扶肺固肾饮对慢性阻塞性肺疾病稳定期患者BODE指数的影响

Effect of Fufei Gushen Decoction on BODE Index of Patients with Chronic Obstructive Pulmonary Disease at Stable Stage

【目的】观察扶肺固肾饮对慢性阻塞性肺疾病(COPD)稳定期重度、极重度,且中医证型为肺肾两虚夹痰瘀证患者BODE指数(B为体质量指数,O为气流阻塞程度,D为呼吸困难,E为运动耐力)的影响。【方法】将80例患者随机分为治疗组和对照组各40例。对照组给予吸入沙美特罗替卡松粉吸入剂(舒利迭)治疗,治疗组在对照组基础上加用扶肺固肾饮口服治疗。2组疗程均为3个月。比较2组患者治疗前后体质量指数(BMI)、气流阻塞程度[第1秒用力呼气容积占预计值百分比(FEV1%)]、呼吸困难指数(MMRC)、运动耐力[6 min步行距离(6MWT)]指标的变化情况。【结果】(1)组内比较:治疗组重度、极重度患者FEV1%、MMRC、6MWT治疗后积分及BODE指数治疗后总分均较治疗前改善(P<0.05),BMI无明显改善(P>0.05);对照组重度、极重度患者MMRC、6MWT治疗后积分及BODE指数治疗后总分均较治疗前改善(P<0.05),FEV1%、BMI无明显改善(P>0.05)。(2)组间比较:除BMI外,治疗组FEV1%、MMRC、6MWT治疗后积分及BODE指数治疗后总分均较对照组治疗后明显改善(P<0.05)。【结论】扶肺固肾饮联合舒利迭吸入能显著降低COPD稳定期患者的BODE指数积分,改善COPD稳定期患者的临床症状、肺功能和运动耐力,提高患者生活质量。

Objective To observe the effect of Fufei Gushen Decoction on the BODE index, an index for body mass index（BMI）, airflow obstruction, dyspnea, and exercise capacity, in severe and extremely severe chronic obstructive pulmonary disease （COPD） patients with lung-kidney deficiency interweaved with phlegm and blood stasis at stable stage. Methods Eighty qualified COPD patients were randomly divided into treatment group and control group, 40 cases in each group. Both groups were given inhalation of Seretide （Salmeterol Xinafoate and Fluticasone Propionate Powder for inhalation） , and the treatment group was given oral use of Fufei Gushen Decoction additionally. The treatment for the two groups lasted for 3 months. Before and after treatment, BMI, the percentage of forced expiratory volume in one second of the predicted value （FEV1%） , dyspnea index of modified British Medical Research Council （MMRC）, and exercise performance index of 6-min walking test （6MWT） in the two groups were observed. Results （1） After treatment, FEV1%, MMRC dyspnea index, 6MWT scores and BODE index overall scores of severe and extremely severe patients in the treatment group were much improved（P 〈 0.05 compared with those before treatment ）, but BMI was not much improved（P 〉 0.05）. MMRC dyspnea index, 6MWT scores and BODE index overall scores of severe and extremely severe patients inthe control group were much improved （P〈0.05 compared with those before treatment） , b ut the improvement of FEV1% and BMI was not obvious（P 〉 0.05）.（2） Except for BMI, the parameters of FEV1%, MMRC dyspnea index, 6MWT scores and BODE index overall scores of the treatment group were much improved as compared with those of the control group after treatment（P 〈 0.05）. Conclusion Fufei Gushen Decoction combined with inhalation of Seretide exerts certain effects on decreasing the BODE index scores, relieving symptoms, and improving pulmonary function, exercise performance and the quality of life of COPD patients with lung-kidney deficiency interweaved with phlegm and blood stasis at stable stage.