健脾化痰方加温灸中脘治疗轻中度稳定期肺脾气虚型COPD患者的疗效及生存质量评价

Effects of "Jianpi Huatan Recipe" plus Zhongwan(CV12) Moxibustion on Patients with Mild to Moderate COPD of Qi-deficiency of Lung and Spleen at Stable Stage and Quality of Life

目的:观察健脾化痰方加温灸中脘治疗肺脾气虚型稳定期轻中度慢性阻塞性肺疾病(COPD)患者的临床疗效及其对患者生存质量的影响。方法:90例轻中度稳定期COPD患者随机分为综合组(健脾化痰方+温灸中脘+西医基础治疗)、中药组(健脾化痰方+西医基础治疗)和对照组(西医基础治疗),每组30例。治疗8周后,观察三组的临床疗效及主要临床症状(包括咳嗽、咯痰、气短/呼吸困难、哮鸣音)改善情况,同时采用蔡氏改良呼吸疾病量表评价三组患者的生活质量。结果:①综合组的临床总有效率为86.7%,中药组为86.7%,对照组为70.0%,综合组和中药组的疗效均明显优于对照组(P<0.01,P<0.05)。②治疗后,三组患者的主要临床症状较治疗前均明显改善(P<0.05,P<0.01),且综合组对咳嗽、咯痰的治疗效果显著优于对照组(P<0.01),中药组对咯痰的疗效亦显著优于对照组(P<0.01)。③治疗后,综合组和中药组患者的生存质量量表总均分(TMS)较治疗前均显著降低(P<0.01),且综合组、中药组患者的TMS较对照组亦显著降低(P<0.01);综合组患者的F1S、F2S、F3S和F4S量表评分较治疗前均显著降低(P<0.01),中药组患者的F1S、F3S、F4S量表评分较治疗前亦显著降低(P<0.01);且综合组和中药组患者的F3S、F4S量表评分较对照组显著降低(P<0.05)。结论:健脾化痰方加温灸中脘穴能显著改善肺脾气虚型轻中度稳定期COPD患者的临床症状及生存质量。

Objective： To observe the clinical effects of ＂Jianpi Huatan Recipe＂ plus Zhongwan（CV 12） moxibustion on patients with mild to moderate chronic obstructive pulmonary disease（COPD） of qi-deficiency of lung and spleen at stable stage and the quality of life of patients.Methods： Ninety patients with COPD at stable stage were randomized into three groups： the comprehensive group which was treated by ＂Jianpi Huatan Recipe＂ plus Zhongwan（CV 12） moxibustion on the basis of western medical treatment,the Chinese medical group which was treated by ＂Jianpi Huatan Recipe＂ on the basis of western medical treatment,and the control group which was treated by western medical treatment,with thirty cases in each group.Eight weeks after treatment,the clinical effects and the improvement of main symptoms（including cough,expectoration,shortness of breath/dyspnea,and wheezing） were observed,meanwhile the quality of life of all the patients were evaluated by Modified Respiratory Disease Scale.Results： ①The total effective rates of comprehensive group,Chinese medical group and control group were 86.7%,86.7% and 70.0% respectively,and the clinical effects of comprehensive group and Chinese medical group were better than those of control group（P0.01,P0.05）.②After treatment,the main symptoms in three groups obviously improved（P0.05,P0.01）,and the symptoms of cough and expectoration in comprehensive group and the symptom of expectoration in Chinese medical group significantly improved compared with control group（P0.01）.③After treatment,the total mean scores（TMS） of life quality scale in comprehensive and Chinese medical groups decreased compared with before treatment（P0.01）,and the TMS of comprehensive and Chinese medical groups were lower than those of control group（P0.01）;the scores of F1S,F2S,F3S and F4S scales in comprehensive groups markedly decreased（P0.01）,the scores of F1S,F3S and F4S scales in Chinese medical group also markedly decreased（P0.01）,and the scores of F3S and F4S scales of comprehensive and Chinese medical groups were lower than those of control group（P0.05）.Conclusion： ＂Jianpi Huatan Recipe＂ plus Zhongwan（CV 12） moxibustion can improve the clinical symptoms and quality of life of patients with mild to moderate COPD of qi-deficiency of lung and spleen at stable stage.