沙美特罗替卡松结合穴位贴敷及注射治疗COPD稳定期疗效分析

目的 探讨穴位贴敷联合足三里注射治疗慢性阻塞性肺疾病（COPD）稳定期的临床疗效及安全性.方法 选取COPD稳定期患者100例,随机分为观察组与对照组,各50例.两组均予沙美特罗替卡松粉吸入剂联合家庭氧疗常规治疗,观察组再予穴位贴敷联合足三里注射治疗.观察两组治疗前后急性发作次数、急诊次数等远期疗效及肺功能、生存质量、6分钟步行距离、呼吸困难程度,评估其安全性及疗效.结果 治疗后两组患者急性发作次数、急诊次数、医疗费用、间隔时间、生存质量评分均低于治疗前（P〈0.01）,且观察组低于对照组（P〈0.05）.治疗后两组FEV1、FEV1/FVC、6分钟步行距离均高于治疗前（P〈0.05）,且观察组高于对照组（P〈0.05）.治疗后观察组呼吸困难分级（mMRC）降级,与治疗前比较差异有统计学意义（P〈0.05）.观察组总有效率92.0％,对照组74.0％,两组比较差异有统计学意义（P〈0.05）.两组总不良反应发生率比较,差异无统计学意义（P〉0.05）.结论 穴位贴敷联合足三里注射治疗COPD稳定期安全可靠,有利于提高患者生存质量及改善患者预后,值得推广.

Objective To study the therapeutic effect and safety of acupoint application and foot three li injection therapy on chronic obstructive pulmonary disease stable phase. Methods 100 stable phase patients were selected and divided into control group and study group randomly. 50 patients were included in control and study group respectively. Both control and study groups were given routine treatment ofsalmeterol xina/bate and fluticasone propionate powder for inhalation and home oxygen therapy. For study group, acupoint application and foot three li injection therapy were applied additionally. Then the improvement of several items were observed before and after therapy： prospective efficacy such as acute exacerbation frequency and emergency treatment frequency, pulmonary function, survival quality, six minutes walk distance and dyspnea index degree. Finally, the safety of and therapeutic effect were evaluated. Results For both groups, acute exacerbation frequency, emergency treatment frequency, medical care cost and acute exacerbation interval after therapy were lower than those before therapy （P〈0.01） . After therapy, acute exacerbation frequency, emergency treatment frequency, medical care cost and acute exacerbation interval of study group were lower than those of control group （P〈0.05） . For both groups, FEV1 and FEV1/FVC after therapy were higher than those before therapy （P〈0.05） . After therapy, FEV1 and FEVI/FVC of study group were higher than those of control group （P〈0.05） . For both groups, survival quality and six minutes walk distance after therapy were higher than those before therapy （ P〈0.05 ） . After therapy, survival quality and six minutes walk distance of study group were higher than those of control group （ P〈0.05 ） . After therapy, dyspnea index （ mMRC ） of study group degraded with statistical significance （P〈0.05） . For control group, there was no obvious dyspnea index （ mMRC ） degradation after therapy （ P〉0.05 ） . Total adverse reaction incidences of control and study group were 0.0% and 6.0% respectively, and there was no statistical significance between control and study groups （ X2=3-093, P=0.079〉0.05 ） . Total effective rates of control and study group were 74.0% and 92% respectively, and there was obvious statistical significance between control and study groups （ X 2=5.741, P=0.017〈0.05 ） . Conclusion Acupoint application and foot three li injection therapy on chronic obstructive pulmonary disease stable phase is safe and effective. This therapy can improve the survival quality and prognosis of patients, and reduce economic burden. It deserves great attention.