健脾化痰方治疗肺脾两虚型慢性阻塞性肺疾病的临床观察及生活质量评价

Clinical Effect of “Jianpi Huatan Decoction”on Patients with Chronic Obstructive Pulmonary Disease of Lung and Spleen Deficiency Type and Evaluation of Life Quality

目的：探讨健脾化痰方治疗肺脾两虚型慢性阻塞性肺疾病（COPD）稳定期Ⅱ~Ⅲ级患者的疗效。方法：采用随机分组、平行对照的方法,选取肺脾两虚型COPD稳定期Ⅱ~Ⅲ级患者60例,随机分为治疗组30例和对照组30例。对照组给予西医基础治疗,治疗组给予西医基础治疗加健脾化痰方治疗,疗程均为3个月。评价两组的临床疗效,观察两组治疗前后肺通气功能、主要临床症状、改良的英国医学研究委员会呼吸困难量表（mMRC）评分、6 min步行距离（6MWD）、COPD评估测试（CAT）问卷评分等的变化。结果：治疗组的总有效率为86.67%,对照组为66.67%,治疗组疗效优于对照组（P〈0.05）。治疗后,两组患者的症状总积分较治疗前均显著降低（P〈0.01）,且治疗组患者的总积分低于对照组（P〈0.01）,特别是治疗组患者的咳嗽、咯痰、喘息、气短症状的改善优于对照组（P〈0.05）。治疗后,治疗组患者的FEV1%、PEF%均显著升高（P〈0.01,P〈0.05）,对照组患者的FEV1%亦显著升高（P〈0.05）;两组的mMRC评分均显著降低（P〈0.01）,且治疗组患者的评分低于对照组（P〈0.05）;治疗组患者的6MWD明显延长（P〈0.01）,且较对照组亦明显延长（P〈0.01）;两组患者的CAT问卷评分均显著降低（P〈0.01,P〈0.05）,且治疗组患者的评分低于对照组（P〈0.01）。结论：健脾化痰方配合常规西医疗法治疗肺脾两虚型慢性阻塞性肺疾病Ⅱ~Ⅲ级患者具有较好的临床疗效,并能改善患者的生活质量。

Objective：To study the effect of＂Jianpi Huatan Decoction＂on patients with gradeⅡ ~ Ⅲ chronic obstructive pulmonary disease（ COPD） of lung and spleen deficiency type at stable stage.Methods：A randomized,parallel control method was applied,and 60 patients with gradeⅡ ~ Ⅲ COPD of lung and spleen deficiency type at stable stage were divided into treatment group（ n = 30） and control group（ n = 30）.The control group was treated with the conventional western medicine and the treatment group was treated with ＂Jianpi Huatan Decoction＂and conventional western medicine,with a course of 3 months.The clinical effect was evaluated,and the lung function,main symptoms,modified Medical Research Council Scale（ mMRC） score,6 min walk distance（ 6MWD） and COPD Assessment Test（ CAT） score were observed.Results：The total effective rate was 86.67% in treatment group and 66.67% in control group,and the effect of the treatment group was better than that of the control group（ P 0.05）.After treatment,the total scores of symptoms in both groups were significantly decreased（ P 0.01）,and the scores of treatment group were lower than those of control group（ P 0.01）,especially the improvement of the symptoms of cough,expectoration,wheezing and shortness of breath in the treatment group was better than that in the control group（ P 0.05）.After treatment,the levels of FEV 1 % and PEF% were increased in treatment group（ P 0.01,P 0.05）,and the level of FEV 1 % were also increased in control group（ P 0.05）; the mMRC scores of two groups were obviously decreased（ P 0.01）,and the scores of treatment group were lower than those of control group（ P 0.05）; the 6MWD of treatment group was prolonged（ P 0.01）,and the 6MWD of treatment group was longer than that of the control group（ P 0.01）; the CAT scores of two groups were remarkably decreased（ P 0.01,P 0.05）,and the scores of treatment group were lower than those of control group（ P 0.01）.Conclusion：＂Jianpi Huatan Decoction＂ combined with routine western medicine therapy have good effect in the treatment of grade Ⅱ ~ Ⅲ COPD of lung and spleen deficiency type and can improve the life quality of patients.