参蛤补肺汤治疗肺气亏虚型稳定期慢性阻塞性肺疾病的研究

Study of Shenhabufei Decoction in treating qi deficiency in stable chronic obstructive pulmonary disease

目的探讨观察慢性阻塞性肺疾病(COPD)稳定期肺肾气虚型患者使用参蛤补肺汤的临床治疗效果。方法选取住院的COPD稳定期患者120例,采用随机单盲法均分为2组,对照组对患者进行西医常规用药,如解痉、祛痰、平喘、支气管扩张剂类和糖皮质激素类药物;研究组在对照组的基础上加服参蛤补肺汤。对比2组患者组间及治疗前后与本组的治疗后综合疗效、中医证候积分、COPD评估测试CAT评分以及肺功能指标。结果治疗后综合疗效:对照组总有效率(71.67%)显著低于研究组(95.00%),差异有统计学意义(P<0.01)。中医证候积分:疗程结束后,对照组中医证候积分下降水平低于研究组(P<0.05),2组治疗前后积分均明显降低(P<0.05)。COPD评估测试(CAT):疗程结束后,对照组CAT评分下降水平低于研究组(P<0.05),2组治疗前后,CAT评分明显降低(P<0.05)。肺功能指标:研究组治疗后呼气容积(FEV1)和其占预计值百分比(FEV1%)、其占用力肺活量百分比(FEV1/FVC)均较治疗前有明显改善(P<0.05),治疗后2组肺功能改善效果研究组显著优于对照组(P<0.05)。结论采用参蛤补肺汤治疗COPD稳定期患者的疗效显著、安全、可靠,能明显改善患者肺功能。

Objective To investigate the clinical effect of Shenhabufei Decoction in the treatment of patients with lung and kidney qi deficiency in chronic obstructive pulmonary disease （COPD） stable period. Methods 120 patients with stable COPD hospitalized patients were divided into 2 groups randomly.The control group of patients were given conventional drugs such as bronchial spasm,expectorant,antiasthmatic,expansion agent,and glucocorticoid drugs.The patients in the study group were treated by adding Shenhabufei Decoction on the basis of routine treatment in the control group.Comprehensive efficacy,TCM syndrome score,COPD assessment test CAT score,and lung function index was compared between and in the 2 groups before and after treatment. Results Comprehensive efficacy after treatment：the total effective rate of the control group （71.67%） was significantly lower than that of the study group （95.00%）,the difference was significant （ P〈 0.01）.TCM syndrome score：after the course of treatment,the decline of TCM syndrome score in the control group was lower than that in the study group（ P〈 0.05）,the scores of the 2 groups before and after treatment were significantly decreased （ P〈 0.05）.The COPD assessment test （CAT）：at the end of treatment,the CAT score of the control group was lower than of the study group （ P〈 0.05）, the 2 groups before and after treatment,CAT score decreased significantly （ P〈 0.05）.Pulmonary function index：FEV1% of the study group after treatment,FEV1/FVC,FEV1 improved significantly compared with before treatment （ P〈 0.05）,the 2 groups after treatment of lung function improvement effect of the study group was significantly better than the control group （ P〈 0.05）. Conclusion The curative effect of Shenhabufei Decoction in the treatment of stable COPD patients is significant,safe and reliable,and can significantly improve the pulmonary function of patients.