中医定向透化治疗对尘肺合并慢性阻塞性肺疾病患者疗效观察

Curative effect observation on TCM-oriented permeabilization to treat sufferers with pneumoconiosis combined with chronic obstructive pulmonary disease

目的探讨中医定向透化治疗在尘肺合并慢性阻塞性肺疾病(COPD)中的疗效。方法选取2016年尘肺合并中重度COPD患者80例,随机分为两组,对照组常规采用抗炎、祛痰、解痉、平喘治疗,治疗组在常规治疗基础上加用中医定向透化治疗。结果治疗后3 d及7 d,咳嗽、咳痰症状治疗组较对照组均有较好表现,差异有统计学意义,P<0.05;治疗后7 d治疗组及对照组均较术前症状改善,差异有高度统计学意义,P<0.01。治疗组肺部湿性啰音、干性啰音减少或消失时间在(2.6±1.3)d,术前准备达到肺灌洗条件时间在(6.7±1.1)d;而对照组肺部啰音变化时间在(5.8±2.3)d,术前准备达到肺灌洗条件时间在(10.6±1.4)d,两组比较,差异有高度统计学意义,P<0.01。治疗组显效11例(27.5%),有效26例(65.0%),无效3例(7.5%),总有效率92.5%;对照组显效4例(10.0%),有效26例(65.0%),无效10例(25.0%),总有效率75.0%。两组显效率及总有效率差异有统计学意义,P<0.05。治疗组治疗后肺通气功能较疗前明显改善,治疗组FVC(实测/预计):治疗前(48.2±9.8)%,治疗后(54.6±8.2)%;FEV1.0(实测/预计):治疗前(40.8±7.6)%,治疗后(50.8±8.5)%,差异有高度统计学意义,P<0.01。结论中医定向透化治疗结合西医药物治疗尘肺合并COPD具有改善症状迅速、肺部啰音消失快、改善患者肺通气功能的优点。

Objective To explore the curative effect of TCM-oriented permeabilization to treat sufferers with pneumoconiosis combined with chronic obstructive pulmonary disease （COPD）.Methods 80 cases with pneumoconiosis combined with mid-severe COPD in 2016 were selected and randomly divided into two groups.The control group were given conventional treatment of anti-inflammation, phlegm elimination, spasmolysis and asthma relieving, while the treatment group were given TCM-oriented permeabilization on the basis of conventional treatment.Results On the third and seventh day after treatment, the treatment group was better than the control group in terms of cough and expectoration, with differences of statistical significance （P〈 0.05）.On the seventh day after treatment, the symptoms in both the treatment group and the control group improved a lot compared to those before treatment, with differences of high statistical significance（P〈 0.01）.In the treatment group, the time of lung moist rale and dry rale reducing and elimination was （2.6± 1.3）d, and the time for lung lavage condition was （6.7 ± 1.1 ）d.In the control group, the time of lung rale changes was（5.8 ± 2.3）d, and the time for lung lavage condition was（10.6 ± 1.4）d.Comparison between the two groups showed differences of high statistical significance（P〈 0.01）.In the treatment group, 11 cases had excellent effects（27.5%）,26 cases with effects（65.0%）,3 cases with no effect（7.5%）,and the total effective rate was 92.5%.In the control group,4 cases had excellent effects （10.0%）,26 cases with effects （65.0%）, 10 cases with no effect （25.0%）, and the total effective rate was 75.0%.The differences of excellent effects and total effective rates in both groups showed statistical significance（P〈0.05）.In the treatment group, pulmonary ventilation function after treatment got improved compared to that before treatment, FVC was（48.2 ± 9.8）% before treatment and（54.6 ±8.2）% after treatment;FEV1.0 was（40.8 ± 7.6）% before treatment and（50.8±8.5）% after treatment, with differences of high statistical significance （P 〈0.01）.Conclusion TCM-oriented permeabilization together with Western medicine bears the advantages of rapid symptom improvement, quick lung rale elimination, and clear pulmonary ventilation function improvement to treat sufferers with pneumoconiosis combined with COPD.