六君子汤+呼吸康复联合西药治疗慢性阻塞性肺疾病稳定期随机平行对照研究

Liujunzi Decoction(六君子汤)+Respiratory Therapy combined with Western Medicine in the Treatment of Chronic Obstructive Pulmonary Diseases Stable Phase Random and Parallel Control Study

[目的]观察六君子汤+呼吸康复联合西药治疗慢性阻塞性肺疾病稳定期疗效。[方法]使用随机平行对照方法,将156例门诊患者按病志号抽签方法简单随机分为两组。对照组79例常规对症治疗。治疗组77例六君子汤(党参、白术、茯苓、法半夏各10g,炙甘草3g,陈皮6g),开水100mL冲匀,早晚饭前温服;呼吸康复①缩唇呼吸:行、走、坐、卧均可,训练患者经鼻腔吸气,呼气时将嘴唇缩紧,如吹口哨样,尽可能缓慢将气体呼出,锻炼时尽可能用力;②腹式呼吸:与缩唇呼吸练习同时进行,注意力集中于丹田,双手重叠放于小腹,吸气时要体会小腹鼓起,呼气时小腹内收,逐渐形成腹式呼吸;理疗师指导呼吸康复锻炼,早晚各;1次,15min/次,训练≥5d/周;西药治疗同对照组。连续治疗2周为1疗程。观测临床症状、生存质量量表评分、6min步行距离、不良反应。连续治疗3疗程,判定疗效。[结果]生活质量评分治疗组均明显改善(P<0.05),对照组无显著变化(P>0.05);日常活动能力改善治疗组优于对照组(P<0.05),社会活动能力、抑郁症状、焦虑症状两组无显著差异(P>0.05)。6min步行距离治疗组明显改善(P<0.05),对照组无显著变化(P>0.05),治疗组优于对照组(P<0.05)。[结论]六君子汤+呼吸康复联合西药治疗慢性阻塞性肺疾病稳定期,疗效满意,不良反应轻,值得推广。

[Objective] To observe the efficacy of Liujunzi decoction＋respiratory therapy combined with western medicine in the treatment of chronic obstructive pulmonary diseases in its stable phases.[Methods] Using random and parallel control method,156 outpatients were divided into 2 groups,treatment group and control group.The control group 79 cases were given conventional treatment. The Treatment group 77 cases were treated with Liujunzi decoction＋respiratory therapy combined with western medicine.LiuJunZi decoction （Dangshen, Atractylodes,Poria Cocos and rhizoma pinellinae praeparata each 10g,Honey-fried licorice root 3g, pericarpium citri reticulatae 6g）,mixing well with 100ml boiled water, to be taken with warm water before meals in morning and evening.Respiratory therapy （lip breathing and abdominal breathing） lip breathing, patients can be doing when action,walk,sit or lie all are ok, training patient inhaling through the nose, crimpling lip when exhaling, like whistling,breathe out slowly as far as possible.And with the effort when do exercising as far as possible. Abdominal breathing training is doing at the same time with pursed lips breathing. Just focus your mind on the pubic region,both hands put on lower abdomen,pushing your belly out when breathe in and relaxing it as you breathe out, gradually formed abdominal breathing.Physical therapist guide the training,apply once respectively in the morning and evening,15 minutes per time, training time^Sdays/week,also with western medicine in the treatment same as control group.2 weeks of continuous treatment for 1 courses.Observing clinical symptoms, life quality score,walking distance for 6 minutes, untoward effect ect.Then judge the curative effect after 3 courses of continuous treatment. [Results] For treatment group, the life quality score is much improved（P〈0.05）compared with control group, control group have no significant change（P〉0.05）.Daily living activity also is more superior than control group（P〈0.05）.The ability of social activities,depressive symptom, anxiety symptom have no obvious difference（P〉0.05）.For 6minutes walking distance,treatment group is more improved（P〈0.05）,but control group have no obvious change（P〉0.05）.So the total effect is treatment group is better than Control group（P〈0.05）.[Conclusion] The efficacy is good for Liujunzi decoction＋respiratory therapy combined with western medicine in the treatment of COPD stable phase.