培土生金综合疗法对慢性阻塞性肺病稳定期患者生存质量的影响

Effect of Spleen-invigorating and Lung-nourishing Therapy on Quality of Life in Patients with Chronic Obstructive Pulmonary Disease at Stationary Phase

[目的]观察培土生金综合疗法对慢性阻塞性肺病(COPD)稳定期患者综合疗效、营养指标和生存质量的影响。[方 法]将90例COPD患者分为对照组、中药组和中药加穴位疗法组3组,每组30例。中药组在常规对症治疗基础上予健脾益 肺冲剂口服,中药加穴位疗法组在常规治疗基础上予健脾益肺冲剂口服,同时对双足三里交替进行隔姜灸与参麦注射液穴 位注射;对照组则单纯给予常规对症治疗。疗程均为2个月。 [结果]中药加穴位疗法组有效率为93.33％,中药组为 86.67％,均高于对照组的56.67％(P<0.01)。中药加穴位疗法组治疗后患者的实际体重占理想体重的百分比(PIBW)、血 清总蛋白含量(ρTP)、血清白蛋白含量(ρAIB)、血清前白蛋白含量(ρPAlb)等营养学指标均有升高(P<0.01);中药组治 疗后ρTP、ρAlb及ρPAlb也有升高(P<0.01),而PIBW和血红蛋白量(ρHb)与治疗前比较差异无显著性(P>0.05)。中药加 穴位疗法组及中药组用药后日常生活分、抑郁分、焦虑分以及生存质量总计分均明显下降(与用药前比较,P<0.01),两 者对患者生存质量的改善作用均优于对照组(P<0.01)。[结论]培土生金综合治疗慢性阻塞性肺病稳定期患者,可有效 地改善患者的消化吸收功能,改善营养状态,提高患者的生存质量。

[Objective] To observe the therapeutic effect of spleen-invigorating and lung-nourishing therapy and its influence on nutritive index and quality of life (QOL) in patients with chronic obstructive pulmonary disease (COPD) at stationary phase. [ Methods ] Ninety cases of COPD were randomized into three groups. Group A was given routine symptomatic treatment; groups B and C were given oral use of Jianpi yifei Granules and routine symptomatic treatment and group C was additionally treated with garlic-partition moxibustion and acupoint injection of Shenmai Injection on bilateral Zusanli (ST 36) point alternatively. The treatment lasted 2 months. [Results] The effective rate was 93.33% in group C, 86.67% in group B and 56.67% in group A (P < 0.01 compared with group A). Nutritive indexes such as ratio of actual weight and expected weight (IBM) , serum contents of total protein (TP) , albumin (Alb) and pre-albumin (PAlb) in group C were increased ( P < 0.01); TP, Alb and PAlb in group B also increased (P < 0.01) while the ratio and hemoglobin (Hb) remained unchanged ( P > 0.05) compared with those before treatment. Scores of activity of daily life (ADL) , depression and anxiety and the total score of QOL were obviously decreased in groups B and C (P <0.01 compared with those before treatment) . QOL was much improved in groups B and C as compared with that in group A ( P < 0.01) . [Conclusion] Spleen-invigorating and lung-nourishing therapy combined acupuncture can promote the gastrointestinal function and improve the nutritive status and QOL in patients with COPD at stationary phase.