三参健肺汤对慢阻肺患者血流变和生活质量的影响

The Influence of SANSHENJIANFEITANG on Hemorheology and Quality of Life of Patients with Chronic Obstructive Pulmonary Disease

目的：观察中药三参健肺汤对慢性阻塞性肺病稳定期患者临床综合疗效及血液流变学及生活质量的影响。方法：①选取2006年3月-2008年4月在南京军区杭州疗养院康复科住院的COPD患者62例，男49例，女13例，年龄46～78岁，均符合中华医学会呼吸病学会2002年《慢性阻塞性肺疾病诊治指南》诊断标准，且对治疗方案和检测项目知情同意。按随机抽签法将患者分为两组：对照组32例和治疗组30例。②治疗方法：对照组予氧疗、氨茶碱或沙丁胺醇常规对症治疗。治疗组在常规治疗基础上加用“三参健肺汤”（太子参30g，丹参30g，沙参15g，云苓15g，白术15g，红花10g，当归12g，桃仁10g，桔梗10g，赤芍12g，天花粉12g，制半夏6g，生甘草6g，砂仁（后下）6g，香附12g，橘红12g等组成。生药由南京军区杭州疗养院中医科提供），水煎服，1剂／d，分2次服。两组均以2个月为1个疗程。③于治疗前后分别进行临床症状、体征计分；血液流变学检测。采用蔡映云等编制的生活质量量表进行治疗前后患者生活质量的评估。该量表共分日常生活能力、社会活动能力、抑郁症状和焦虑症状4类共35小项。评分越高，生存质量越差。④组间和组内计量结果差异比较分别采用t检验和配对t检验。结果：62例COPD患者中，对照组3例因严重的急性感染退出观察，两组共59人进入结果分析。①综合疗效评价：治疗组总有效率93．3％，对照组总有效率55．2％。治疗组总有效率显著高于对照组（P〈0．01）。②血液流变学指标：对照组各项指标治疗前后无统计学差异。治疗组各项指标和治疗前比较有显著差异，和对照组治疗后比较也有显著差异。③生活质量量表评分：对照组的日常生活能力、社会活动能力和治疗前无统计学差异。抑郁症状和焦虑症状差于治疗前。治疗组的日常生活能力、社会活动能力、抑郁症状和焦虑症状均较治疗前有显著改善，和对照组治疗后比较也有显著差异。结论：三参健肺汤可有效改善稳定期COPD患者的临床症状和体征，对血液流变学异常有明显的调整作用，并可以显著改善患者的生活质量。

Objective：To observe the influence of T. C. M. recipe SANSHENJIANFEITANG on chronic obstructive pulmonary disease（COPD） patients with hemorheology and quality of life index. Methods：62 patients with COPD were recruited in the rehabilitation department of our sanitarium from 2006.3 to 2008.4. There is 49 male, 13 female, aged from 46 to 78. All patients was diagnosed according to the guideline of COPD made by the Chinese medical association of respiratory disease at 2002. All patients were informed with the trail. The patients were entered treatment group and control group randomly. 30 patients in control group was treated with oxygen therapy, aminophylline or albuterol according the guideline. 32 patients in treatment group was treated according the guideline plus T. C. M. recipe SANSHENJIANFEITANG（ radix pseudostellariae 30 gram, Radix Salivae Mihiorrhizae 30 gram, root of straight ladybell 15 gram, Tuckahoe 15 gram,rhizome 15 gram, flores carthami 10 gram, radix angelicae sinen- sis 12 gram, semen persicae 10 gram, platycodi 10 gram, Paeonia 12 gram, radix trichosanthis 12 gram, pinelliae 6 gram,licorice 6 gram,semen amomi 6 gram, rhizoma cyperi 12 gram, epicarpium citri 12 gram）. The herbs are provided by the T. C. M. department. One dose each day,boiled with water and serve twice. Both groups is treated for 2 months. Clinical symptoms and signs were observed before and after treatment, also with hemorheology and quality of life. The quality of life was queried with the scale made by Cai Yingyun. The scale has 35 questions falls into 4 classes,including daily life, social life, depress and anxiety. Patients will score higher when their quality of life worsen. Deference between the groups was tested with T test. Results ： 3 patients in the control group was dropped because of exacerbation. 59 included into analysis. The overall effectiveness is 93.3% in treatment group and 55.2% in control group （ P 〈 0. 01 ）. The hemorheology indices have no difference in control group before and after treatment. But the treatment group made significant progress in hemorheology. They also made significant progress in quality of life. Conclusion ： T. C. M. recipe SANSHENJIANFEITANG can improve the symptoms and signs of patient with COPD. It can modulate hemorheology, and improve quality of life.