symptom improvement, curative effect index 鈮，

本文编号：1811141