目的探究咳喘定方中药贴敷治疗慢性阻塞性肺疾病(Chronic obstructive pulmonary disease,COPD)痰湿阻肺证的临床价值。方法选取2021年1月—2022年10月期间海口市第三人民医院收治的COPD急性加重期痰湿阻肺证患者110例作为研究对象,依...目的探究咳喘定方中药贴敷治疗慢性阻塞性肺疾病(Chronic obstructive pulmonary disease,COPD)痰湿阻肺证的临床价值。方法选取2021年1月—2022年10月期间海口市第三人民医院收治的COPD急性加重期痰湿阻肺证患者110例作为研究对象,依据简单随机数字表法分为对照组和试验组,每组各55例。对照组采取常规西医治疗,试验组在对照组基础上采取咳喘定方中药贴敷,两组患者均治疗10 d。观察比较两组患者临床疗效、治疗安全性、复发率,治疗前后中医证候积分、病情状况[COPD评估测试(COPD assessment test,CAT)、6 min步行距离(Six Minute Walk Distance,6MWT)]、肺功能[第1秒用力呼气量占预计百分比(Forced expiratory volume in one second,FEV1%)、第1秒用力呼气量占用力肺活量百分比(Forced expiratory volume in the first second as a percentage of forced lung capacity,FEV1/FVC)]及血气分析指标[血氧分压(Blood oxygen partial pressure,PaO_(2))、二氧化碳分压(Partial pressure of carbon dioxide,PaCO_(2))]水平。结果(1)临床疗效:治疗后试验组临床控制率62.96%(34/54)高于对照组43.40%(23/53),差异有统计学意义(P<0.05);试验组临床总有效率96.30%(52/54)与对照组92.45%(49/53)比较,差异无统计学意义(P>0.05)。(2)中医证候积分:治疗后两组患者咳嗽、喘息、痰多、胸闷、气短、食少纳呆、胃脘痞满积分均较治疗前降低,差异有统计学意义(P<0.05);且试验组低于对照组,差异有统计学意义(P<0.05)。(3)病情评估:治疗后两组患者病情指标CAT分值均较治疗前降低,6MWT分值较治疗前升高,差异有统计学意义(P<0.05);且试验组CAT分值低于对照组,6MWT分值高于对照组,差异有统计学意义(P<0.05)。(4)肺功能与血气状态:治疗后两组患者FEV1%、FEV1/FVC、PaO_(2)均较治疗前升高,PaCO_(2)均较治疗前降低,差异有统计学意义(P<0.05);且试验组FEV1%、FEV1/FVC、PaO_(2)均高于对照组,PaCO_(2)低于对照组,差异有统计学意义(P<0.05)。(5)安全性:治疗期间,两组患者均未出现严重不良反应与并发症,仅试验组出现1例局部皮红,未给予特殊处理,1 d后自行消退,且该患者无主诉不适,未对治疗进展产生影响。(5)疾病复发率:随访期间,试验组疾病复发率3.77%(2/53)低于对照组14.81%(8/54),差异有统计学意义(χ^(2)=4.005,P=0.045)。结论常规西医基础上采取咳喘定方中药贴敷治疗痰湿阻肺证COPD效果显著,可缓解患者临床症状及病情程度,提升运动耐力,恢复肺功能与血气状态,利于提升整体治疗效果,减少疾病复发,且具有安全性。展开更多
Background The body mass index, airflow obstruction, dyspnea, and exercise capacity （BODE） index was shown at predicting the risk of death, exacerbation and disease severity among patients with COPD, but few studies...Background The body mass index, airflow obstruction, dyspnea, and exercise capacity （BODE） index was shown at predicting the risk of death, exacerbation and disease severity among patients with COPD, but few studies verified relationship between BODE index and health related quality of life （HRQoL） among Chinese COPD patients. The objective of this study was to evaluate the relationship between BODE index and HRQoL in cross-sectional and longitudinal association analyses. Methods A multi-center prospective cohort study was initially conducted in 491 stable COPD patients in Beijing, China. Health status （HRQoL） was assessed by St. George＇s Respiratory Questionnaire （SGRQ）; the BODE index was calculated for each patient; dyspnea was assessed using the 5-grade Medical Research Council dyspnea scale. Other measurements included socio-demographic, body mass index （BMI）, lung function test and 6-minute-walk test （6MWT）. Patients were then followed monthly for 12 months. Results Only 450 patients completed the 1-year follow up and were enrolled in our present analyses. Mean age was （65.2 ±10.6）years,＇ men 309 （68.7%）. The BODE index was categorized into 4 subgroups： 0-2, 3-4, 5-6 and 7-10. At baseline BODE index was gradually increased with baseline total SGRQ and SGRQ subscales （P trend 〈0.001）. For individual components of BODE index, with the decrease of airflow limitation, and 6MWD, and with the increase of Medical Research Council （MRC） dyspnea grade, total SGRQ and SGRQ subscales were increased correspondingly, P trend 〈0.05, respectively. Similar association patterns were found between baseline BODE index and its individual components and mean SGRQ scores at the end of 1-year follow up. By multiple linear regression analyses, baseline BODE index was not only significantly associated with SGRQ score at baseline but also with SGRQ score at the end of 1-year follow up after adjustment for age, male, current smoking, 13s being 0.434 and 0.378, respectively. Conclusions BODE index is associated with SGRQ score cross-sectionally and longitudinally among stable COPD patients. BODE index might have potential to be used as a sensitive tool to assess the status of quality of life and to monitor disease progression among stable COPD patients.展开更多
