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Asthma-chronic obstructive pulmonary disease overlap syndrome: A diagnostic puzzle for the clinicians
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作者 Ourania Koltsida Antonia Koutsoukou +1 位作者 Nikolaos G Koulouris Nikoletta Rovina 《World Journal of Respirology》 2016年第2期54-56,共3页
Although asthma and chronic obstructive pulmonary disease(COPD) are distinct airway diseases characterized by chronic inflammation, in some cases distinguishing between them is puzzling. For example, chronic smoking l... Although asthma and chronic obstructive pulmonary disease(COPD) are distinct airway diseases characterized by chronic inflammation, in some cases distinguishing between them is puzzling. For example, chronic smoking leads asthmatic inflammation to a differentiated pattern resembling the COPD inflammation, and in some cases to fixed obstruction as in COPD, and on the other hand, few COPD patients may present with airway reversibility. ACOS is the condition sharing features encountered both in asthma and COPD. Asthma-COPD overlap syndrome(ACOS) represents a diagnostic challenge in the clinical practice, since there is lack of specific indicators to distinguish it from asthma or COPD, and moreover, genetic risk factors, underlying pathology and molecular pathways, clinical characteristics, therapeutic interventions, response to treatment and prognosis are poorly described. The management of ACOS is recommended to be individualized and should target on the maximum effectiveness with the least side effects. Combination therapy with ICS/LABA or LAMA, or newly developed specific anti-eosinophil therapies and treatments specifically targeting neutrophils might be of relevance in the management of ACOS, but studies are needed in order to assess the response and prognosis. Based on the current knowledge about ACOS thus far, it would be recommended that we approached chronic obstructive airway disease rather by describing than by classifying the disease; this would allow us to have a picture that better describes the disease and to implement an individualized therapeutic approach, according to the custom phenotype. Nevertheless, more studies are needed in order to clarify several important issues with regard to ACOS, such as the genetic risk factors for developing ACOS, the links between genotype and phenotype, the molecular pathways and underlying mechanisms of ACOS, the identification of possible specific biomarkers for diagnosis and targeted treatment, the optimal therapeutic interventions, and finally, the prognosis of ACOS. 展开更多
关键词 ASTHMA chronic obstructive pulmonary disease asthma-chronic obstructive pulmonary disease overlap syndrome DIAGNOSTIC challenges Therapeutic dilemmas
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Exploring the biological mechanism of qi deficiency syndrome with chronic obstructive pulmonary disease(COPD)based on integrated pharmacology 被引量:2
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作者 Dayu Lin Shuai Li +3 位作者 Chunying Hou Xue Xu Shuzhen Guo Qingqing Wang 《Journal of Traditional Chinese Medical Sciences》 2021年第1期72-81,共10页
Objective:To explore the potential biological mechanism of chronic obstructive pulmonary disease(COPD)qi deficiency syndrome,we used the integrated pharmacology network computing platform and carried out experimental ... Objective:To explore the potential biological mechanism of chronic obstructive pulmonary disease(COPD)qi deficiency syndrome,we used the integrated pharmacology network computing platform and carried out experimental verification.Methods:Using an integrated pharmacology strategy to analyze the potential biological targets of COPD qi deficiency syndrome.Based on the established qi deficiency syndrome rat model of COPD,the biological targets of lung and skeletal muscle were detected by electron microscopy,adenosine triphosphate(ATP)content assays,and western blotting.Results:According to the integrated pharmacological results,it was found that the locations of cell components related to COPD qi deficiency syndrome were mainly mitochondria.Electron microscopy results using lung tissue showed that mitochondria in the lipopolysaccharide(LPS group)and pulmonary instillation of LPS combined with cigarette smoke(LPStCS group)were swollen,deformed,and fragmented,with disappearing or broken crista.Results also showed that the total content of ATP in the lung and skeletal muscle of both groups was significantly lower than that in the control group at the 12th week(P<.05).At the 12th week,the expression of dynamin-related protein 1(DRP1)and mitofusin 1(MFN1)protein was significantly difference than that of the control group(P<.05).At the 10th and 14th weeks,changes in fission and fusion proteins in mitochondria of the lung and skeletal muscle were further detected.There was also a significant difference in the expression between the two groups compared to that in the control group at the 10th week and 14th week(P<.05).Conclusion:These findings suggest that the changes in mitochondrial morphology and ATP content and the unbalanced expression of DRP1 and MFN1 might be the key mechanisms underlying qi deficiency syndrome in rats with COPD. 展开更多
