培元顺气膏配合八段锦对慢性阻塞性肺疾病稳定期的临床防治研究

Study on the clinical prevention and treatment of Peiyuan Shunqi Paste combined with Baduanjin in stable chronic obstructive pulmonary disease

目的探讨培元顺气膏配合八段锦治疗慢性阻塞性肺疾病(慢阻肺,COPD)稳定期的临床疗效及安全性。方法60例慢阻肺稳定期患者,按随机数字表法分为对照组和观察组,每组30例。对照组患者单纯使用沙美特罗替卡松气雾剂(商品名:舒利迭)吸入治疗,治疗组在对照组基础上联合培元顺气膏、八段锦治疗。比较两组患者中医证候积分、呼吸困难量表(mMRC)评分、慢阻肺患者自我评估测试(CAT)评分、6 min步行距离、肺功能指标[第1秒用力呼气容积占预计值百分比(FEV1%)、第1秒用力呼气容积占用力肺活量百分比(FEV1/FVC)]、血气指标[动脉血氧分压(PaO_(2))、动脉二氧化碳分压(PaCO_(2))]、临床疗效、不良反应发生情况。结果治疗后,两组中医证候积分、mMRC评分、CAT评分均低于治疗前,且观察组中医证候积分、mMRC评分、CAT评分分别为(6.10±0.50)、(0.64±0.12)、(9.06±1.14)分,明显低于对照组的(12.50±1.60)、(1.06±0.16)、(13.33±1.88)分(P<0.05)。治疗后,两组患者6 min步行距离、FEV1%、FEV1/FVC、PaO_(2)均高于治疗前,PaCO_(2)低于治疗前,且观察组6 min步行距离(433.35±50.25)m、FEV1%(61.85±6.55)%、FEV1/FVC(70.42±6.23)%、PaO_(2)(89.35±7.07)mm Hg(1 mm Hg=0.133 kPa)均高于对照组的(384.80±48.60)m、(55.64±6.30)%、(65.26±6.33)%、(79.34±7.06)mm Hg,PaCO_(2)(42.02±5.55)mm Hg低于对照组的(56.12±5.23)mm Hg(P<0.05)。观察组临床总有效率为93.33%高于对照组的73.33%(χ^(2)=4.320,P<0.05)。两组治疗过程中均未见明显不良反应。结论培元顺气膏配合八段锦是治疗慢阻肺稳定期的安全可靠、疗效确切、操作简单的治疗手段,能够有效缓解临床症状,改善肺功能指标及血气指标,提高运动耐力。

Objective To discuss the clinical efficacy and safety of Peiyuan Shunqi Paste combined with Baduanjin in the treatment of stable chronic obstructive pulmonary disease(COPD).Methods 60 patients with stable COPD were divided into a control group and an observation group according to random number table,with 30 cases in each group.The control group was treated with salmeterol xinafoate and fluticasone propionate aerosol(trade name:Seretide)inhalation alone,and the treatment group was treated with Peiyuan Shunqi Paste and Baduanjin on the basis of the control group.Both groups were compared in terms of traditional Chinese medicine syndrome score,modified medical British research council(mMRC)score,COPD Asessment Test(CAT)score,6-min walking distance,lung function indicators[forced expiratory volume in one second as a percentage to the predicted value(FEV1%),ratio of forced expiratory volume in one second to forced vital capacity(FEV1/FVC)],the blood gas indicators[arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2))],the clinical efficacy,and the occurrence of adverse reactions.Results After treatment,the traditional Chinese medicine syndrome score,mMRC score and CAT score in both groups were lower than those before treatment;and the traditional Chinese medicine syndrome score,mMRC score and CAT score in the observation group were(6.10±0.50),(0.64±0.12)and(9.06±1.14)points,which were significantly lower than(12.50±1.60),(1.06±0.16)and(13.33±1.88)points in the control group(P<0.05).After treatment,the 6-min walking distance,FEV1%,FEV1/FVC and PaO_(2) in both groups were all higher than those before treatment,and PaCO_(2) was lower than that before treatment;the observation group had 6-min walking distance of(433.35±50.25)m,FEV1%of(61.85±6.55)%,FEV1/FVC of(70.42±6.23)%,PaO_(2) of(89.35±7.07)mm Hg(1 mm Hg=0.133 kPa),which were higher than(384.80±48.60)m,(55.64±6.30)%,(65.26±6.33)%,(79.34±7.06)mm Hg in the control group;the observation had lower PaCO_(2) of(42.02±5.55)mm Hg than(56.12±5.23)mm Hg in the control group(P<0.05).The total effective rate was 93.33%in the observation group,which was higher than 73.33%in the control group(χ^(2)=4.320,P<0.05).No obvious adverse reactions were observed in both groups during treatment.Conclusion Peiyuan Shunqi Paste combined with Baduanjin is a safe,reliable,effective and simple treatment for stable COPD.It can effectively relieve clinical symptoms,improve lung function index and blood gas index,and improve exercise endurance.