健脾补肾益肺方治疗慢性阻塞性肺疾病稳定期患者疗效及对生活质量的影响

Effect of Jianpi Bushen Yifei Decoction on patients with stable chronic obstructive pulmonary disease and its influence on quality of life

目的探讨健脾补肾益肺方加减治疗慢性阻塞性肺疾病(COPD)稳定期疗效及对患者生活质量的影响。方法将2018年4月—2020年4月在北京市宣武中医医院中医肺病科、东方医院呼吸热病科接受治疗的100例COPD稳定期患者随机分为2组。对照组50例采用常规西药治疗,观察组50例在常规西药治疗的基础上采用健脾补肾益肺方加减治疗,2组均治疗3个月后评价疗效。观察比较2组治疗前后肺功能指标[呼气峰值流速(PEF)、第1秒用力呼气容积(FEV_(1))、第1秒用力呼气容积与用力肺活量的比值(FEV_(1)/FVC)]、中医症状积分、呼吸困难严重程度[采用改良版英国医学研究委员会呼吸问卷(mMRC)评估]、6 min步行试验(6WMD)及生活质量(采用CAT量表评估),统计2组临床疗效、COPD急性加重住院次数和时间及不良反应发生情况。结果治疗后,2组PEF、FEV_(1)、FEV_(1)/FVC、6WMD均显著升高(P均<0.05),而各项中医症状积分、mMRC分级、CAT评分均显著降低(P均<0.05),COPD急性加重住院次数显著减少且持续时间显著缩短(P均<0.05),且治疗后观察组上述指标改善情况均显著优于对照组(P均<0.05)。观察组和对照组治疗总有效率分别为96%(48/50),80%(40/50),观察组显著高于对照组(P<0.05)。观察组和对照组不良反应发生率分别为2%(1/50),8%(4/50),2组比较差异无统计学意义(P>0.05)。结论常规西药治疗基础上联合健脾补肾益肺方加减治疗COPD稳定期疗效更好,可明显缓解临床症状,改善患者肺功能,促进身体恢复,提高生活质量,且不增加不良反应。

Objective It is to explore the curative effect of Jianpi Bushen Yifei Decoction on chronic obstructive pulmonary disease(COPD)at stable phase and its effect on the quality of life of patients.Methods One hundred patients with stable COPD who were treated in the Department of Pulmonary Disease of Beijing Xuanwu Hospital of Traditional Chinese Medicine and Department of Respiratory Medicine and Heat Disease of Dongfang Hospital were randomly divided into 2 groups.50 cases in the control group were treated with conventional western medicine,and 50 cases in the observation group were treated with modified Jianpi Bushen Yifei Decoction on the basis of conventional western medicine.Both groups were treated for 3 months to evaluate the curative effect.The pulmonary function indexes[peak expiratory flow rate(PEF),forced expiratory volume in the first second(FEV_(1)),ratio of forced expiratory volume in the first second to forced vital capacity(FVC)(FEV_(1)/FVC)],TCM symptom scores,severity of dyspnea[assessed by a modified version of British Medical Research Council Respiratory Questionnaire(mMRC)],6-min walk test(6WMD)and quality of life(assessed by CAT scale)of the two groups were observed and compared before and after treatment,the clinical efficacy was evaluated,the times and duration of hospitalization of acute exacerbation of COPD and the occurrence of adverse reactions were calculated.Results After treatment,PEF,FEV_(1),FEV_(1)/FVC,and 6WMD were significantly increased in the two groups(all P<0.05),while the scores of symptoms of TCM,mMRC classification,and CAT score were significantly reduced(all P<0.05),the times of acute exacerbation of COPD were significantly reduced and the duration was significantly shortened(all P<0.05),and the improvement of the above indicators in the observation group after treatment was significantly better than that of the control group(all P<0.05).The total effective rates of treatment in the observation group and the control group were 96.0%(48/50)and 80.0%(40/50),respectively,the observation group was significantly higher than the control group(P<0.05).The incidence of adverse reactions in the observation group and the control group were 2.0%(1/50)and 8.0%(4/50),respectively,there was no statistically significant difference between the two groups(P>0.05).Conclusion Conventional western medicine combined with Jianpi Bushen Yifei Decoction has a better effect in the treatment of stable COPD,which can significantly relieve clinical symptoms,improve patients’lung function,promote physical recovery,improve quality of life,and do not increase adverse reactions.