培土生金法治疗间质性肺疾病（脾气虚证）的临床观察

发布时间：2019-01-24 13:07

【摘要】：目的:本研究通过观察培土生金法(培土生金汤加减)治疗间质性肺疾病(脾气虚证)患者,观察患者治疗前后中医疾病临床表现症候积分、脾气虚证临床表现症候积分、肺功能指标TLC%预计值和DLCO%预计值、未吸氧指脉氧饱和度、影像学表现评分、六分钟步行试验距离、临床综合疗效方面的改善情况,从而阐明培土生金法对间质性肺疾病的治疗作用,为中医治疗该疾病提供新的临床依据。方法:对40例符合间质性肺疾病诊断标准,且符合中医脾气虚证诊断标准的患者,采用随机分组原则分为两组,分别为试验组与对照组,每组各20例,试验组采用西医常规治疗方案联合中药(培土生金汤加减)治疗,对照组采用西医常规治疗方案。两组连续治疗观察3个月。分别比较两组患者治疗前后的中医疾病临床表现症候积分、脾气虚证临床表现症候积分、肺功能指标TLC%预计值和DLCO%预计值、未吸氧指脉氧饱和度、影像学表现评分、六分钟步行试验距离、临床综合疗效,并运用统计学方法评判两组治疗的临床疗效。结果:经统计学检验,治疗前后,在改善中医疾病临床表现症状积分、脾气虚证症状积分、肺功能指标TLC%预计值和DLCO%预计值、未吸氧指脉氧饱和度、六分钟步行距离方面,两组进行组内比较,P0.05,有显著统计学差异,试验组与对照组的患者在上述指标方面皆得到明显改善;治疗后两组之间进行上述比较,P0.05,有显著统计学差异,试验组患者在上述指标方面的改善程度明显优于对照组患者,说明培土生金汤加减联合西医治疗组在改善上述指标方面取得的疗效明显优于单用西医治疗组。在改善患者影像学评分方面,治疗前后两组组内比较,P0.05,无显著统计学差异;治疗后两组之间进行比较,P0.05,无显著统计学差异,治疗前后试验组与对照组患者在影像学评分方面皆未得到明显改善,说明培土生金汤加减联合西医治疗组与单用西医治疗组在改善患者影像学评分指标方面疗效皆不显著。在临床综合疗效方面,试验组显效3人、进步6人、稳定8人、无效3人,总有效率85%,对照组显效3人、进步3人、稳定5人、无效9人,总有效率55%,经统计学检验,P0.05,有显著统计学差异,培土生金汤加减联合西药组较单用西药组取得更优的临床综合疗效,在安全性观察指标上未出现显著异常,具有良好的安全性。结论:培土生金法(培土生金汤加减)联合西医常规方案治疗间质性肺疾病与单用西医治疗都能减轻患者的中医疾病临床表现症状与脾气虚证的临床症状、改善患者肺功能指标TLC%预计值和DLCO%预计值、提高患者未吸氧指脉氧饱和度、增加患者六分钟步行距离,但中药联合西药组较单用西药组疗效改善更明显、临床综合疗效更优,值得在临床上推广使用。
[Abstract]:Objective: to observe the treatment of interstitial lung disease (spleen qi deficiency syndrome) by using the method of Peitushengjin decoction, observe the clinical symptom integral of TCM disease before and after treatment, and observe the clinical symptom integral of Qi deficiency syndrome. Pulmonary function index TLC% and DLCO% predictive value, oxygen saturation of unoxygenated finger pulse, imaging score, distance of 6-minute walking test, improvement of clinical comprehensive curative effect. The therapeutic effect of the method of cultivating native gold on interstitial pulmonary disease is expounded, which provides a new clinical basis for the treatment of this disease by traditional Chinese medicine. Methods: forty patients with interstitial lung disease and TCM syndrome of deficiency of temper were randomly divided into two groups: experimental group (n = 20) and control group (n = 20), each group was divided into two groups: control group (n = 20), control group (n = 20) and control group (n = 20). The experimental group was treated with routine western medicine combined with traditional Chinese medicine (Peitu Shengjin decoction plus or minus), while the control group was treated with western medicine routine therapy. The two groups were treated continuously for 3 months. Before and after treatment, the clinical symptom scores of TCM diseases, the clinical symptoms of tantal-deficiency syndrome, the TLC% and DLCO% predictors of pulmonary function, the oxygen saturation of the unoxygenated finger, and the imaging scores were compared between the two groups. Six-minute walking test distance, clinical comprehensive efficacy, and statistical methods were used to evaluate the clinical efficacy of the two groups. Results: before and after treatment, we improved the scores of clinical symptoms of TCM diseases, the score of syndrome of deficiency of temper, the predicted value of TLC% and DLCO% of pulmonary function index, the oxygen saturation of unoxygenated finger pulse, the distance of walking for six minutes. There was a significant difference between the two groups (P0.05). The patients in the test group and the control group were significantly improved in the above indexes. There was significant statistical difference between the two groups after treatment (P0.05). The improvement of the above indexes in the trial group was significantly better than that in the control group. The results showed that the therapeutic effect of Peitushengjin decoction combined with western medicine in improving the above indexes was obviously better than that in the single western medicine treatment group. In improving the imaging score of the patients, there was no significant difference between the two groups before and after treatment (P0.05). There was no significant difference between the two groups after treatment (P0.05). The imaging scores of the patients in the experimental group and the control group were not significantly improved before and after treatment. The results showed that the therapeutic effect of Peitushengjin decoction combined with western medicine treatment group and single western medicine treatment group was not significant in improving the imaging scoring index of the patients. In the clinical comprehensive curative effect, the experimental group showed remarkable effect 3, improvement 6, stable 8, ineffective 3, total effective rate 85, control group 3 remarkable, improvement 3, stable 5, ineffective 9, total effective rate 5555. P0.05, there was significant difference between the two groups. Peitushengjin decoction plus or minus western medicine group obtained better clinical comprehensive curative effect than the western medicine group, and there was no significant abnormality in safety observation index, which had good safety. Conclusion: the treatment of interstitial lung diseases with traditional western medicine combined with Peitusheng Gold decoction and western medicine alone can alleviate the clinical symptoms of TCM diseases and spleen Qi deficiency syndrome. The TLC% and DLCO% predictive values of lung function indexes were improved, the oxygen saturation of finger pulse without oxygen was increased, and the walking distance of six minutes was increased. However, the curative effect of traditional Chinese medicine combined with western medicine group was better than that of western medicine group alone. Clinical comprehensive curative effect is better, it is worth popularizing in clinical use.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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