宣肺平喘胶囊治疗慢性阻塞性肺疾病急性加重期的临床疗效观察

发布时间：2018-03-17 23:11

本文选题：宣肺平喘胶囊　切入点：慢性阻塞性肺疾病急性加重期　出处：《山西中医学院》2016年硕士论文　论文类型：学位论文

【摘要】：目的通过观察宣肺平喘胶囊治疗慢性阻塞性肺疾病急性加重期(AECOPD)患者的临床疗效,进一步探讨该药治疗AECOPD的安全性及有效性,为其临床应用提供科学的依据,为开发新药及申请专利奠定基础,同时,也为AECOPD患者提供一种新的有可靠疗效的中草药制剂。方法收集2014年1月至2015年6月就诊于山西省中医院肺病科的AECOPD患者,采用随机数字表法将符合纳入标准的患者随机分为两组,每组各40例。对照组给予抗感染、解痉平喘、止咳化痰等常规治疗,治疗组加用宣肺平喘胶囊,疗程均为14天,观察两组患者治疗前后中医证候评分、肺功能、血气分析、血常规及安全性指标的变化。结果1.临床总体疗效评价,宣肺平喘胶囊治疗后,临床总有效率为95.00%,与对照组有效率(76.90%)比较,差异有统计学意义(P0.05)。2.中医证候方面,主要症状组间比较,治疗组在改善咳嗽、咳痰、气喘、胸闷、胸痛方面明显优于对照组,差异有统计学意义(P0.05)。次要症状组间比较,治疗组在改善腹胀、便秘、紫绀、干湿性Up音方面明显优于对照组(P0.05),而在改善纳呆方面无统计学意义(P0.05)。3.肺功能方面,与对照组比较,治疗组治疗后患者肺活量占预计值的百分比(VC%)、第一秒用力呼气容积占用力肺活量的百分比(FEV1.0/FVC)、第一秒用力呼气容积占预计值的百分比(FEV1.0%)、最大自主通气量占预计值的百分比(MVV%)均升高,其中FEV1.0/FVC、FEV1.0%改善程度有统计学意义(P0.05),而VC%、MVV%无统计学意义(P0.05)。4.血气分析方面,治疗后,治疗组患者动脉血氧分压(PaO2)及血氧饱和度(SaO2)较对照组明显升高,差异有统计学意义(P0.05),二氧化碳分压(PaCO2)降低,差异无统计学意义(P0.05)。5.抗感染方面,治疗后组间比较,治疗组患者白细胞计数(WBC)、中性粒细胞百分比(NE%)明显降低,淋巴细胞百分比(LY%)明显升高,差异有统计学意义(P0.05)。6.安全性指标方面,两组治疗前后肝肾功能、尿常规、便常规、心电图等各项安全检查均未见异常改变。结论1.宣肺平喘胶囊能明显改善患者的中医证候,提高肺通气功能,改善缺氧和缓解二氧化碳潴留,且未见明显不良反应,表明宣肺平喘胶囊治疗AECOPD是安全有效的;2.从“痰瘀”论治慢性阻塞性肺疾病及多种治肺方法联合治疗AECOPD疗效较好。
[Abstract]:Objective to observe the clinical efficacy of Xuanfei Pingchuan capsule in treating patients with chronic obstructive pulmonary disease (COPD) at acute exacerbation stage, and to further explore the safety and efficacy of Xuanfei Pingchuan capsule in the treatment of AECOPD, so as to provide scientific basis for its clinical application. To lay the foundation for the development of new drugs and patent applications, and to provide a new and reliable Chinese herbal medicine preparation for AECOPD patients. Methods from January 2014 to June 2015, AECOPD patients in the Department of Pulmonary Diseases, Shanxi traditional Chinese Medicine Hospital, were collected. Patients who met the inclusion criteria were randomly divided into two groups with 40 cases in each group. The control group was given routine treatment such as anti-infection, antispasmolysis, relieving cough and resolving phlegm, and the treatment group was treated with Xuanfei Pingchuan capsule for 14 days. Observe the changes of TCM syndrome score, lung function, blood gas analysis, blood routine and safety index before and after treatment. The total clinical effective rate was 95.00, compared with the control group (76.90), the difference was statistically significant (P0.050.2.Compared with the main symptom groups, the treatment group was superior to the control group in improving cough, expectoration, asthma, chest tightness and chest pain. The difference was statistically significant (P 0.05). The treatment group was superior to the control group in improving abdominal distension, constipation, cyanosis, dry and wet up sound, but no significant difference was found in the improvement of anorexia. Pulmonary function was higher in the treatment group than in the control group. In the treatment group, the percentage of vital capacity in the predicted value after treatment was as follows: the percentage of the forced expiratory volume occupied by the forced expiratory volume at 1 second was equal to that of FEV1.0 / FVC1, and the percentage of forced expiratory volume to the predicted value at 1 second was equal to that of FEV1.0, and the maximal autonomic ventilation volume accounted for the predicted value. The percentage of MVV increased, The improvement of FEV1.0 / FVC+ FEV1.0% was significantly higher than that of the control group (P 0.05), but the MVV% had no statistical significance. 4. In blood gas analysis, after treatment, the arterial partial pressure of oxygen (PaO2) and the saturation of oxygen (SaO2) in the treatment group were significantly higher than those in the control group. The difference was statistically significant (P 0.05, P 0.05, Paco 2), but there was no significant difference between the two groups. In the aspect of anti-infection, the white blood cell count and neutrophil percentage of the patients in the treatment group were significantly lower than those in the control group after treatment. The percentage of lymphocytes was significantly increased, the difference was statistically significant (P 0.05). 6. In terms of safety index, the liver and kidney function, urine routine and routine routine were observed in the two groups before and after treatment. Conclusion: Xuanfei Pingchuan capsule can obviously improve TCM syndrome, improve pulmonary ventilation function, improve hypoxia and alleviate carbon dioxide retention, and no obvious adverse reactions. 2. Xuanfei Pingchuan capsule is a safe and effective treatment for AECOPD. From the viewpoint of "phlegm and blood stasis", the treatment of chronic obstructive pulmonary disease (COPD) and combined treatment of multiple methods of lung treatment with AECOPD is better.
【学位授予单位】：山西中医学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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