三桑肾气汤加减联合西药治疗肾不纳气型缓解期慢性阻塞性肺疾病68例

Clinical observation of modified "Sansang Shenqi Decoction" in treating 68 cases of chronic obstructivepulmonary disease of kidney failing to receive qi

目的观察三桑肾气汤加减结合西医常规疗法治疗肾不纳气型稳定期慢性阻塞性肺疾病(COPD)的临床疗效。方法将144例肾不纳气型稳定期COPD患者随机分为治疗组和对照组各72例,对照组采用西医常规治疗,治疗组在常规西医治疗基础上加服三桑肾气汤。观察比较两组治疗前后中医证候积分、第1秒用力呼气肺容量占预计值百分比(FEV1%)、第1秒用力呼气容积(FEV1)/用力肺活量(FVC)、生存质量评分的变化情况,并评价临床疗效。结果治疗组、对照组总有效率分别为85.29%、67.16%,组间疗效差异有统计学意义(P<0.05)。两组治疗后中医证候积分均较治疗前降低(P<0.05,P<0.01),且治疗组低于对照组(P<0.05)。治疗组治疗后FEV1%、FEV1/FVC高于对照组(P<0.01)。治疗组治疗后生存质量量表中日常生活能力、社会活动情况、抑郁心理症状、焦虑心理症状的评分和总积分均减少(P<0.01),且日常生活能力、抑郁心理症状、焦虑心理症状的评分及总积分改善优于对照组(P<0.05)。结论三桑肾气汤加减结合西医常规治疗对稳定期COPD肾不纳气型患者的疗效优于单纯使用西医常规疗法。

Objective To observe the clinical efficacy of ＂Sansang Shenqi Decoction＂ in treating chronic obstructive pulmonary disease of kidney failing to receive qi. Methods One hundred and forty-four subjects were randomized into two groups： control group in which 72 cases were treated with conventional western modality, and treatment group in which 72 cases were treated with ＂Sansang Kidney Decoction＂ besides the medicines above, with a course of 6 months. Scores of TCM syn- drome and life quality were observed, and forced expiratory volume in one second capacity ratil （ FEV1% ）, ratio of forced expiratory volume in one second （ FEV1 ） and forced vital capacity （FVC） were detected. Results After treatment, the total effective rate was 85.29% in the treatment group and 67.16% in the control group, and the difference was significant （P 〈0.05 ）. Symptom scores in both groups were lower than those before treatment （ P 〈0.05, P 〈0.01 ）, and the score in the treatment group was significantly lower than that in the control group （ P 〈0.05 ）. After treatment FEV1% and FEV1/FVC in the treatment group were higher than those in the control group （P 〈0.01 ）. In the treatment group, the scores of daily living, social activities, psychological＂ symptoms of depression and anxiety symptoms and total score in life quality scale were reduced （P 〈0.01 ）, and had better improvement than the control group in daily living skills, psychological symptoms of depression and anxiety symptoms score and total score （ P 〈 0.05 ）. Conclusion ＂Sansang Shenqi Decoction＂ combined with conventional western treatment has better effect on chronic obstructive pulmonary disease of kidney failing to receive qi than western conventional treatment only.