中医药体质干预治疗哮喘缓解期患者的临床疗效观察

Clinical efficacy of traditional Chinese medicine intervention on body constitution in the treatment of stable asthma

目的探讨中医药对哮喘缓解期患者进行体质干预后的临床疗效及其对生活质量和肺功能的影响。方法选择杭州市中医院及浙江省立同德医院2012年6月—2013年7月期间门诊哮喘缓解期患者94例,随机分为治疗组(48例)和对照组(46例),对照组采用西药沙美特罗替卡松粉吸入剂抗炎解痉治疗,治疗组在对照组基础上根据体质加用中医药联合治疗。疗程12周。比较2组临床疗效、中医症状体征总积分、哮喘控制测试(asthma control test,ACT)评分及肺功能的改变情况。结果治疗组总有效率95.83%,对照组78.26%,2组比较差异有统计学意义(P<0.05)。2组在治疗各阶段中医症状体征总积分均呈减少趋势,且治疗6周、9周及12周后,治疗组低于对照组,比较差异有统计学意义(P<0.05,P<0.01)。2组在治疗各阶段ACT评分均呈增加趋势,且治疗12周后,治疗组高于对照组,比较差异有统计学意义(P<0.05)。治疗6周后,2组肺功能FEV1、FVC较治疗前均明显提高(P<0.01);治疗12周后2组FEV1、FEV1%、FVC较治疗前均明显提高(P<0.01),且组间比较差异有统计学意义(P<0.05);2组FEV1/FVC(%)较治疗前均有显著提高(P<0.01)。结论在哮喘缓解期运用中医药干预体质治疗,与单纯西医治疗相比,能有效改善哮喘缓解期患者的临床症状,提高临床疗效及患者生活质量,改善肺通气功能。

Objective To study the clinical efficacy of traditional Chinese medicine intervention on body constitution in the treatment of asthma patients in remission, and its influence on quality of life and lung function. Methods 94 outpatients with bronchial asthma in remission in our hospital and Tongde Hospital of Zhejiang Province from June 2012 to July 2013 were enrolled and randomly divided into treatment group （48 patients ）and control group （46 patients）. The control group received salmeterol fluticasone inhalant for anti-inflammatory and spasmolysis treatment, while the treatment group received additional traditional Chinese medicine intervention on body constitution based on the treatment performed in the control group. The course of treatment was 12 weeks. The clinical efficacy, total TCM clinical symptoms and signs score, asthma control test（ACT） score and lung function changes in both were compared. Results The total effective rate of the treatment group was 95.83%, and of the control group was 78.26%, the difference was statistically significant （ P 〈 0.05 ）. The total TCM clinical symptoms and signs score during the various stages of treatment showed a decreasing trend in both groups;and after the combinational treatment of 6 weeks ,9 weeks and 12 weeks,the total TCM clinical symptoms and signs score was lower than the control group, which was statistically significant（ P 〈 0.05, P 〈 0.01 ）. ACT scores in all stages of the treatment showed an increasing trend in both groups;12 weeks after the treatment, the treatment group was higher which had statistically significant（ P 〈 0.05 ）. After 6 weeks of treatment, both groups was significantly increased in lung function of FEV1 and FVC（P 〈 0.01 ）. After 12 weeks of treatment, FEV1, FEVI% and FVC were significantly improved as compared with those before treatment in both groups（ P 〈 0.01 ） ,which was statistically significant between the two groups（ P 〈 0.05 ） ;both FEV1 and FVC （%） were significantly improved as compared to those before the treatment （ P 〈 0.01 ）. Conclusion The traditional Chinese medicine intervention on body constitution for asthma patients in remission can effectively improve the clinical symptoms, pulmonary function, curative efficacy and quality of life of patients when compared with conventional Western medicine therapy alone.