补气温阳法治疗慢性阻塞性肺疾病稳定期的临床研究
发布时间：2019-06-27 15:31
【摘要】：目的:通过观察补气温阳法联合长效支气管舒张剂对慢性阻塞性肺疾病稳定期肺阳虚证患者的临床疗效,总结其对患者肺通气功能、急性加重次数、生活质量、呼吸困难症状、肺阳虚症状等方面的影响。初步探讨补气温阳法在慢性阻塞性肺疾病稳定期中的作用机制,为中西医结合治疗本病提供更多的临床依据。方法:本研究采用回顾性分析的方法,筛选整理2014年9月至2015年9月,于湖北省中医院肺病科治疗的武汉市慢阻肺重症患者数据库资料。所有患者必须符合2013年慢性阻塞性肺疾病GOLD指南稳定期诊断标准以及中医“肺胀”肺阳虚证标准。在符合纳入标准和除外排除标准条件下,筛选出使用长效支气管舒张剂(英国葛兰素史克生产的沙美特罗氟替卡松粉吸入剂50ug/250ug和正大天晴药业生产的噻托溴铵粉雾剂18ug联用)治疗12周的30例患者设为对照组。在同期患者中筛选使用长效支气管舒张剂治疗12周(同对照组),同时使用补气温阳辨证方12周的30例患者设为观察组。提取60例患者的基本信息,分析两组患者治疗前后随访录入的病程、病情严重程度、肺功能、生活质量评分、呼吸困难程度、肺阳虚症状等评估量表数据(慢阻肺数据库随访周期为12周),并记录治疗后1年内的急性加重次数。本文数据运用统计学软件SPSS17.0进行分析。结果:1.肺功能评价:治疗前后比较,两组患者FEV1%预计值以及FEV1/FVC均提高,且观察组治疗前后差异有显著统计学意义(P0.01);治疗结束后,观察组FEV1%预计值及FEV1/FVC较对照组均有明显提高,差异有统计学意义(P0.05)。治疗结束后,两组患者肺功能稳定的人数比较,观察组明显高于对照组,差异有统计学意义(P0.05)。2.急性加重次数:治疗后观察组患者急性加重次数较对照组明显减少,差异存在统计学意义(P0.05)。3.肺阳虚症状评分:治疗结束后,两组患者肺阳虚症状评分均低于治疗前,观察组治疗前后评分差异存在显著统计学意义(P0.01),对照组治疗后较治疗前有改善,但差异无统计学意义;治疗结束后两组组间比较,观察组肺阳虚症状评分明显低于对照组,差异具有统计学意义(P0.05)。4.呼吸困难症状严重程度的改善:治疗结束后,两组患者mMRC分级比较,差异具有统计学意义(P0.05);治疗前后观察组在mMRC分级的分布差异存在统计学意义(P0.05);治疗前后对照组在mMRC分级的分布无显著差异;5.生活质量的改善:治疗结束后,两组患者的CAT评分与治疗前相比较均有降低(P0.05);治疗结束后,观察组CAT评分明显低于对照组,有显著性差异(P0.01)。结论:补气温阳辨证方联合长效支气管舒张剂治疗COPD稳定期肺阳虚证患者,对患者肺功能有明显改善作用,能减少急性加重的次数,可延长稳定期持续的时间,使患者呼吸困难的症状得以缓解,提升了患者的生存质量,还能缓解患者肺阳虚症状。中西医结合治疗较单纯西医治疗有明显优势,对不同体质特征的患者辨证用药,提高治疗效果,提升患者生活品质。
[Abstract]:Objective: To observe the effect of combined long-acting bronchodilator and long-acting bronchodilator on the patients with chronic obstructive pulmonary disease with chronic obstructive pulmonary disease, and to sum up its effects on the function of lung ventilation, the number of acute exacerbations, the quality of life, the symptoms of dyspnea, and the symptoms of lung-yang deficiency. To explore the mechanism of warming yang in the stabilization of chronic obstructive pulmonary disease, it can provide more clinical evidence for the treatment of this disease with the combination of traditional Chinese and western medicine. Methods: A retrospective analysis was used to screen the data of the patients with chronic obstructive pulmonary disease in Wuhan, from September 2014 to September 2015. All patients must meet the criteria for the stabilization of the period of stable period of the GOLDs in the chronic obstructive pulmonary disease in 2013, as well as the traditional Chinese medicine "swelling of the lung" lung-yang deficiency syndrome standard. in that condition that meet the inclusion criteria and the exclusion criteria, A control group was selected for 30 patients with 12 weeks of treatment with a long-acting bronchodilator (50 ug/250 ug of the Salmeterol fluticasone powder inhaler manufactured by GlaxoSmithKline and 18 ug of a bitutobromate powder, manufactured by Zhengda Tianqing Pharmaceutical Co., Ltd.). In the same period, the long-acting bronchodilator was used for 12 weeks (in the same control group). The basic information of 60 patients was extracted, and the course, severity of the disease, lung function, quality of life, the degree of dyspnea, and the symptoms of lung-yang deficiency were analyzed in the two groups. The follow-up period of the chronic obstructive pulmonary database was 12 weeks. The number of acute exacerbations within 1 year after treatment was recorded. The data of this paper is analyzed by using the statistical software SPSS17.0. Results:1. Pulmonary function evaluation: compared before and after treatment, the predicted value of FEV1% and FEV1/ FVC in both groups were increased, and the difference between the observation group and the before and after treatment was significant (P0.01); after the treatment, the predicted value of FEV1% and FEV1/ FVC in the observation group were significantly improved, and the difference was statistically significant (P0.05). After the treatment, the number of lung function in the two groups was stable, and the observation group was significantly higher than that in the control group (P <0.05). The number of acute exacerbations: the number of acute exacerbations in the treated group was significantly lower than that in the control group (P0.05). After the treatment, the scores of lung-yang-deficiency symptoms in the two groups were significantly lower than those before treatment (P 0.01), and the difference between the two groups was improved before and after the treatment, but the difference was not significant. After the treatment, the scores of lung-yang-deficiency symptoms in the group were significantly lower than that in the control group, and the difference was statistically significant (P0.05). The scores of mMRC in the two groups were statistically significant (P0.05). There was no significant difference in the distribution of mMRC in the control group before and after treatment (P0.05). 5. The improvement of the quality of life: after the treatment, the CAT score of the two groups was lower than that of the control group (P0.05); after the treatment, the CAT score of the observation group was significantly lower than that of the control group, and there was a significant difference (P0.01). Conclusion: The effect of the combined long-acting bronchodilator and long-acting bronchodilator on the lung function of the patients with COPD during the stabilization period can be improved, the number of acute exacerbations can be reduced, the duration of the stabilization period can be prolonged, and the symptoms of the patient's breathing difficulty can be relieved, The survival quality of the patient is improved, and the symptoms of lung-yang deficiency of the patient can be relieved. The combination of traditional Chinese and western medicine has a clear advantage over the treatment of pure western medicine, and the treatment effect is improved and the quality of life of the patient is improved.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R563.9
