摘要
【目的】观察自血疗法联合化痰固本汤治疗慢性阻塞性肺疾病急性加重(AECOPD)危险窗期痰湿阻肺兼肺脾气虚证患者的临床疗效。【方法】将80例AECOPD危险窗期痰湿阻肺兼肺脾气虚证患者随机分为治疗组和对照组,每组各40例。对照组给予吸入沙美特罗氟替卡松粉吸入剂治疗,治疗组在对照组的基础上给予自血疗法联合化痰固本汤治疗,疗程为14 d。观察2组患者治疗前后中医证候积分、肺功能、炎症指标、6 min步行距离、改良英国医学研究学会呼吸困难指数(mMRC)评分的变化情况,比较2组患者的中医证候疗效及半年内首次复发天数,并记录用药过程中不良反应发生情况。【结果】(1)治疗14 d后,治疗组的总有效率为95.0%(38/40),对照组为70.0%(28/40),组间比较,治疗组的中医证候疗效明显优于对照组(P<0.05)。(2)治疗后,2组患者的中医证候积分均较治疗前明显下降(P<0.05),且治疗组的下降幅度明显优于对照组(P<0.01)。(3)治疗后,2组患者的第1秒用力呼气容积(FEV1)、用力肺活量(FVC)及FEV1/FVC比值等肺功能指标均较治疗前改善(P<0.05),且治疗组的改善幅度均略优于对照组,但差异均无统计学意义(P>0.05)。(4)治疗后,2组患者的6 min步行距离和mMRC评分均较治疗前改善(P<0.05),且治疗组的改善幅度均明显优于对照组(P<0.05或P<0.01)。(5)治疗后,2组患者血清白细胞介素6(IL-6)和C反应蛋白(CRP)等炎症指标水平均较治疗前下降(P<0.05),且治疗组的下降幅度均明显优于对照组(P<0.01)。(6)治疗组患者发生首次急性加重平均天数为(128.7±26.5)d,较对照组的(160.0±21.8)d明显缩短,组间比较,差异有统计学意义(P<0.01)。(7)治疗过程中,2组患者均未出现明显的不良反应。【结论】自血疗法联合化痰固本汤可显著改善AECOPD危险窗期患者临床症状,有效帮助患者安全过渡到稳定期,使患者的生活质量得到显著提高。
Objective To observe the clinical efficacy of autohemotherapy combined with Huatan Guben Decoction for the treatment of patients in the risk window of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and differentiated as the syndrome of phlegm-damp obstructing lung complicated with deficiency of lung and spleen qi.Methods Eighty AECOPD patients during the risk window stage differentiated as the syndrome of phlegm-damp obstructing lung complicated with deficiency of lung and spleen qi were randomly divided into the treatment group and the control group,40 patients in each group.The control group was given Salmeterol Xinafoate and Fluticasone Propionate Powder for Inhalation,and the treatment group was given autohemotherapy combined with Huatan Guben Decoction on the basis of treatment for the control group.The treatment for the two groups lasted for 14 days.The changes of traditional Chinese medicine(TCM)syndrome scores,pulmonary function,inflammation indexes,6-minute walking distance,and modified Medical Research Council(mMRC)dyspnea scale scores in the two groups were observed before and after treatment,and the efficacy for TCM syndromes and the interval time for first relapse within six months were compared between the two groups.Meanwhile,the occurrence of adverse reactions during the drug administration was recorded.Results(1)After 14 days of treatment,the overall effective rate in the treatment group was 95.0%(38/40)and that in the control group was 70.0%(28/40),and the intergroup comparison showed that the efficacy for TCM syndrome in the treatment group was significantly superior to that in the control group(P<0.05).(2)After treatment,the TCM syndrome scores of patients in both groups were significantly compared with those before treatment(P<0.05),and the decreasing degree in the treatment group was significantly superior to that in the control group(P<0.01).(3)After treatment,the pulmonary function indexes such as the forced expiratory volume in one second(FEV1),forced vital capacity(FVC)and FEV1/FVC ratio in both groups were improved compared with those before treatment(P<0.05),and the improvement in the treatment group was slightly superior to that in the control group,the difference being not statistically significant(P>0.05).(4)After treatment,the 6-minute walking distance and mMRC scores of patients in both groups were improved compared with those before treatment(P<0.05),and the improvement in the treatment group was significantly superior to that of the control group(P<0.05 or P<0.01).(5)After treatment,the serum levels of inflammatory indexes such as interleukin 6(IL-6)and C-reactive protein(CRP)in both groups were decreased compared with those before treatment(P<0.05),and the decreasing degree in the treatment group was significantly superior to that in the control group(P<0.01).(6)The mean interval time for the first acute exacerbation in the treatment group was(128.7±26.5)days,which was significantly shorter than that in the control group[(160.0±21.8)days].The intergroup comparison showed that the difference was statistically significant(P<0.01).(7)During the treatment,there were no significant adverse reactions occurring in the two groups.Conclusion Autohemotherapy combined with Huatan Guben Decoction has significant effect on relieving the clinical symptoms of patients in the risk window of AECOPD with the syndrome of phlegm-damp obstructing lung complicated with deficiency of lung and spleen qi.The combined therapy is helpful for the safe transition to the stable stage,and significantly improves the quality of life of the patients.
作者
陈金娣
陈宁
覃丹
CHEN Jin-Di;CHEN Ning;QIN Dan(The Fifth Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Guangdong Second Traditional Chinese Medicine Hospital,Guangzhou 510095 Guangdong,China;Huangpu District Branch Hospital of Guangdong Second Traditional Chinese Medicine Hospital,Guangzhou 510700 Guangdong,China)
出处
《广州中医药大学学报》
CAS
2022年第8期1755-1762,共8页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
广东省中医药局科研项目(编号:20202006)。
关键词
慢性阻塞性肺疾病急性加重(AECOPD)
危险窗期
自血疗法
化痰固本汤
痰湿阻肺兼肺脾气虚
肺功能
炎症指标
生活质量
acute exacerbation of chronic obstructive pulmonary disease(AECOPD)
risk window stage
autohemotherapy
Huatan Guben Decoction
syndrome of phlegm-damp obstructing lung complicated with deficiency of lung and spleen qi
lung function
inflammatory indexes
quality of life
