补虚汤合参蛤散加味治疗COPD稳定期肺肾气虚证的效果观察

Effect of Buxu decoction combined with Shenaishi powder on lung and kidne y Qi deficiency syndrome in stable COPD

目的:研究补虚汤合参蛤散加味对慢性阻塞性肺疾病(COPD)稳定期肺肾气虚证患者临床疗效的影响。方法:本研究中的100例研究对象均为2018年7月至2020年7月期间黄冈市麻城市中医医院收治的COPD稳定期肺肾气虚证患者。病例选择完毕后,按照随机数表法对其进行分组,其中观察组和对照组中均各有患者50例。对照组患者采用沙美特罗替卡松粉吸入剂+氨茶碱片治疗,观察组患者在此基础上加用补虚汤合参蛤散加味治疗。比较两组患者治疗前后的肺功能指标、中医证候(喘息、气短、乏力、易感冒、耳鸣、腰膝酸软)积分及临床疗效。结果:治疗前,两组患者的肺功能指标及中医证候积分相比,差异无统计学意义(P>0.05)。治疗后,观察组患者的第1 s用力呼气容积(FEV1)和FEV1/用力肺活量(FVC)均高于对照组患者,其喘息、气短、乏力、易感冒、耳鸣、腰膝酸软积分均低于对照组患者,差异有统计学意义(P<0.05)。观察组患者的临床治疗总有效率为94.00%(47/50),对照组患者的临床治疗总有效率为72.00%(36/50),组间相比差异有统计学意义(P<0.05)。结论:在西医对症治疗的基础上,用补虚汤合参蛤散加味治疗COPD稳定期肺肾气虚证能显著提高患者的临床疗效,改善其肺功能,减轻其临床症状。

Objective:To study the effect of Buxu decoction combined with Shenaishi powder on the clinical efficacy of patients with lung and kidney Qi deficiency syndrome in stable stage of chronic obstructive pulmonary disease(COPD).Methods:All the 100 subjects in this study were COPD patients with lung and kidney Qi deficiency syndrome in stable phase admitted to Macheng Traditional Chinese Medicine Hospital of Huanggang City from July 2018 to July 2020.After the selection of cases,they were divided into two groups according to the random number table method,and there were 50 patients in the observation group and 50 patients in the control group.The patients in the control group were treated with salmeterol fluticasone powder inhalation plus aminophylline tablets,and the patients in the observation group were treated with Buxu decoction and Shenbao SAN on this basis.The pulmonary function indexes,TCM syndromes(wheezing,shortness of breath,fatigue,susceptibility to cold,tinnitus,waist and knee tenderness)scores and clinical efficacy were compared between the two groups before and after treatment.Results:Before treatment,there was no significant difference in lung function index and TCM syndrome score between the two groups(P>0.05).After treatment,the forced expiratory volume in the first second(FEV1)and FEV1/forced vital capacity(FVC)of the observation group were higher than those of the control group,and the wheezing,shortness of breath,fatigue,susceptibility to cold,tinnitus,and lumbar and knee acid and soft score were lower t han those of the control group,and the differences were statistically significa nt(P<0.05).The total effective rate of clinical treatment in the o bservation group was 94.00%(47/50),and that in the control group was 72.00%(36/50),and the difference between the two groups was statistically significant(P<0.05).Conclusion:On the basis of symptomatic treatment of Western medicine,Buxu decoction combi ned with Shenaishi powder can significantly improve the clinical effect of COPD patients with lung and kidney qi deficiency syndrome in stable stage,improve their lung function and reduce their clinical symptoms.