本文编号：2506916
[Abstract]:Objective: To observe the effect of combined long-acting bronchodilator and long-acting bronchodilator on the patients with chronic obstructive pulmonary disease with chronic obstructive pulmonary disease, and to sum up its effects on the function of lung ventilation, the number of acute exacerbations, the quality of life, the symptoms of dyspnea, and the symptoms of lung-yang deficiency. To explore the mechanism of warming yang in the stabilization of chronic obstructive pulmonary disease, it can provide more clinical evidence for the treatment of this disease with the combination of traditional Chinese and western medicine. Methods: A retrospective analysis was used to screen the data of the patients with chronic obstructive pulmonary disease in Wuhan, from September 2014 to September 2015. All patients must meet the criteria for the stabilization of the period of stable period of the GOLDs in the chronic obstructive pulmonary disease in 2013, as well as the traditional Chinese medicine "swelling of the lung" lung-yang deficiency syndrome standard. in that condition that meet the inclusion criteria and the exclusion criteria, A control group was selected for 30 patients with 12 weeks of treatment with a long-acting bronchodilator (50 ug/250 ug of the Salmeterol fluticasone powder inhaler manufactured by GlaxoSmithKline and 18 ug of a bitutobromate powder, manufactured by Zhengda Tianqing Pharmaceutical Co., Ltd.). In the same period, the long-acting bronchodilator was used for 12 weeks (in the same control group). The basic information of 60 patients was extracted, and the course, severity of the disease, lung function, quality of life, the degree of dyspnea, and the symptoms of lung-yang deficiency were analyzed in the two groups. The follow-up period of the chronic obstructive pulmonary database was 12 weeks. The number of acute exacerbations within 1 year after treatment was recorded. The data of this paper is analyzed by using the statistical software SPSS17.0. Results:1. Pulmonary function evaluation: compared before and after treatment, the predicted value of FEV1% and FEV1/ FVC in both groups were increased, and the difference between the observation group and the before and after treatment was significant (P0.01); after the treatment, the predicted value of FEV1% and FEV1/ FVC in the observation group were significantly improved, and the difference was statistically significant (P0.05). After the treatment, the number of lung function in the two groups was stable, and the observation group was significantly higher than that in the control group (P <0.05). The number of acute exacerbations: the number of acute exacerbations in the treated group was significantly lower than that in the control group (P0.05). After the treatment, the scores of lung-yang-deficiency symptoms in the two groups were significantly lower than those before treatment (P 0.01), and the difference between the two groups was improved before and after the treatment, but the difference was not significant. After the treatment, the scores of lung-yang-deficiency symptoms in the group were significantly lower than that in the control group, and the difference was statistically significant (P0.05). The scores of mMRC in the two groups were statistically significant (P0.05). There was no significant difference in the distribution of mMRC in the control group before and after treatment (P0.05). 5. The improvement of the quality of life: after the treatment, the CAT score of the two groups was lower than that of the control group (P0.05); after the treatment, the CAT score of the observation group was significantly lower than that of the control group, and there was a significant difference (P0.01). Conclusion: The effect of the combined long-acting bronchodilator and long-acting bronchodilator on the lung function of the patients with COPD during the stabilization period can be improved, the number of acute exacerbations can be reduced, the duration of the stabilization period can be prolonged, and the symptoms of the patient's breathing difficulty can be relieved, The survival quality of the patient is improved, and the symptoms of lung-yang deficiency of the patient can be relieved. The combination of traditional Chinese and western medicine has a clear advantage over the treatment of pure western medicine, and the treatment effect is improved and the quality of life of the patient is improved.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R563.9
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