经络注血疗法联合半夏厚朴汤合三子养亲汤加减治疗痰湿阻肺型慢阻肺急性加重期患者的效果观察

Observation on effect of meridian blood injection therapy combined with modified Banxia Houpo Tang and Sanzi Yangqin Tang in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease(phlegm-dampness obstructing the lung pattern)

目的 观察经络注血疗法联合半夏厚朴汤合三子养亲汤加减治疗痰湿阻肺型慢性阻塞性肺疾病(慢阻肺)急性加重期患者的临床疗效。方法 120例痰湿阻肺型慢阻肺急性加重期患者,以随机区组法分为综合治疗组、经络注血疗法组、中药治疗组及对照组,各30例。对照组患者均进行综合评估,根据患者急性加重严重程度,参照诊疗指南规范使用支气管扩张剂、糖皮质激素和抗生素进行治疗;中药治疗组在对照组的基础上予以半夏厚朴汤合三子养亲汤加减治疗;经络注血疗法组在对照组的基础上行经络注血疗法治疗;综合疗法组在对照组基础上给予半夏厚朴汤合三子养亲汤加减联合经络注血疗法治疗。比较四组患者治疗前后咳嗽症状评分、视觉模拟评分法(VAS)评分、痰液粘稠度分级、呼吸困难评分、综合临床症状评分、慢阻肺评估测试评分差值。结果 综合治疗组咳嗽症状评分差值为(-3.43±1.10)分、VAS评分差值为(-6.80±0.96)分、痰液粘稠度分级差值为(-1.60±0.50)级、呼吸困难评分差值为(-1.63±0.67)分,经络注血疗法组咳嗽症状评分差值为(-3.13±0.68)分、VAS评分差值为(-5.80±1.10)分、痰液粘稠度分级差值为(-1.27±0.79)级、呼吸困难评分差值为(-1.20±0.47)分,中药治疗组咳嗽症状评分差值为(-3.00±0.64)分、VAS评分差值为(-5.70±1.12)分、痰液粘稠度分级差值为(-0.80±0.71)级、呼吸困难评分差值为(-0.47±0.51)分,对照组咳嗽症状评分差值为(-2.83±0.75)分、VAS评分差值为(-5.63±1.63)分、痰液粘稠度分级差值为(-0.90±0.55)级、呼吸困难评分差值为(-0.37±0.56)分。四组治疗前后咳嗽症状评分、痰液粘稠度分级、呼吸困难评分差值比较,差异均具有统计学意义(P<0.05)。四组治疗前后VAS评分差值比较,差异无统计学意义(P>0.05)。综合治疗组综合临床症状评分差值为(-7.70±2.65)分、慢阻肺评估测试评分差值为(-12.87±4.39)分,经络注血疗法组综合临床症状评分差值为(-6.73±2.27)分、慢阻肺评估测试评分差值为(-7.87±4.17)分,中药治疗组综合临床症状评分差值为(-4.73±2.26)分、慢阻肺评估测试评分差值为(-6.50±3.06)分,对照组综合临床症状评分差值为(-4.07±1.62)分、慢阻肺评估测试评分差值为(-4.47±2.79)分。四组治疗前后综合临床症状、慢阻肺评估测试评分差值比较,差异均具有统计学意义(P<0.05)。结论 经络注血疗法联合半夏厚朴汤合三子养亲汤加减治疗痰湿阻肺型慢阻肺急性加重期患者具有一定的推广价值。

Objective To observe the clinical efficacy of meridian blood injection therapy combined with modified Banxia Houpo Tang and Sanzi Yangqin Tang in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease(phlegm-dampness obstructing the lung pattern).Methods 120 patients with acute exacerbation of chronic obstructive pulmonary disease(phlegm-dampness obstructing the lung pattern)were divided into comprehensive treatment group,meridian blood injection therapy group,traditional Chinese medicine treatment group and control group using the randomized controlled trial method,with 30 cases in each group.Patients in the control group were comprehensively evaluated,and bronchodilators,glucocorticoids and antibiotics were prescribed according to the severity of acute aggravation of patients in accordance with the diagnosis and treatment guidelines.The traditional Chinese medicine treatment group was given modified Banxia Houpo Tang and Sanzi Yangqin Tang on the basis of the control group,the meridian blood injection therapy group was treated with meridian blood injection therapy on the basis of the control group,the comprehensive treatment group was given meridian blood injection combined with modified Banxia Houpo Tang and Sanzi Yangqin Tang on the basis of the control group.Comparison was made on cough symptom score,visual analogue scale(VAS)score,sputum viscosity grading,dyspnea score,comprehensive clinical symptom score,COPD assessment test before and after treatment between the two groups.Results In comprehensive treatment group,the difference in cough symptom score was(-3.43±1.10)points,the difference in VAS score was(-6.80±0.96)points,the difference in sputum viscosity grading was(-1.60±0.50)points,and the difference in dyspnea score was(-1.63±0.67)points.In meridian blood injection therapy group,the difference in cough symptom score was(-3.13±0.68)points,the difference in VAS score was(-5.80±1.10)points,the difference in sputum viscosity grading was(-1.27±0.79)points,and the difference in dyspnea score was(-1.20±0.47)points.In traditional Chinese medicine treatment group,the difference in cough symptom score was(-3.00±0.64)points,the difference in VAS score was(-5.70±1.12)points,the difference in sputum viscosity grading was(-0.80±0.71)points,and the difference in dyspnea score was(-0.47±0.51)points.In control group,the difference in cough symptom score was(-2.83±0.75)points,the difference in VAS score was(-5.63±1.63)points,the difference in sputum viscosity grading was(-0.90±0.55)points,the difference in dyspnea score was(-0.37±0.56)points.The difference in cough symptom score,sputum viscosity grading,dyspnea score before and after treatment were compared among the four groups,and the difference was statistically significant(P<0.05).Comparison of the difference in VAS scores before and after treatment among the four groups was not statistically significant(P>0.05).In comprehensive treatment group,the difference in comprehensive clinical symptom score was(-7.70±2.65)points,the difference in COPD assessment test was(-12.87±4.39)points;in meridian blood injection therapy group,the difference in comprehensive clinical symptom score was(-6.73±2.27)points,the difference in COPD assessment test was(-7.87±4.17)points;in traditional Chinese medicine treatment group,the difference in comprehensive clinical symptom score was(-4.73±2.26)points,the difference in COPD assessment test was(-6.50±3.06)points;in control group,the the difference in comprehensive clinical symptom score was(-4.07±1.62)points,the difference in COPD assessment test was(-4.47±2.79)points.The difference in comprehensive clinical symptom score and COPD assessment test before and after treatment of the four groups was compared,and the difference was statistically significant(P<0.05).Conclusion Meridian blood injection therapy combined with modified Banxia Houpo Tang and Sanzi Yangqin Tang has a certain promotion value in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease(phlegm-dampness obstructing the lung pattern).