关键词 chronic obstructive pulmonary disease(COPD) Qi deficiency syndrome MITOCHONDRION Integrated pharmacology
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Traditional Chinese medicine nursing protocols for chronic obstructive pulmonary disease 被引量:1
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作者 Editorial Board of Nursing of Integrated Traditional Chinese and Western Medicine 《中西医结合护理(中英文)》 2020年第4期241-246,共6页
Chronic obstructive pulmonary disease(COPD)is a complex respiratory disorder,characterized by chronic airflow limitation and an elevated inflammatory response of the airways.The people with COPD are more likely to dev... Chronic obstructive pulmonary disease(COPD)is a complex respiratory disorder,characterized by chronic airflow limitation and an elevated inflammatory response of the airways.The people with COPD are more likely to develop comorbidities,with significant impacts on patients'quality of life,exacerbation frequency,and survival.Traditional Chinese medicine(TCM)exhibits good therapeutic effects on improving the clinical symptoms,lung function and quality of life in patients with COPD.Herein,this article primarily summarized the key points of common syndromes,TCM nursing methods and healthy guidance of COPD,aiming at maintaining and developing the strengths of TCM,improving its efficacy and standardizing its behavior. 展开更多
关键词 chronic obstructive pulmonary disease COUGH EXPECTATION traditional Chinese medicine nursing syndrome differentiation
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Efficacy and safety of Qingfei Huatan formula in the treatment of acute exacerbation of chronic obstructive pulmonary disease:A multi-centre,randomised,double-blind,placebo-controlled trial
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作者 Hui-zhi Zhu Cheng-yi Li +9 位作者 Liang-ji Liu Jia-bing Tong Zhi-hui Lan Shu-guang Tian Qiao Li Xiang-li Tong Ji-feng Wu Zhen-gang Zhu Su-yun Li Jian-sheng Li 《Journal of Integrative Medicine》 SCIE CAS CSCD 2024年第5期561-569,共9页
Background Chronic obstructive pulmonary disease(COPD),a common respiratory disease,can be effectively treated by traditional Chinese medicine(TCM).Qingfei Huatan,a TCM formula,has been reported to effectively allevia... Background Chronic obstructive pulmonary disease(COPD),a common respiratory disease,can be effectively treated by traditional Chinese medicine(TCM).Qingfei Huatan,a TCM formula,has been reported to effectively alleviate the clinical symptoms of COPD patients.However,there is a lack of multi-centre,randomised,double-blind,controlled clinical trials documenting the clinical efficacy and safety of this formula in the treatment of acute exacerbation of COPD(AECOPD).Objective This study evaluated the efficacy and safety of Qingfei Huatan formula in the treatment of AECOPD,thereby providing high-quality clinical evidence.Design,setting,participants and interventions A total of 276 patients with AECOPD were included in this multi-centre,randomised,double-blind,placebo-controlled trial and were randomised into treatment and control groups at a ratio of 1:1.Patients in the treatment and control groups took Qingfei Huatan granules or simulated Qingfei Huatan granules twice a day,for 14 days,in addition to Western medicine treatment.All patients were followed up for 3 months.Main outcome measures The primary outcome was time taken to symptom stabilisation.The secondary outcomes included duration of antibiotic use,clinical symptom and sign score,TCM syndrome score,dyspnoea score,and quality of life(QOL)score.Meanwhile,the safety of the formula was assessed through routine urine and stool tests,electrocardiograms,liver and kidney function tests,and the observation of adverse events throughout the trial.Results The time taken for effective stabilisation(P<0.05)and obvious stabilisation(P<0.01),and the duration of antibiotic use(P<0.05)were significantly shorter in the treatment group than in the control group.On days 6,9,12 and 14 of treatment,clinical symptom and sign score decreased in both groups,particularly in the treatment group(P<0.01).On days 9,12 and 14 of treatment,the TCM syndrome scores of both groups were reduced(P<0.01),with more significant reductions in the treatment group.At 3 months after the end of treatment,the treatment group continued to have lower clinical symptom and sign score and TCM syndrome score than the control group(P<0.01).On days 6,9,12 and 14 of treatment,dyspnoea and QOL scores were markedly reduced in the two groups(P<0.05 and P<0.01,respectively),especially in the treatment group.At 3 months after the end of treatment,dyspnoea and QOL scores were lower in the treatment group than those in the control group(P<0.01).No serious adverse events were observed in either group.Conclusion The Qingfei Huatan formula can effectively shorten the duration of AECOPD and antibiotic use,significantly relieve clinical symptoms,and increase QOL for AECOPD patients,with a favourable safety profile.These results suggest that this formula can be used as a complementary treatment for AECOPD patients. 展开更多
关键词 Acute exacerbation of chronic obstructive pulmonary disease Clinical trial syndrome of phlegm-heat congesting lung Qingfei Huatan formula Traditional Chinese medicine