Background The 2009 pandemic H1 N1 （pH1N1） influenza showed that relatively young adults accounted for the highest rates of hospital admission and death.In preparation for pH1N1,the aim of the study is to identify f...Background The 2009 pandemic H1 N1 （pH1N1） influenza showed that relatively young adults accounted for the highest rates of hospital admission and death.In preparation for pH1N1,the aim of the study is to identify factors associated with the mortality of patients with 2009 pH1N1 infection,especially for young patients without chronic medical conditions.Methods Retrospective observational study of 2151 severe or critical adult cases （-≥14 years old） admitted to a hospital with pH1N1 influenza from September 1,2009 to December 31,2009 from 426 hospitals of 27 Chinese provinces.A confirmed case was a person whose pH1N1 virus infection was verified by real-time reverse-transcriptase polymerase chain reaction （rRT-PCR）.Severe and critical cases were defined according to the H1N1 2009 Clinical guidelines （Third Edition,2009） released by the Ministry of Health of China.Results Among the 2151 patients,the mean age was 34.0 years.Two hundred and ninty-three （13.6%） died during hospital stay.One thousand four hundred and forty-two patients （67.0%） had no comorbidities and 189 （13.1%） of them died.Pregnancy （OR 8.03）,pneumonia （OR 8.91）,dyspnea （OR 3.95）,central nervous system （CNS） symptom （OR 1.55）,higher APACHE （Acute Physiology and Chronic Health Evaluation） Ⅱ score （OR 1.06）,Alanine aminotransferase （ALT） （OR 1.002）,and the lactate dehydrogenase （LDH） level （OR 1.001） were independent risk factors for death among adults without chronic medical conditions.Higher APACHE Ⅱ score （OR 1.08） and age （OR 1.06） were independent risk factors for death among adults with respiratory diseases.A multivariate analysis showed an association between mortality and CNS symptoms （OR 2.66）,higher APACHE Ⅱ score （OR 1.03）,ALT （OR 1.006）,and LDH level （OR 1.002） in patients with cardiovascular diseases.Dyspnea （OR 11.32） was an independent risk factor for patient death in patients with diabetes mellitus.Conclusion Clinical knowledge of identified prognostic factors for mortality may aid in the management of adult influenza infection.展开更多
Background The ADRA2B gene insertion/deletion （I/D） polymorphism is associated with various cardiovascular and metabolic phenotypes. Large （C1） and small （C2） artery compliance, assessed by pulse wave analysis, ...Background The ADRA2B gene insertion/deletion （I/D） polymorphism is associated with various cardiovascular and metabolic phenotypes. Large （C1） and small （C2） artery compliance, assessed by pulse wave analysis, is considered as sensitive markers or risk factors for cardiovascular disease. Therefore whether the ADRA2B I/D polymorphism is associated with CI and C2 need to be investigated. Methods A total of 227 men and 243 women were enrolled in a Chinese family-based study. C1 and C2 were measured by pulse wave analysis. ADRA2B genotypes were determined by polymerase chain reaction. Statistical methods included generalized estimation equations and quantitative transmission disequilibrium test. Results The II （31.9%）, ID （46.8%） and DD （21.3%） genotype frequencies were in Hardy-Weinberg equilibrium （P = 0. 73 ）. The covariates selected by stepwise regression for C1 and C2 were age, systolic pressure and gender. The population based association analysis showed that C1 and C2 were not associated with ADRA2B genotype both before （C1 ： P =0. 28; C2： P =0. 27） and after （C1 ： P =0. 58; C2： P =0. 18） the adjustment. The family-based analyses of 128 informative offspring showed that transmission of the D-allele was not associated with C1 orC2, both before （CI： P=0.42; C2： P=0.85） and after （CI： P=0.31; C2： P= 0. 82） the adjustment. Conclusion The study do not support that the ADRA2B gene I/D polymorphism has a major gene effect on C1 or C2 in the Chinese population of current sample size.展开更多
