培土生金法治疗稳定期肺脾气虚证慢性阻塞性肺疾病的临床观察

发布时间：2018-05-14 14:08

本文选题：慢性阻塞性肺疾病 + 稳定期　；参考：《辽宁中医药大学》2016年硕士论文

【摘要】：目的:观察以培土生金法为理论基础的中药汤剂治疗稳定期肺脾气虚证慢性阻塞性肺疾病的临床疗效。材料与方法:将2013年12月至2015年6月于辽宁中医药大学附属第二医院肺病科门诊就诊的稳定期肺脾气虚证COPD患者,符合纳入标准的60例采用区组随机法分为治疗组、对照组,每组各30例。经统计学检验两组患者在年龄、性别、病程、吸烟史及病情轻重(综合评估分组)等客观指标上均无明显差异(P0.05),具有可比性。对照组根据《慢性阻塞性肺疾病诊疗指南》稳定期治疗方案,予以常规西药治疗:沙美特罗替卡松粉吸入剂(商品名:舒利迭),规格:50ug/500ug*60,每次1吸,每日2次;治疗组在对照组的基础上加用以培土生金为法的中药汤剂,100ml日3次口服。疗程为12周,每四周进行一次访视,于治疗前后及访视期间分别测定两组患者的中医临床症状评分、肺通气功能、呼吸困难程度、生活质量评估问卷评分等相关指标,并于治疗前后进行安全性指标检测(血常规、尿常规、肝功、肾功、心电图)。并用SPSS18.0统计软件对其结果进行统计分析,得出结论。结果:治疗组总有效率86.67%,对照组总有效率58.62%,差异具有统计学意义(P0.05),说明治疗组疗效优于对照组。治疗组与对照组均能改善肺通气功能,且治疗组较对照组更具有延缓肺功能下降的趋势(治疗组FEV1%增加约7.73%,FEV1/FVC%增加约6.29%;对照组FEV1%增加约4.28%,FEV1/FVC%增加约3.82%)。治疗后治疗组在咯痰、乏力、便溏三项中医临床症状评分、CAT评分及呼吸困难程度上较对照组有明显改善,差异有统计学意义(P0.05)。治疗前后两组患者的肝、肾功能及血、尿常规、心电图均未见明显异常。结论:针对稳定期肺脾气虚证COPD患者,以培土生金为法的中药汤剂联合常规西药治疗可明显改善患者咯痰、乏力、便溏三项中医临床症状;可明显缓解患者的呼吸困难程度;可明显提高患者的生活质量;且更具有延缓肺功能下降的趋势;其疗效明显,安全性较高。
[Abstract]:Objective: to observe the clinical effect of traditional Chinese medicine decoction (TCM) on chronic obstructive pulmonary disease (COPD) with deficiency of the lung in stable period. Materials and methods: from December 2013 to June 2015, 60 COPD patients with stable lung temper deficiency syndrome were randomly divided into treatment group and control group. There were 30 cases in each group. There were no significant differences between the two groups in age, sex, course of disease, smoking history and severity of the disease (comprehensive assessment group). The control group was treated with routine western medicine according to the "guidelines for the diagnosis and treatment of chronic obstructive Pulmonary Disease". On the basis of the control group, the treatment group was treated with 100ml Chinese medicine decoction for cultivating native gold three times a day. The course of treatment was 12 weeks. The clinical symptoms of TCM, pulmonary ventilation function, degree of dyspnea, quality of life assessment questionnaire were measured before and after treatment and during the visit. The safety indexes (blood routine, urine routine, liver function, renal function, electrocardiogram) were detected before and after treatment. The results are analyzed by SPSS18.0 software, and the conclusion is drawn. Results: the total effective rate of the treatment group was 86.67 and the total effective rate of the control group was 58.62. The difference was statistically significant (P 0.05), which indicated that the curative effect of the treatment group was better than that of the control group. Both the treatment group and the control group could improve the pulmonary ventilation function, and the treatment group had the tendency of delaying the decline of pulmonary function (FEV1% increased by 7.73% and FEV1 / FVC% increased about 6.29%, FEV1% increased about 4.28% FEV1 / FVC% increased about 3.82%. After treatment, the treatment group in sputum, fatigue, loose stool in three TCM clinical symptoms score cat score and breathing difficulty degree significantly improved compared with the control group, the difference was statistically significant (P 0.05). Before and after treatment, the liver, kidney function, blood, urine routine, electrocardiogram were not abnormal. Conclusion: traditional Chinese medicine decoction combined with conventional western medicine can obviously improve the clinical symptoms of sputum, fatigue and stools in patients with COPD with deficiency of lung and temper in stable period, and can obviously alleviate the degree of dyspnea in patients. It can obviously improve the quality of life of the patients, and has the tendency of delaying the decline of pulmonary function.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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