摘要
目的探讨祛痰救肺汤联合针灸治疗慢性阻塞性肺疾病(COPD)稳定期患者的临床效果。方法选取2017年2—12月蓬莱市中医医院肺病科收治的130例稳定期COPD患者,按照单双数分为针灸治疗组和祛痰救肺汤组,每组65例,针灸治疗组男35例,女30例,年龄(57.92±11.36)岁,年龄范围为36~70岁;祛痰救肺汤组男34例,女31例,年龄(58.24±12.07)岁,年龄范围为35~70岁。针灸治疗组患者在常规治疗基础上应用针灸治疗,祛痰救肺汤组患者在针灸治疗组治疗基础上给予祛痰救肺汤治疗。应用中医症状积分评估患者症状改善情况,应用第1秒用力呼吸容积(FEV1)、第1秒用力呼吸容积/用力肺活量百分比(FEV1/FVC)评估患者肺功能;评估慢性阻塞性肺疾病症状评分(CAT),检测血C反应蛋白(CRP)、肿瘤坏死因子(TNF-α)、白细胞介素8(IL-8)浓度。治疗后跟踪随访6个月,观察急性复发率。结果治疗后,祛痰救肺汤组患者中医症状总积分[(3.22±0.73)分]低于针灸治疗组[(4.38±0.61)分];FEV1和FEV1/FVC[(1.89±0.43)L、(68.46±2.84)%]均高于针灸治疗组[(1.53±0.47)L、(63.80±2.93)%];CAT[(11.36±1.30)分]低于针灸治疗组[(14.90±1.27)分];CRP、TNF-α和IL-8[(24.37±4.24)g/L、(53.20±8.61)pg/ml、(7.12±0.97)μg/L]均低于针灸治疗组[(31.49±4.30)g/L、(71.38±9.39)pg/ml、(9.68±0.93)μg/L],差异均有统计学意义(P<0.05)。治疗后跟踪随访6个月,祛痰救肺汤组患者急性复发率[4.6%(3/65)]低于针灸治疗组[15.4%(10/65)],差异有统计学意义(P<0.05)。结论应用祛痰救肺汤联合针灸治疗COPD能够显著改善患者症状,提高肺功能,降低炎性因子水平及急性复发率。
Objective To investigate the clinical effect of expectorant and lung saving decoction combined with acupuncture in the treatment of chronic obstructive pulmonary disease(COPD)patients with stable period. Methods A retrospective study was performed on 130 cases of COPD patients who were admitted from February to December 2017.According to the odd and even numbers, they were divided into the acupuncture and moxibustion treatment group and the expectorant and lungs-relieving decoction group, with 65 patients were in each group.In the acupuncture treatment group, 35 males and 30 females were aged(57.92±11.36)years, ranging from 36 to 70 years.There were 34 males and 31 females in the expectorant and lung-saving decoction group, whose ages ranged from 35 to 70 years old(58.24±12.07)years.Patients in the acupuncture and moxibustion treatment group were treated with acupuncture and moxibustion on the basis of conventional treatment, while patients in the expectorant and lung-saving decoction group were treated with expectorant and lung-saving decoction on the basis of acupuncture and moxibustion treatment group.TCM symptom score was used to evaluate the improvement of patients′ symptoms, and forced breathing volume(FEV1)in the first second and forced breathing volume/forced vital capacity(FEV1/FVC)in the first second were used to evaluate patients′ lung function.To assess the chronic obstructive pulmonary disease symptom score(CAT), blood levels of c-reactive protein(CRP), tumor necrosis factor(TNF-α), and interleukin 8(IL-8)were measured.The acute recurrence rate was observed after 6 months follow-up. Results After treatment, the total score of TCM symptoms in the expectorant and lung-saving decoction group [(3.22±0.73)scores] was lower than that in the acupuncture and moxibustion group [(4.38±0.61)scores]. FEV1 and FEV1/FVC [(1.89±0.43)L,(68.46±2.84)%] were higher than those in the acupuncture and moxibustion group [(1.53±0.47)L,(63.80±2.93)%]. CAT [(11.36±1.30)scores] was lower than that of the acupuncture and moxibustion group [(14.90±1.27)scores]. CRP, TNF-α and IL-8 [(24.37 ± 4.24)g/L,(53.20±8.61)pg/ml,(7.12±0.97)g/L] were lower than those of the acupuncture and moxibustion group [(31.49±4.30)g/L,(71.38±9.39)pg/ml,(9.68±0.93)g/L], and the differences were statistically significant(P<0.05). After 6 months of follow-up, acute recurrence rate [4.6%(3/65)] was lower in the treatment group than in the acupuncture and moxibustion group [15.4%(10/65)], and the difference was statistically significant(P<0.05). Conclusion The application of Qutanjiufeitang combined with acupuncture for stable COPD improve lung function, reduce inflammatory factor levels and acute recurrence.
作者
于霞
刘建邦
武玉栋
王丽梅
Yu Xia;Liu Jianbang;Wu Yudong;Wang Limei(Department of Lung Disease, Penglai Traditional Chinese Medicine Hospital, Yantai 265600, China;Department of Cardiology, Penglai Traditional Chinese Medicine Hospital, Yantai 265600, China;Department of Respiratory, Penglai People′s Hospital, Yantai 265600, China)
出处
《中国临床实用医学》
2019年第3期12-15,共4页
China Clinical Practical Medicine
关键词
祛痰救肺汤
针灸
慢性阻塞性肺疾病
肺功能
复发
Qutanjiufeitang decoction
Acupuncture
Chronic obstructive pulmonary disease
Lung function
Recurrence
