杏贝止咳颗粒联合补肺汤合参蛤散治疗老年COPD肺肾气虚证患者的效果观察

Effect of Xingbei cough-relieving granules combined with Lung-tonifying decoction and ginseng gecko powder on elderly COPD patients with lung and kidney qi deficiency syndrome

目的探讨杏贝止咳颗粒联合补肺汤合参蛤散治疗老年慢性阻塞性肺疾病(COPD)肺肾气虚证患者的效果,以期为临床治疗提供参考。方法选择2018年4月—2020年10月在河南省南阳市第二人民医院进行治疗的80例老年COPD患者为研究对象。采用随机数字表法将患者分为研究组(n=40)与对照组(n=40)。对照组患者采用常规治疗。研究组患者在对照组基础上加用补肺汤合参蛤散治疗。比较2组患者治疗前后COPD评估量表(CAT量表)、圣·乔治呼吸问卷(SGRQ)评分及第1秒用力呼气容积(FEV1)水平、6 min步行距离、急性加重发作次数及BODE指数。比较2组患者治疗后呼吸困难严重程度。结果治疗前,2组患者CAT评分和FEV1水平比较,差异无统计学意义(P>0.05)。治疗后,2组患者CAT评分均低于治疗前,且研究组低于对照组,差异均有统计学意义(P<0.05)。治疗后,2组患者FEV1水平均高于治疗前,且研究组高于对照组,差异均有统计学意义(P<0.05)。治疗前,2组患者SGRQ中呼吸道症状、活动能力、疾病影响评分及总分比较,差异无统计学意义(P>0.05)。治疗后,2组患者SGRQ中呼吸道症状、活动能力、疾病影响评分及总分均低于治疗前,且研究组低于对照组,差异均有统计学意义(P<0.05)。治疗前,2组患者6 min步行距离、急性加重发作次数及BODE指数比较,差异无统计学意义(P>0.05)。治疗后,2组患者6 min步行距离长于治疗前,且研究组长于对照组,差异有统计学意义(P<0.05);2组患者急性加重发作次数少于治疗前,且研究组少于对照组,差异有统计学意义(P<0.05);2组患者BODE指数小于治疗前,且研究组小于对照组,差异有统计学意义(P<0.05)。对照组患者呼吸困难严重程度为3~4级人数所占比例(2.5%)低于对照组(17.5%),差异有统计学意义(P<0.05)。结论杏贝止咳颗粒联合补肺汤合参蛤散对老年COPD肺肾气虚证患者具有较好的治疗效果,可以改善患者呼吸困难症状,提高患者运动耐量和生活质量,减少患者急性加重发作次数,改善患者肺功能,值得临床推广应用。

Objective To investigate the effect of Xingbei cough-relieving granules combined with Lung-tonifying decoction and ginseng gecko powder on elderly COPD patients with lung and kidney qi deficiency syndrome,in order to provide guidance for clinical treatment.Methods Eighty elderly patients with COPD who were treated in the Second People's Hospital of Nanyang from April 2018 to October 2020 were selected as the study participants.The patients were assigned to a study group(n=40)and a control group(n=40)by random number table.Patients in the control group received conventional therapy and the patients in the study group received Lung-tonifying decoction and ginseng gecko powder based on the control group.COPD assessment test(CAT),St.George's Respiratory Questionnaire(SGRQ)score,forced expiratory volume in 1 second(FEV1)level,6-min walking distance,number of exacerbations and BODE(Body Mass Index,Airflow Obstruction,Dyspnea,and Exercise Capacity)index were compared between the two groups before and after treatment.After treatment,the severity of dyspnea was compared between the 2 groups.Results Before treatment,there was no significant difference in CAT score and FEV1 level between the two groups(P>0.05).After treatment,CAT scores in both groups were lower than those before treatment,and the study group was lower than the control group,with statistical significance(P<0.05).After treatment,FEV1 levels in both groups were higher than those before treatment,and the study group was higher than the control group,with statistical significance(P<0.05).Before treatment,there was no significant difference in respiratory symptoms,mobility,disease impact score,and total score in SGRQ between the two groups(P>0.05).After treatment,the respiratory symptoms,activity ability,disease impact score,and total score in the SGRQ in the two groups were lower than those before treatment,and the study group was lower than the control group,with statistical significance(P<0.05).Before treatment,there was no significant difference in 6-min walking distance,number of acute attacks,and BODE index between the two groups(P>0.05).After treatment,the 6-min walking distance in the two groups was longer than that before treatment,and the study group was longer than the control group,with statistical significance(P<0.05);the number of acute attacks in the two groups was less than that before treatment,and the study group was less than the control group,with statistical significance(P<0.05);BODE index in the two groups was less than that before treatment,and the study group was less than the control group,with statistical significance(P<0.05).The proportion of patients with dyspnea of grade 3~4 in the study group(2.5%)was significantly lower than that in the control group(17.5%)(P<0.05).Conclusion Xingbei cough-relieving granules combined with Lung-tonifying decoction and ginseng gecko Powder has a better therapeutic effect on elderly COPD patients with lung-kidney qi deficiency syndrome.It can improve the symptoms of dyspnea,exercise tolerance,and quality of life,reduce the frequency of acute attacks and improve the pulmonary function of patients.These benefits justify a wider application of this procedure clinically.