冬屏汤冬病夏治对COPD稳定期患者肺功能和生活质量的影响

Effect of Dongpingtang with TCM theory ‘Winter Disease Being Cured in Summer’ on Pulmonary Function and Life of Quality in Patients with Chronic Obstructive Pulmonary Disease in Stable Stage

目的:研究冬屏汤冬病夏治对慢性阻塞性肺疾病(COPD)稳定期患者肺功能及生活质量的影响。方法:将65例COPD患者随机分为冬病夏治治疗组32例,西药治疗组33例,两组均接受COPD稳定期常规西药治疗,冬病夏治组每年夏至至秋分加用中药冬屏汤内服,连续治疗2年。治疗前后测定肺通气、残气、弥散功能,生活质量(QOL)评定,并纪录症状、体征评分。结果:冬病夏治组总有效率93.75%,西药治疗组总有效率69.70%,差异有显著性意义(P<0.05)。冬病夏治组治疗后肺通气功能各项指标、肺残气、残总比、弥散功能均比治疗前明显改善(P<0.05);西药治疗组FVC、FEV1治疗后较治疗前有明显改善(P<0.05),TLC、RV较治疗前明显增多(P<0.01,P<0.05),FEV1/FVC%、MMEF75/25、MVV、RV/TLC、TLCOSB、TLCO/VA则无明显改善(P>0.05)。冬病夏治组治疗后QOL总均分、日常生活能力、社会活动能力、抑郁症状和焦虑症状评分显著降低(P<0.01),而且明显低于西药治疗组(P<0.01)。结论:冬屏汤冬病夏治能改善慢性阻塞性肺疾病稳定期患者的临床症状,延缓肺功能下降速度,显著改善患者的QOL。

Objective：To investigate the influence of Dongpingtang with the method of winter disease being cured in summer＇of TCM on pulmonary function and life of quality in patients with chronic obstructive pulmonary disease（COPD） in stable stage. Methods： A total of COPD 65 patients were randomized into western drug group （ n = 33） and Dongpingtang group（ n = 32 ）. Both groups were treated with the same western drugs for COPD. The Dongpingtang group was taken additional Dongpingtang from the summer solstice to the autumnal equinox in a 2-year circle. Lung ventilation, residual volume and diffusion function before and after treatment were determined, quality of life was assessed, and scoring for symptoms and signs was evaluated. Results： The therapeutic efficiency of the Dongpingtang group was 93.75%, with a significant difference compared to 69.70% in the western drug group（ P 〈 0.05 ）. The lung ventilation, residual volume and diffusion function was greatly improved after the treatment of Dongpingtang（ P 〈 0.05） ; in the western drug group, FVC and FEV1 was improved （ P 〈 0. 05 ）, TLC and RV was increased （ P 〈 0.01 and P 〈 0.05 ）, but FEV1/FVC%, MMEF75/25, MVV ,RV/TLC ,TLCOSB ,TLCO/VA showed no improvement（ P 〉 0. 05 ）. After the Dongpingtang treatment ,the mean score for quality of life, daily activities and social activities had been greatly improved in the patients; suppression and anxiety had been attenuated more compared to the western drug group （P 〈 0. 01 ）. Conclusion： Using Dongpingtang with the TCM method winter disease being cured in summer can improve the symptom and signs of COPD, suspend the decline of pulmonary function, and significantly increase the quality of life.