文摘目的探究咳喘定方中药贴敷治疗慢性阻塞性肺疾病(Chronic obstructive pulmonary disease,COPD)痰湿阻肺证的临床价值。方法选取2021年1月—2022年10月期间海口市第三人民医院收治的COPD急性加重期痰湿阻肺证患者110例作为研究对象,依据简单随机数字表法分为对照组和试验组,每组各55例。对照组采取常规西医治疗,试验组在对照组基础上采取咳喘定方中药贴敷,两组患者均治疗10 d。观察比较两组患者临床疗效、治疗安全性、复发率,治疗前后中医证候积分、病情状况[COPD评估测试(COPD assessment test,CAT)、6 min步行距离(Six Minute Walk Distance,6MWT)]、肺功能[第1秒用力呼气量占预计百分比(Forced expiratory volume in one second,FEV1%)、第1秒用力呼气量占用力肺活量百分比(Forced expiratory volume in the first second as a percentage of forced lung capacity,FEV1/FVC)]及血气分析指标[血氧分压(Blood oxygen partial pressure,PaO_(2))、二氧化碳分压(Partial pressure of carbon dioxide,PaCO_(2))]水平。结果(1)临床疗效:治疗后试验组临床控制率62.96%(34/54)高于对照组43.40%(23/53),差异有统计学意义(P<0.05);试验组临床总有效率96.30%(52/54)与对照组92.45%(49/53)比较,差异无统计学意义(P>0.05)。(2)中医证候积分:治疗后两组患者咳嗽、喘息、痰多、胸闷、气短、食少纳呆、胃脘痞满积分均较治疗前降低,差异有统计学意义(P<0.05);且试验组低于对照组,差异有统计学意义(P<0.05)。(3)病情评估:治疗后两组患者病情指标CAT分值均较治疗前降低,6MWT分值较治疗前升高,差异有统计学意义(P<0.05);且试验组CAT分值低于对照组,6MWT分值高于对照组,差异有统计学意义(P<0.05)。(4)肺功能与血气状态:治疗后两组患者FEV1%、FEV1/FVC、PaO_(2)均较治疗前升高,PaCO_(2)均较治疗前降低,差异有统计学意义(P<0.05);且试验组FEV1%、FEV1/FVC、PaO_(2)均高于对照组,PaCO_(2)低于对照组,差异有统计学意义(P<0.05)。(5)安全性:治疗期间,两组患者均未出现严重不良反应与并发症,仅试验组出现1例局部皮红,未给予特殊处理,1 d后自行消退,且该患者无主诉不适,未对治疗进展产生影响。(5)疾病复发率:随访期间,试验组疾病复发率3.77%(2/53)低于对照组14.81%(8/54),差异有统计学意义(χ^(2)=4.005,P=0.045)。结论常规西医基础上采取咳喘定方中药贴敷治疗痰湿阻肺证COPD效果显著,可缓解患者临床症状及病情程度,提升运动耐力,恢复肺功能与血气状态,利于提升整体治疗效果,减少疾病复发,且具有安全性。
文摘Background The body mass index, airflow obstruction, dyspnea, and exercise capacity （BODE） index was shown at predicting the risk of death, exacerbation and disease severity among patients with COPD, but few studies verified relationship between BODE index and health related quality of life （HRQoL） among Chinese COPD patients. The objective of this study was to evaluate the relationship between BODE index and HRQoL in cross-sectional and longitudinal association analyses. Methods A multi-center prospective cohort study was initially conducted in 491 stable COPD patients in Beijing, China. Health status （HRQoL） was assessed by St. George＇s Respiratory Questionnaire （SGRQ）; the BODE index was calculated for each patient; dyspnea was assessed using the 5-grade Medical Research Council dyspnea scale. Other measurements included socio-demographic, body mass index （BMI）, lung function test and 6-minute-walk test （6MWT）. Patients were then followed monthly for 12 months. Results Only 450 patients completed the 1-year follow up and were enrolled in our present analyses. Mean age was （65.2 ±10.6）years,＇ men 309 （68.7%）. The BODE index was categorized into 4 subgroups： 0-2, 3-4, 5-6 and 7-10. At baseline BODE index was gradually increased with baseline total SGRQ and SGRQ subscales （P trend 〈0.001）. For individual components of BODE index, with the decrease of airflow limitation, and 6MWD, and with the increase of Medical Research Council （MRC） dyspnea grade, total SGRQ and SGRQ subscales were increased correspondingly, P trend 〈0.05, respectively. Similar association patterns were found between baseline BODE index and its individual components and mean SGRQ scores at the end of 1-year follow up. By multiple linear regression analyses, baseline BODE index was not only significantly associated with SGRQ score at baseline but also with SGRQ score at the end of 1-year follow up after adjustment for age, male, current smoking, 13s being 0.434 and 0.378, respectively. Conclusions BODE index is associated with SGRQ score cross-sectionally and longitudinally among stable COPD patients. BODE index might have potential to be used as a sensitive tool to assess the status of quality of life and to monitor disease progression among stable COPD patients.
