麻桔喘咳方治疗慢性阻塞性肺疾病急性加重期急诊留观病人的疗效观察

发布时间：2018-05-27 07:37

本文选题：慢性阻塞性肺疾病急性加重 + 麻桔喘咳方　；参考：《成都中医药大学》2016年硕士论文

【摘要】：目的：评价麻桔喘咳方治疗AECOPD急诊留观病人的临床疗效和安全性,客观分析麻桔喘咳方在A ECOPD治疗中的应用价值,推动我科验方的实用性转化,为中药新药研发提供前期准备和数据支撑。方法：采用随机对照方法,选择AEOPD患者102例(对照组46例,治疗组56例),治疗组给予西医标准治疗的基础上加用麻桔喘咳方,对照组给予西医标准治疗,观察治疗前后的中医症状积分、痰液变化情况、CAT评分、实验室检查、综合疗效评价等指标。结果：1.可比性分析：两组患者治疗前一般资料(年龄、性别、吸烟史)、一般情况(收缩压、舒张压、呼吸、心率、体温、BMI)、病情严重程度(病程、CAT评分、中医症状总分、急性发作次数、mMRC评分)差异均无统计学意义(P0.05),两组问具有可比性。2.中医证候分析：两组均可使中医症状明显改善,治疗组疗效明显优于对照组(P0.05)。总体趋势上,各时间节点中医证候积分呈递减趋势,并且治疗组优于对照组。在痰液变化(痰质、色、量)方面,治疗组也明显优于对照组(P0.05)。中医证候疗效评价方面,治疗组总有效率85.71%,对照组总有效率65.21%,治疗组明显高于对照组(P0.05)。3.CAT评分分析：治疗组治疗前后各指标均有显著改善(P0.01)。除家务、外出指标外,对照组其他各指标及CAT总分均有明显减少(P0.05)。除胸闷、爬楼两个症状外,其他各指标治疗组均优于对照组(P0.05)。总体趋势上,各时间节点上CAT评分呈递减趋势,并且治疗组优于对照组。4.实验室检查指标分析：两组均可使WBC、N%明显改善(P0.05),但组间比较未见明显差异(P0.05)。血气分析指标PH、PaCO2、PaO2明显改善(P0.05),治疗组优于对照组(P0.05)。5.综合疗效评价：治疗组总有效率82.14%,对照组总有效率67.39%,治疗组综合疗效明显高于对照组(P0.05)。6.入院情况比较：治疗组共有10例患者入院治疗,对照组共17例患者入院治疗,减少入院情况比较,治疗组明显优于对照组。7.安全性评价：治疗后两组患者血常规、肝肾功、心电图及大小便常规检测组内比较,未发现明显异常(P0.05),说明两种治疗方案对血常规、肝肾功、心电图均无明显影响。结论：1.研究证实在西医标准治疗基础上加用麻桔喘咳方,在改善患者咳嗽、咳痰、喘息、哮鸣等主要症状方面优于西医对照组,并且有助于腹胀、自汗、气短等次要症状缓解。对于中医证候总分及中医症状疗效率的改善亦有明显优势。从整体趋势上看,治疗组与对照组无论是主要症状积分、次要症状积分还是症状总积分上,呈递减趋势。随着治疗时间的延长,无论对照组还是治疗组,疗效越来越好,并且治疗组优于对照组。2.研究发现麻桔喘咳方在痰液质色量改善方面均具有明显效果,西医标准治疗加用麻桔喘咳方在促进痰液稀释、痰色改变、痰液的排出等方面明显优于西医对照组。3.本研究选用CAT评分作为AECOPD疗效评价指标,多项研究证明CAT评分与SGRQ评分具有良好的相关性,且简便易行。研究结果显示,西医标准治疗加用麻桔喘咳方在缓解咳嗽、咳痰等单项指标及CAT总分方面优于单纯西医组。在改善胸闷、爬楼两指标上与对照组疗效相当。从整体趋势上看,治疗组与对照组CAT积分呈递减趋势,随着治疗时间的延长,其疗效越来越好,并且治疗组优于对照组。4.实验室检查方面,治疗组在WBC、N%的改善上与对照组相当。在改善血气分析指标上治疗组优于对照组,这可能跟治疗组呼吸困难情况缓解较快有关。5.在综合疗效分析上,治疗组有效率明显优于对照组,并能够明显减少病人的住院率。6.入院情况比较：治疗组共有10例患者入院治疗,对照组共17例患者入院治疗,减少入院情况比较,治疗组明显优于对照组。7.安全性评价：麻桔喘咳方用于治疗慢性阻塞性肺疾病急性加重安全可靠。
[Abstract]:Objective: To evaluate the clinical efficacy and safety of matangchuan cough prescription in the treatment of AECOPD emergency patients, objectively analyze the application value of Ma tangchuan prescription in the treatment of A ECOPD, promote the practical transformation of my laboratory, provide early preparation and data support for the research and development of Chinese medicine new drugs. Method: 102 cases of AEOPD patients were selected by random control method. (46 cases in the control group, 56 cases in the treatment group), the treatment group was given the standard treatment of Western Medicine on the basis of Ma orange Chuan Fang, and the control group was given the standard treatment of Western medicine. The score of TCM symptoms, the change of sputum, the CAT score, the laboratory examination, the comprehensive therapeutic evaluation and so on were observed before and after the treatment. Results: 1. comparability analysis: two groups of patients were treated before treatment. The general conditions (age, sex, smoking history), general conditions (systolic pressure, diastolic pressure, respiration, heart rate, body temperature, BMI), the severity of the disease (course of disease, CAT score, TCM symptoms total, acute attack times, mMRC score) were not statistically significant (P0.05), the two groups were comparable to.2. syndrome analysis: the two groups could make the symptoms of traditional Chinese medicine obviously changed The curative effect of the treatment group was obviously better than the control group (P0.05). On the general trend, the TCM syndrome score of each time node was reduced, and the treatment group was better than the control group. The treatment group was obviously superior to the control group (P0.05) in the change of sputum (phlegm quality, color and quantity). The total effective rate of the treatment group was 85.71% in the treatment group, and the control group was always in the control group. Efficiency 65.21%, the treatment group was significantly higher than the control group (P0.05).3.CAT score analysis: the treatment group had significant improvement (P0.01) before and after treatment. Except for housework and outgoing index, the other indexes and the total score of CAT in the control group were significantly decreased (P0.05). Except for chest tightness and two symptoms of climbing the building, all the other indexes were better than the control group (P0.05). On