人参四逆汤加减联合氧疗治疗老年慢性阻塞性肺疾病临床研究

Clinical Study on Modified Renshen Sini Decoction Combined with Oxygen Treatment for Senile Patients with Chronic Obstructive Pulmonary Disease

目的:观察人参四逆汤加减联合氧疗治疗老年慢性阻塞性肺疾病的临床疗效及对患者认知功能的影响。方法:采用随机数字表法将84例老年慢性阻塞性肺疾病患者分成对照组及观察组各42例。对照组给予常规药物加氧疗治疗,观察组在对照组基础上联用人参四逆汤加减治疗。比较2组临床疗效及治疗前后中医证候积分、简易精神状态量表(MMSE)、蒙特利尔认知评估量表(MoCA)评分;比较2组治疗前后血清皮质醇(COR)、促肾上腺皮质激素(ACTH)、动脉血氧分压(PaO_(2))、动脉二氧化碳分压(PaCO_(2))水平及肺功能指标。结果:治疗后,观察组总有效率高于对照组(P<0.05)。治疗后,2组MMSE、MoCA评分均较治疗前升高(P<0.05),主症、次症评分及总分均降低(P<0.05);2组用力肺活量(FVC)、最大呼气峰流速值(PEF)、第1秒用力呼气容积(FEV_(1))、COR、PaO_(2)水平均较治疗前升高(P<0.05),ACTH、PaCO_(2)水平降低(P<0.05);观察组上述指标改善优于对照组(P<0.05)。结论:人参四逆汤加减联合氧疗治疗老年慢性阻塞性肺疾病疗效确切,能够有效改善患者肺功能及血气指标,调节患者COR、ACTH水平,提高认知功能。

Objective:To observe the clinical effect of modified Renshen Sini Decoction combined with oxygen treatment for senile patients with chronic obstructive pulmonary disease and its effect on cognitive function.Methods:A total of 84 cases of senile patients with chronic obstructive pulmonary disease were divided into the control group and the observation group according to the random number table method,with 42 case in each group.The control group was given routine medicines and oxygen treatment,and the observation group was additionally treated with modified Renshen Sini Decoction based on the treatment of the control group.Traditional Chinese medicine(TCM) syndrome scores,Mini-Mental State Examination(MMSE) and Montreal Cognitive Assessment(MoCA) before and after treatment as well as the clinical effects in the two groups were compared.The levels of serum cortisol(COR),adrenocorticotropic hormone(ACTH),partial pressure of oxygen in arterial blood(PaO_(2)),partial pressure of carbon dioxide in arterial blood(PaCO_(2)) and lung function indexes before and after treatment in the two groups were compared.Results:After treatment,the total effective rate in the observation group was higher than that in the control group(P<0.05).After treatment,the scores of MMSE and MoCA in the two groups were increased when compared with those before treatment(P<0.05),and the scores of primary,secondary and total symptoms were decreased(P<0.05);the levels of forced vital capacity(FVC),peak expiratory flow(PEF),forced expiratory volume in the first second(FEV_(1)),COR and PaO_(2) in the two groups were increased when compared with those before treatment(P<0.05),and the levels of ACTH and PaCO_(2) were decreased(P<0.05);the improvement of the above indexes in the observation group was better than that in the control group(P<0.05).Conclusion:The therapy of modified Renshen Sini Decoction combined with oxygen treatment for senile patients with chronic obstructive pulmonary disease has a definite curative effect,which can effectively improve lung function and blood gas indexes,regulate the levels of COR and ACTH,and enhance cognitive function.