基金This work wassupported by grants from the Ministry of Health of the People＇s Republic of China, the World Health Organization for the clinical study of the influenza A pandemic A （H1N1） 2009 and the National Natural Science Foundation of China （No. 81030032 and No. 81070005）.Acknowledgements： The authors gratefully acknowledge the following individuals who helped identifying cases and collated clinical data： SONG Shu-fan, LI Ran, YANG Ting, YIN Yu-dong, MA Chen, and BAI Lu who participated in the collection of clinical data Hui David Shu-Cheong （Hong Kong, China）, Colin James McArthur （New Zealand）, Dale Andrew Fisher （Singapore）, OH Myoung Don （Korea）, Dong Jie （World Health Organization） who provided technical support XIAO Fei and WU Si-nan who help reviewing the manuscript.
文摘Background The 2009 pandemic H1 N1 （pH1N1） influenza showed that relatively young adults accounted for the highest rates of hospital admission and death.In preparation for pH1N1,the aim of the study is to identify factors associated with the mortality of patients with 2009 pH1N1 infection,especially for young patients without chronic medical conditions.Methods Retrospective observational study of 2151 severe or critical adult cases （-≥14 years old） admitted to a hospital with pH1N1 influenza from September 1,2009 to December 31,2009 from 426 hospitals of 27 Chinese provinces.A confirmed case was a person whose pH1N1 virus infection was verified by real-time reverse-transcriptase polymerase chain reaction （rRT-PCR）.Severe and critical cases were defined according to the H1N1 2009 Clinical guidelines （Third Edition,2009） released by the Ministry of Health of China.Results Among the 2151 patients,the mean age was 34.0 years.Two hundred and ninty-three （13.6%） died during hospital stay.One thousand four hundred and forty-two patients （67.0%） had no comorbidities and 189 （13.1%） of them died.Pregnancy （OR 8.03）,pneumonia （OR 8.91）,dyspnea （OR 3.95）,central nervous system （CNS） symptom （OR 1.55）,higher APACHE （Acute Physiology and Chronic Health Evaluation） Ⅱ score （OR 1.06）,Alanine aminotransferase （ALT） （OR 1.002）,and the lactate dehydrogenase （LDH） level （OR 1.001） were independent risk factors for death among adults without chronic medical conditions.Higher APACHE Ⅱ score （OR 1.08） and age （OR 1.06） were independent risk factors for death among adults with respiratory diseases.A multivariate analysis showed an association between mortality and CNS symptoms （OR 2.66）,higher APACHE Ⅱ score （OR 1.03）,ALT （OR 1.006）,and LDH level （OR 1.002） in patients with cardiovascular diseases.Dyspnea （OR 11.32） was an independent risk factor for patient death in patients with diabetes mellitus.Conclusion Clinical knowledge of identified prognostic factors for mortality may aid in the management of adult influenza infection.
基金The study was supported by a grant from the Natural ScienceFoundation of Jiangsu Province (No.BK2002029).
文摘Background The ADRA2B gene insertion/deletion （I/D） polymorphism is associated with various cardiovascular and metabolic phenotypes. Large （C1） and small （C2） artery compliance, assessed by pulse wave analysis, is considered as sensitive markers or risk factors for cardiovascular disease. Therefore whether the ADRA2B I/D polymorphism is associated with CI and C2 need to be investigated. Methods A total of 227 men and 243 women were enrolled in a Chinese family-based study. C1 and C2 were measured by pulse wave analysis. ADRA2B genotypes were determined by polymerase chain reaction. Statistical methods included generalized estimation equations and quantitative transmission disequilibrium test. Results The II （31.9%）, ID （46.8%） and DD （21.3%） genotype frequencies were in Hardy-Weinberg equilibrium （P = 0. 73 ）. The covariates selected by stepwise regression for C1 and C2 were age, systolic pressure and gender. The population based association analysis showed that C1 and C2 were not associated with ADRA2B genotype both before （C1 ： P =0. 28; C2： P =0. 27） and after （C1 ： P =0. 58; C2： P =0. 18） the adjustment. The family-based analyses of 128 informative offspring showed that transmission of the D-allele was not associated with C1 orC2, both before （CI： P=0.42; C2： P=0.85） and after （CI： P=0.31; C2： P= 0. 82） the adjustment. Conclusion The study do not support that the ADRA2B gene I/D polymorphism has a major gene effect on C1 or C2 in the Chinese population of current sample size.
