苓甘五味姜辛汤合三子养亲汤加减治疗寒饮瘀阻型COPD的临床疗效

Clinical efficacy of modified Linggan Wuwei Jiangxin decoction combined with Sanzi Yangqin decoction in the treatment of COPD with cold drink and blood stasis type

目的观察苓甘五味姜辛汤合三子养亲汤加减治疗寒饮瘀阻型慢性阻塞性肺疾病(COPD)的临床疗效。方法选取2021年12月—2023年12月福建中医药大学附属康复医院收治的寒饮瘀阻型COPD患者80例,根据随机数字表法分为常规西药组40例和联合组40例。常规西药组患者采用常规西药治疗,联合组患者在常规西药组基础上加用苓甘五味姜辛汤合三子养亲汤加减治疗。2组患者均连续治疗3个月。比较2组临床疗效,治疗前后中医证候积分、肺功能指标、6 min步行距离(6MWD)、慢性阻塞肺疾病评估测试(CAT)评分、改良版英国医学研究会呼吸问卷(mMRC)评分及不良反应。结果联合组总有效率为90.00%,高于常规西药组的72.50%(χ^(2)=4.021,P=0.045)。治疗3个月后,2组中医证候积分低于治疗前,且联合组低于常规西药组(P<0.01);2组第1秒用力呼气容积与用力肺活量比值、呼气流量峰值高于治疗前,且联合组高于常规西药组(P<0.01);2组6MWD长于治疗前,CAT评分及mMRC评分低于治疗前,且联合组延长/降低幅度大于常规西药组(P<0.01)。患者在治疗期间均未见严重不良反应。结论苓甘五味姜辛汤合三子养亲汤加减治疗寒饮瘀阻型COPD的疗效显著,能够显著缓解患者的临床症状,改善肺功能,提高运动耐量及生活质量,且具有一定安全性。

Objective To observe the clinical efficacy of modified Linggan Wuwei Jiangxin decoction combined with Sanzi Yangqin decoction in the treatment of COPD with cold drink and blood stasis type.Methods A total of 80 COPD patients with cold drink and blood stasis type treated in Rehabilitation Hospital affiliated to Fujian University of Traditional Chinese Medicine from December 2021 to December 2023 were selected,and they were divided into the routine western medicine group with 40 cases and the combination group with 40 cases.Patients in the routine western medicine group were given conventional therapy,patients in the combination group were given modified Linggan Wuwei Jiangxin decoction combined with Sanzi Yangqin decoction,both groups were received treatment for 3 months.Clinical effect,TCM syndrome score,pulmonary function indexes,6MWD,CAT score,mMRC score before and after treatment,and incidence of adverse reactions were compared between the two groups.Results Total effective rate of the combination group was higher than that of the routine western medicine group(90.00%vs.72.50%,χ2=4.021,P=0.045).After 3 months of treatment,TCM syndrome score of the two groups was lower than that before treatment,and TCM syndrome score in the combination group was lower than that in the routine western medicine group(P<0.01);FEV 1/FVC,PEF of the two groups were higher than those before treatment,and FEV 1/FVC,PEF in the combination group were lower than those in the routine western medicine group(P<0.01);6MWD of the two groups was longer than that before treatment,scores of CAT and mMRC were lower than those before treatment,and 6MWD in the combination group was longer than that in the routine western medicine group,scores of CAT and mMRC were lower than those in the routine western medicine group(P<0.01).No serious adverse reactions was observed during treatment.Conclusion Modified Linggan Wuwei Jiangxin decoction combined with Sanzi Yangqin decoction have remarkable curative effect on treating COPD with cold drink and blood stasis type,which can significantly relieve the patients′clinical symptoms,improve pulmonary function,improve exercise tolerance and quality of life,and has a certain safety.