培土生金法联合西药治疗慢性阻塞性肺疾病稳定期外周骨骼肌功能障碍效果观察

Clinical Observation of Method of Strengthening Earth to Generate Metal Combined with Western Medicine for Peripheral Skeletal Muscle Dysfunction of Chronic Obstructive Pulmonary Disease in the Stable Stage

目的:观察培土生金法联合西药治疗慢性阻塞性肺疾病稳定期外周骨骼肌功能障碍的临床效果。方法:选取72例肺脾气虚型慢性阻塞性肺疾病稳定期合并外周骨骼肌功能障碍的患者,随机分为观察组和对照组各36例,对照组给予布地奈德福莫特罗粉吸入剂吸入式治疗,观察组在对照组治疗基础上加用培土生金法方药进行干预。观察2组的临床疗效,治疗前后肺功能指标1秒量占预计值百分比(FEV_1%pred)、1秒率(FEV_1/FVC)、6 min步行试验(6MWT)、股四头肌最大自主收缩力(QMVC)及手握力(HGS)的变化。结果:治疗后,观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。2组6 min步行距离、FEV_1%pred、FEV_1/FVC、QMVC、HGS均较治疗前增加,观察组5项指标值均高于对照组,差异均有统计学意义(P<0.05)。结论:培土生金法具有健脾益肺而提升肌力的作用,联合用药能更好地改善慢性阻塞性肺疾病稳定期合并外周骨骼肌功能障碍患者的临床症状,提高治疗效果,具有一定的临床指导意义。

Objective： To observe the clinical effect of method of strengthening earth to generate metal combined with western medicine for peripheral skeletal muscle dysfunction of chronic obstructive pulmonary disease（COPD） in the stable stage. Methods：Selected 72 cases of patients with peripheral skeletal muscle dysfunction of COPD with qi deficiency of lung-spleen type in the stable stage and divided them into the observation group and the control group randomly,36 cases in each group. The control group was given inhalation therapy of budesonide/formoterol single inhaler for treatment, while the observation group was additionally given the prescription of method of strengthening earth to generate metal for intervention. Observed the clinical effect and changes of lung function indexes like forced expiratory volume in one second（FEV1% pred）, forced vital capacity FEV1%（FEV1/FVC）, 6 min walking test（6 MWT）,quadriceps maximum voluntary contraction（QMVC） and hand grip strength（HGS） before and after treatment in the two groups.Results：After treatment,the total effective rate in the observation group was higher than that in the control group,difference being significant（P〈0.05）. 6 min walking distance,FEV1%pred,FEV1/FVC,QMVC and HGS in the two groups were all increased when compared with those before treatment,and those five indexes in the observation group were all higher than those in the control group,differences being significant（P〈0.05）. Conclusion：The method of strengthening earth to generate metal has a function of strengthening the spleen and benefiting the lungs so as to improve the muscle strength. The combination therapy can better improve the clinical symptoms of the peripheral skeletal muscle dysfunction of COPD in the stable stage, improve the curative effect, and has certain significance in clinical guidance.