六君子汤联合平喘敷贴治疗老年慢性阻塞性肺疾病临床观察

Liujunzi Decoction Combined with Antiasthmatic Application in the Treatment of Senile Chronic Obstructive Pulmonary Disease

目的探讨六君子汤加减联合平喘敷贴对老年慢性阻塞性肺疾病(COPD)患者肺功能及生活质量的影响。方法将108例老年COPD稳定期患者随机分为对照组和试验组,各54例。对照组给予常规治疗及沙美特罗替卡松吸入粉雾剂,试验组在对照组基础上给予六君子汤加减联合平喘敷贴治疗。治疗3个月后,比较2组临床疗效、肺功能指标、血气分析指标、圣乔治呼吸问卷(SGRQ)评分及不良反应。结果试验组总有效率为90.74%(49/54),高于对照组的74.07%(40/54)(P<0.05)。治疗后,试验组第1秒用力呼气容积(FEV1)/用力肺活量(FVC)和FEV1占预计值的百分比(FEV1%)较对照组高(P<0.05)。试验组平均血氧饱和度(MSaO_(2))、平均最低氧饱和度(MmSaO_(2))、动脉血氧分压(PaO_(2))、动脉血氧饱和度(SaO_(2))较对照组高,整夜睡眠过程中血氧饱和度(SpO_(2))<90%的时间占总监测时间的百分比(T90)、动脉血二氧化碳分压(PaCO_(2))水平较对照组低(P<0.05)。试验组SGRQ症状评分、活动能力评分、疾病影响评分,以及总评分较对照组低(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论六君子汤加减联合平喘敷贴能明显缓解老年COPD患者症状,改善其肺功能,提高生活质量,临床疗效确切。

Objective To investigate the effects of modified Liujunzi decoction combined with antiasthmatic application on pulmonary function and quality of life in elderly patients with chronic obstructive pulmonary disease(COPD).Methods One hundred and eight el⁃derly patients with stable COPD were randomly divided into control group and experimental group,with 54 cases in each group.The control group was given conventional treatment and salmeterol ticasone inhalation powder,and the experimental group was given Liu⁃junzi decoction combined with antiasthmatic application on the basis of the control group.After 3 months of treatment,the clinical effi⁃cacy,pulmonary function index,blood gas analysis index,Saint George’s Respiratory questionnaire(SGRQ)score and adverse reac⁃tions were compared between the two groups.Results The total effective rate of experimental group was 90.74%(49/54),which was higher than that of control group(74.07%,40/54)(P<0.05).After treatment,the percentage of forced expiratory volume(FEV1)/forced vital capacity(FVC)and FEV1 in the predicted value(FEV1%)in the experimental group was higher than that in the control group(P<0.05).The mean blood oxygen saturation(MSaO_(2)),mean minimum oxygen saturation(MmSaO_(2)),arterial partial oxygen pressure(PaO_(2))and arterial partial oxygen saturation(SaO_(2))of experimental group were higher than those of control group,and the percentage of SpO_(2)<90%in total monitoring time(T90)and arterial partial pressure of carbon dioxide(Pa)during sleep all night were higher than those of control group The level of PaCO_(2)was lower than that of control group(P<0.05).SGRQ symptom score,activity ability score,disease impact score and total score of experimental group were lower than those of control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Modified Liujunzi decoction combined with antiasthmatic application can significantly alleviate the symptoms of elderly patients with COPD,improve lung function and im⁃prove the quality of life,which has definite clinical effect.