the overall trend, the CAT score on each time node was reduced, and the treatment group was better than the control group.4. laboratory examination index analysis: the two groups could make WBC and N% obviously improve (P0.05), but there was no significant difference between the groups (P0.05). The blood gas analysis index PH, PaCO2, PaO2 obviously improved (P0.05), the treatment group was superior to the control group (P0.05).5. comprehensive therapy. Efficacy evaluation: the total effective rate of the treatment group was 82.14%, the total effective rate of the control group was 67.39%. The comprehensive curative effect of the treatment group was obviously higher than that of the control group (P0.05).6. admission. There were 10 patients in the treatment group, and 17 patients in the control group were admitted to hospital. The treatment group was significantly better than the control group.7. safety evaluation: the treatment group was obviously better than the control group. In the latter two groups, the blood routine, liver and kidney work, electrocardiogram and stool routine test group were compared, no obvious abnormalities were found (P0.05), indicating that the two treatments had no obvious influence on blood routine, liver and kidney work and electrocardiogram. Conclusion: the 1. study confirmed the addition of matangchuan prescription on the basis of standard treatment of Western medicine, and improved the patient's cough, expectoration, wheezing and asthma. The main symptoms are better than the western medicine control group, and it helps to relieve the symptoms of abdominal distention, self perspiration and shortness of breath. It also has obvious advantages for the total score of TCM syndrome and the improvement of the treatment efficiency of TCM symptoms. In the whole trend, the treatment group and the control group are the main symptom score, the secondary symptom score or the total symptom integral, and the presentation of the symptoms. With the prolongation of the treatment time, the curative effect was better and better in both the control group and the treatment group, and the treatment group was better than the control group.2. research found that matangchuan cough prescription had obvious effect on the improvement of the quality of the sputum, and the standard treatment of Western medicine plus matangchuan prescription was in the stimulation of the sputum dilution, the phlegm color change and the excretion of sputum. .3. was obviously better than the western medicine control group. The CAT score was selected as the evaluation index of the curative effect of AECOPD. A number of studies have proved that the CAT score has a good correlation with the SGRQ score, and it is simple and easy. The results of the study show that the standard treatment of Western medicine plus Ma tangchuan prescription is better than the simple western medicine in relieving the single index of cough, expectoration and the total score of the expectoration. On the whole trend, the CAT score of the treatment group and the control group decreased and the curative effect was better and better, and the treatment group was better than the control group.4. laboratory examination. The treatment group was equal to the control group in the improvement of WBC and N% in the improvement of blood. The treatment group was better than the control group on the gas analysis, which may be related to the rapid remission of the dyspnea in the treatment group. The effective rate of the.5. in the treatment group was obviously superior to the control group. The treatment group could obviously reduce the hospitalization rate of the patients with.6. admission. 10 patients in the treatment group were admitted to hospital, and 17 patients in the control group were admitted to hospital. The treatment group was better than the control group.7. safety evaluation. The treatment group was better than the control group. It was safe and reliable for the treatment of acute exacerbation of chronic obstructive pulmonary disease.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R256.1

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