自拟加减养阴清肺汤用于肺叶或肺段切除术后肺阴亏虚型肺功能不全有效性研究

Effect of Modified Setlf-made YangYin Qingfei Decoction on Pulmonary Complications after Pneumonectomy

目的:本文旨在讨论养阴清肺汤用于胸腔镜下肺叶或肺段切除术后围手术期并发肺功能不全、咳嗽、气促、胸闷等症状,且临床辨证为肺阴亏虚型证的临床疗效。方法:选取2019年12月至2021年12月于成都中医药大学附属医院心胸外科行胸腔镜下肺叶或肺段切除且术后出现明显并发肺功能不全、咳嗽、气促、胸闷的辨证均为肺阴亏虚的100例患者,随机分为观察组和对照组,两组患者术后均常规使用抗感染、雾化吸入排痰、吸氧等辅助治疗,观察组患者加服养阴清肺汤。两组患者均以15 d为一个疗程,持续治疗三个疗程。治疗结束后比较两组患者咳嗽评分、症状评分及肺功能表现。结果:与对照组比较,观察组患者术后咳嗽、气促、胸闷消失时间减少,观察组总有效48例(96%),高于对照组总有效35例(70%),术后症状缓解率高;观察组肺活量(2.55±0.21)L高于对照组(2.27±0.33)L;第一秒通气比率(FEV1/FVC)观察组69.33%±3.21%较对照组66.86%±4.32%恢复更好;6 min步行试验(6MWT)观察组(491.22±30.82)m较对照组(454.32±31.12)m有更远的距离,差异有统计学意义。结论:养阴清肺汤可以改善胸腔镜下肺叶或肺段切除术后患者肺功能,缓解术后咳嗽,提升患者术后生活质量。

Objective:The purpose of this study is to investigate the clinical efficacy of modified setlf-made YangYin Qingfei Decoction in the treatment of postoperative pulmonary dysfunction,cough,dyspnea,and chest tightness in patients undergoing pulmonary lobectomy or segmentectomy with clinical syndrome of Lung Yin deficiency.Methods:From December 2019 to December 2021,100 patients who underwent pulmonary lobectomy or segmentectomy and developed obvious postoperative pulmonary dysfunction,cough,dyspnea,and chest tightness with clinical syndrome of Lung Yin deficiency were selected and divided into a control group and an observation group.Both groups received routine treatment including anti-infection,nebulization,sputum suction,and oxygen inhalation,while the control group received additional modified setlf-made YangYin Qingfei Decoction.Both groups were treated for three courses of 15 days each.After treatment,the cough score,symptom score,and lung function were compared between the two groups.Results:Compared with the control group,the observation group showed a decrease in the disappearance time of postoperative cough,shortness of breath,and chest tightness.The observation group had a total effective rate of 48 cases(96%),which was higher than the control group’s total effective rate of 35 cases(70%).The postoperative symptom relief rate was high;The vital capacity of(2.55±0.21)L in the observation group was higher than that of(2.27±0.33)L in the control group,the first second ventilation rate(FEV1/FVC)of 69.33%±3.21%in the observation group was better than that of 66.86%±4.32%in the control group,and the 6-minute walk test(6MWT)of(491.22±30.82)m in the observation group was farther than that of(454.32±31.12)m in the control group.The difference is statistically significant.