苏子降气汤加全蝎、地龙加减对痰浊阻肺型AECOPD的临床疗效

发布时间：2018-03-11 21:52

本文选题：慢性阻塞性肺疾病急性发作　切入点：苏子降气汤　出处：《南京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:本研究在常规治疗基础上,运用苏子降气汤加全蝎、地龙加减(组方)对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,简称COPD)急性加重期中咳痰困难、中医辨证为痰浊阻肺型的患者的临床疗效,观察其临床症候得分、血气的指标,并探讨年龄、性别、低氧血症与疗效的相关性,为中医治疗缓解气道高分泌症状提供有效的临床依据。研究方法:选择纳入标准的60例痰浊阻肺型AECOPD患者作为研究对象,随机分为对照组与治疗组各30例。对照组:常规抗生素、祛痰药、平喘药、氧喷治疗;治疗组:在对照组治疗基础上加服苏子降气汤加全蝎、地龙加减。以14天为疗程,在第1、3、5、7、10、14天记录患者临床症候得分,检测治疗前后血气分析,并监测血常规、肝肾功能及生命体征,记录结束后运用SPSS20.0进行统计学分析。结果:1.治疗前两组性别、年龄经统计学计算均有可比性。2.两组总积分治疗前后均有降低(P=0.000.05);治疗后积分比较有统计学差异(P=0.0230.05);治疗后咳嗽积分比较有统计学差异(P=0.0140.05);对照组平均秩次均大于治疗组。3.两组临床症状总疗效治疗后控显率比较有统计学差异(P=0.0350.05),治疗组优于对照组;单项疗效上咳痰与哮鸣音两组治疗后控显率比较有统计学差异(分别为P=0.028、0.038均0.05),治疗组优于对照组。4.与咳痰疗效相关比较中两组男性患者比较治疗组优于对照组,有统计学差异(P=0.0350.05);70-80岁年龄段的患者比较治疗组优,有统计学差异(P=0.0320.05);两组B组患者治疗组优于对照组,有统计学差异(P=0.0480.05)。5.两组治疗后疗效指数比较有统计学差异(P=0.0040.01)。6.不同性别总疗效无显著差异;血气氧分压无显著差异,且伴有或不伴有低氧血症对于咳痰疗效并无显著差异。结论:1.苏子降气汤加全蝎、地龙加减可提高痰浊阻肺型慢阻肺患者的临床疗效。2.苏子降气汤加全蝎、地龙加减能够较好缓解慢阻肺患者咯痰困难这一症状,促进痰液排出。3.苏子降气汤加全蝎、地龙加减或可通过对支气管平滑肌的作用改善哮鸣音情况。4.苏子降气汤加全蝎、地龙加减对于男性吸烟患者疗效更佳。5.苏子降气汤加全蝎、地龙加减对于老年的慢阻肺患者疗效较好,推论或能改善其功能,调节免疫,有较好的补益功效。6.苏子降气汤加全蝎、地龙加减对于慢阻肺患者通气功能无显著效果,且伴有或不伴有低氧血症对于咯痰困难这一症状并无显著影响。
[Abstract]:Objective: on the basis of routine treatment, the treatment of chronic obstructive pulmonary disease (pulmonary) with Suzi Jiangqi decoction (Scorpion) and Rhizoma Rehmanniae (prescription) in acute exacerbation of sputum dysphonia during the period of chronic obstructive pulmonary disease (COPD) was studied. The clinical curative effect of patients with phlegm turbid obstruction of lung syndrome was observed, the clinical symptom score and blood gas index were observed, and the correlation between age, sex, hypoxemia and curative effect was discussed. Methods: 60 cases of AECOPD with phlegm turbid obstruction and lung obstruction were selected as the research objects. The control group was randomly divided into control group (n = 30) and treatment group (n = 30). The control group was treated with routine antibiotics, expectorant, antiasthmatic medicine and oxygen spray. Clinical symptom scores, blood gas analysis, blood routine examination, liver and kidney function and vital signs were recorded on day 1, 3, 5, 7, 10, 14, respectively. SPSS20.0 was used for statistical analysis after recording. Results: 1. Sex of two groups before treatment. Age was comparable by statistical calculation. 2.The total integral of the two groups were decreased before and after treatment, there were significant differences in the score after treatment (P < 0.05), there was significant difference in the score of cough after treatment (P < 0.0140.05), and the average rank of the control group was greater than that of the treatment. Group 3.There was statistical difference between the two groups in the total curative effect of clinical symptom control after treatment, the treatment group was better than the control group. There was statistical difference between the two groups (P < 0.028, 0.038, respectively), and the treatment group was superior to the control group (.4.Compared with the curative effect of expectoration), the treatment group was better than the control group in comparison with the curative effect of expectoration. There was statistical difference between the two groups (P < 0. 035, 0. 05, P < 0. 035, P = 0. 035, P = 0. 035, P = 0. 035, P = 0. 035, P = 0. 035, P = 0. 035, P = 0. 035). There was significant difference in the curative effect index between the two groups after treatment. There was no significant difference in the total curative effect between the two groups, and there was no significant difference in the partial pressure of oxygen in blood gas. There was no significant difference between patients with or without hypoxemia in expectoration. Conclusion: 1. The effect of Scorpion decoction and the addition and subtraction of Dilong can improve the clinical efficacy of Scorpion in patients with obstructive pulmonary disease with turbid phlegm and obstruction of lung. 2. The addition and subtraction of Rehmannia can better relieve the symptoms of difficulty of sputum in patients with chronic obstructive lung, promote sputum excretion .3.Scorpion from the whole Scorpio of Su Zi Jiang Qi decoction, and improve the wheezing condition by the effect on bronchial smooth muscle .4.The whole scorpion of Su Zi Jiang Qi Tang can be improved by its effect on bronchial smooth muscle. The effect of the addition and subtraction of Rehmannia is better for the male smoking patients. 5. Suzi jiangqi decoction whole scorpion, the addition and subtraction of the dragon is better for the elderly patients with chronic obstructive pulmonary disease, inference or can improve its function, regulate immunity, There was no significant effect on ventilation function in patients with chronic obstructive pulmonary disease, and there was no significant effect on the symptoms of dyspnea with or without hypoxemia.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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