滋阴清热化痰法治疗肺纤维化（虚热证）临床疗效观察

发布时间：2018-07-11 10:00

本文选题：滋阴清热化痰法 + 肺纤维化(虚热证)　；参考：《辽宁中医药大学》2017年硕士论文

【摘要】：目的:通过观察滋阴清热化痰法治疗肺纤维化(虚热证)的主要症状(气短、咳痰、胸痛)、次要症状(咳嗽、口燥咽干)、肺功能、胸部HRCT、血氧饱和度、生活质量问卷评分、综合疗效评定,以探讨滋阴清热化痰法治疗肺纤维化(虚热证)的临床疗效。方法:选取70例西医诊断为特发性肺纤维化和继发性肺纤维化中医证属虚热证患者。采用随机数字表法分为对照组和治疗组,每组35例。对照组采用西医常规的治疗方案给予泼尼松口服;治疗组在对照组治疗的基础上加用“保金汤”口服,疗程均为12周。记录治疗前后两组症状积分、肺功能、血氧饱和度、胸部HRCT、生活质量评分、综合疗效评定。采用SPSS 22.0软件进行统计分析。结果:1.中医症状积分方面:(1)主要症状:(1)两组治疗方案在气短、咳痰、胸痛积分方面,治疗后积分均优于同组治疗前积分且差异显著。(2)比较治疗后气短,咳痰,胸痛积分,治疗组优于对照组,差异显著。(2)次要症状:(1)在咳嗽积分方面,两组治疗方案在治疗后积分均优于同组治疗前积分且差异显著。治疗后积分比较,治疗组优于对照组,差异显著。(2)在口燥咽干积分方面,治疗组在治疗后积分优于治疗前,差异显著。治疗后积分比较,治疗组优于对照组,差异显著。(3)症状总积分:(1)两组治疗方案治疗后总积分均优于同组治疗前总积分且差异显著。(2)治疗后总积分比较,治疗组优于对照组,差异显著。2.西医疗效指标方面:(1)生活质量评分:(1)两组治疗方案在症状表现、活动受限、心理情况方面,治疗后积分均优于同组治疗前积分且差异显著。(2)比较治疗后症状表现、活动受限、心理情况,治疗组均优于对照组,差异显著。(2)肺功能(TLC):两组治疗方案治疗后较治疗前改善均无统计学差异。(3)血氧饱和度方面:治疗组治疗后优于治疗前,差异显著。(4)胸部HRCT方面:两组治疗后胸部HRCT变化比较没有显著差异。(5)综合疗效评定:对照组总有效率为51.61%,治疗组总有效率为78.13%,治疗组优于对照组,差异显著。结论:1.滋阴清热化痰法在治疗肺纤维化(虚热证)的临床疗效显著。2.滋阴清热化痰法在改善肺纤维化(虚热证)的临床症状(气短、咳痰、胸痛、咳嗽、口燥咽干)、生活质量及总有效率均优于西医治疗组。
[Abstract]:Objective: to observe the main symptoms (shortness of breath, expectoration, chest pain), secondary symptoms (cough, dry throat), pulmonary function, chest HRCTs, oxygen saturation of blood and quality of life (QOL) in the treatment of pulmonary fibrosis (deficiency heat syndrome) by the method of nourishing yin and clearing away heat and removing phlegm. Objective: to evaluate the clinical effect of nourishing yin and clearing away heat and removing phlegm in the treatment of pulmonary fibrosis (deficiency heat syndrome). Methods: 70 cases of TCM syndrome of idiopathic pulmonary fibrosis and secondary pulmonary fibrosis were selected. The patients were randomly divided into control group and treatment group with 35 cases in each group. The control group was given prednisone orally by routine western medicine, and the treatment group was treated with "Baojin decoction" for 12 weeks on the basis of the control group. Symptom score, pulmonary function, blood oxygen saturation, chest HRCTs, quality of life score and comprehensive curative effect were recorded before and after treatment. SPSS 22.0 software was used for statistical analysis. The result is 1: 1. TCM symptom integral: (1) the main symptoms: (1) the scores after treatment in the two groups were better than those before treatment in the two groups. (2) the scores of shortness of breath, expectoration and chest pain after treatment were significantly higher than those in the same group, (2) the scores of shortness of breath, expectoration and chest pain after treatment were significantly higher than those in the same group. The treatment group was superior to the control group, the difference was significant. (2) the secondary symptoms: (1) in cough integral, the two groups had better score after treatment than the same group before treatment and the difference was significant. After treatment, the treatment group is better than the control group, the difference is significant. (2) in the dry throat integral, the treatment group is better than before the treatment, the difference is significant. After treatment, the treatment group was superior to the control group, and the difference was significant. (3) the total symptom score: (1) the total score of the two groups was better than that of the same group before treatment and the difference was significant. (2) the treatment group was better than the control group, and the treatment group was better than the control group. The difference is significant. Western medicine curative effect index aspect: (1) quality of life score: (1) two groups of treatment plan in symptom performance, activity limitation, psychological condition, after treatment scores are better than the same group before treatment score and significant difference. (2) compare the symptoms after treatment, limited activity, The psychological condition of the treatment group was better than that of the control group, and the difference was significant. (2) the lung function (TLC): there was no significant difference between the two groups after treatment. (3) blood oxygen saturation: after treatment, the treatment group was better than before. (4) chest HRCT: there was no significant difference between the two groups after treatment. (5) Comprehensive efficacy evaluation: the total effective rate of the control group was 51.61 and the total effective rate of the treatment group was 78.13. The treatment group was superior to the control group, and the difference was significant. Conclusion 1. The clinical curative effect of nourishing yin and clearing away heat and removing phlegm is significant in the treatment of pulmonary fibrosis (deficiency heat syndrome). The method of nourishing yin and clearing away heat and removing phlegm can improve the clinical symptoms of pulmonary fibrosis (deficiency heat syndrome) (short breath, expectoration, chest pain, cough, dryness of throat), the quality of life and the total effective rate are better than that of western medicine treatment group.
【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】：2017
【分类号】：R259

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