稳定期慢性阻塞性肺疾病中医肺康复治疗的疗效

Observation on Curative Effects of TCM Pulmonary Rehabilitation on Chronic Obstructive Pulmonary Disease during Stable Period

目的观察稳定期慢性阻塞性肺疾病(COPD)中医肺康复治疗的疗效。方法选取2017 年2 月至2018 年11 月四川大学华西医院收治的126 例稳定期COPD患者为对象,采用随机数字表法分为对照组(常规西药治疗+常规康复锻炼)和观察组(在对照组基础上进行中医肺康复治疗),每组63 例,比较2 组临床疗效、治疗前后改良英国医学研究委员会呼吸困难量表(mMRC)、中医证候评分、肺功能[1 s 用力呼气容积(FEV1)、每分钟最大通气量(MVV)、用力肺活量(FVC)分别占预测值百分比及运动耐力(6 min步行距离)]。结果观察组总有效率较对照组明显高(90.48%vs76.19%),差异有统计学意义(P<0.05);治疗后2 组mMRC 评分、中医证候评分较治疗前明显降低,FEV1%、FVC%、MVV%、6 min 步行距离明显增高,且观察组mMRC 评分、中医证候评分明显低于对照组,FEV1%、FVC%、MVV%明显高于对照组,观察组6 min 步行距离治疗后1、3、5 个月明显大于对照组(P<0.05)。结论中医肺康复治疗稳定期COPD 患者的疗效明显,可有效改善患者中医证候、呼吸功能及运动耐力。

Objective To observe the curative effects of pulmonary rehabilitation with traditional Chinese medicine(TCM) on chronic obstructive pulmonary disease (COPD) during stable period. Methods A total of 126 patients with COPD during stable period who were admitted to the hospital from February 2017 to November 2018 were enrolled in the study. They were divided into the control group (routine western medicine with routine rehabilitation exercise) and the observation group(TCM pulmonary rehabilitation based on the control group) by random number table method,63 cases in each group. The clinical curative effects, scores of Modified Medical Research Council Scale (mMRC) and TCM syndromes, pulmonary function forced expiratory volume in 1s (FEV1), forced vital capacity(FVC) and maximum ventilatory volume (MVV) as percentages of predicted value and exercise endurance (6 min walking distance) were compared between the two groups. Results The total response rate of the observation group was significantly higher than that of the control group (90.48% vs76.19%)(P< 0.05). After treatment, mMRC score and TCM syndrome scores of both groups were significantly decreased, while FEV1%, FVC%, MVV% and 6min walking distance were significantly increased. The mMRC score and TCM syndrome scores in the observation group were significantly lower than those in the control group, while FEV1%, FVC%and MVV%were significantly higher than those in the control group. At 1 month, 3 months and 5 months after treatment, 6 min walking distance in the observation group was significantly larger than that in the control group (P< 0.05). Conclusion The curative effects of TCM pulmonary rehabilitation are obvious on COPD patients during stable period, which can effectively improve TCM syndromes, respiratory function and exercise endurance.