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Effects of TCM Nursing Based on Syndrome Differentiation on Pulmonary Function and Quality of Life in Patients with Acute Exacerbation of COPD
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作者 Xiaolan FANG Ran MO +1 位作者 Yuanhui JIANG Yaonan DU 《Medicinal Plant》 CAS 2023年第4期77-79,共3页
[Objectives] To investigate the effects of TCM nursing based on syndrome differentiation on pulmonary function and quality of life in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).... [Objectives] To investigate the effects of TCM nursing based on syndrome differentiation on pulmonary function and quality of life in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). [Methods] A total of 92 patients with AECOPD who came to Nanchong Chinese Medicine Hospital from March 2022 to February 2023 were selected for the study, and the intervention group (TCM nursing based on syndrome differentiation, 46 cases) and the conventional group (basic nursing, 46 cases) were selected for the study, and the pulmonary function and quality of life of the two groups were compared. [Results] Before nursing, there was no significant difference in levels of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and percentage of forced expiratory volume in one second to forced vital capacity (FEV1/FVC) between the intervention group and conventional group ( P >0.05). After 3 months of nursing, the levels of FVC, FEV1 and FEV1/FVC in the intervention group were higher than those in the conventional group ( P <0.05). Before nursing, there was no significant difference in the scores of health, emotion and social functions between the two groups ( P >0.05). At three months of nursing, the scores of health, emotion, and social functions in the intervention group were higher than those in the conventional group ( P <0.05). [Conclusions] The implementation of TCM nursing based on syndrome differentiation in patients with AECOPD can effectively improve the pulmonary function and quality of life of patients, and has significant clinical implementation value. 展开更多
关键词 chronic obstructive pulmonary disease(COPD) TCM nursing based on syndrome differentiation pulmonary function Quality of life
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Endothelial function and T-lymphocyte subsets in patients with overlap syndrome of chronic obstructive pulmonary disease and obstructive sleep apnea 被引量:19
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作者 Juan Wang Xin Li +2 位作者 Wan-Ju Hou Li-Xia Dong Jie Cao 《Chinese Medical Journal》 SCIE CAS CSCD 2019年第14期1654-1659,共6页
Background:The coexistence of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) is termed overlap syndrome (OS).COPD and OSA both have increased risks of developing cardiovascular diseases... Background:The coexistence of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) is termed overlap syndrome (OS).COPD and OSA both have increased risks of developing cardiovascular diseases.This study aimed to explore if patients with OS exhibited a higher prevalence of cardiovascular complications,and if patients with OS exhibited vascular endothelial dysfunction and abnormalities in the cellular immune function of T lymphocytes.Methods:Totally 25 patients with stable COPD (COPD group),25 patients with OSA (OSA group),25 patients with OS (OS group),and 20 healthy adults (control group) were enrolled between January 2017 and December 2017 from the Respiratory Department of Tianjin Medical University General Hospital.The clinical characteristics of the four groups were collected and the expression levels of soluble vascular cell adhesion molecule-1 (sVCAM-1),tumor necrosis factor-α(TNF-α),and T-lymphocyte subsets were detected.One-way analysis of variance,x^2 test and Pearson correlation were used to manage the data.Results:The prevalence of hypertension and coronary heart disease was significantly higher in the OS group than in the control,OSA,and COPD groups (x^2 =20.69,P < 0.05 and x^2 =11.03,P < 0.05,respectively).The levels of sVCAM-1 and TNF-α were significantly higher in the OS group than in other groups (F =127.40,P < 0.05 and F =846.77,P < 0.05,respectively).The percentage of CD4+ lymphocytes and CD4+/CD8+ were both significantly lower in the OS group than in any other group (F =25.40,P < 0.05 and F =75.08,P < 0.05,respectively).There were significantly negative correlations in the levels of sVCAM-1 and TNF-α with CD4^+/CD8^+ lymphocytes (r =-0.77,P < 0.05 and r =-0.83,P < 0.05,respectively).Conclusions:The prevalence of hypertension and coronary heart disease was higher in patients with OS than in patients with either OSA or COPD alone.Patients with OS exhibited more severe vascular endothelial injury,stronger inflammatory response,and lower cellular immune function. 展开更多
关键词 chronic obstructive pulmonary disease obstructive sleep APNEA overlap syndrome ENDOTHELIUM T-LYMPHOCYTE SUBSETS
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Clinical Observation of Qi Deficiency Syndrome in72 Patients with Chronic Obstructive Pulmonary DiseaseTreated with Yiqi Mianyi Granule (益气免疫冲剂)
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作者 徐小玉 刘全让 +2 位作者 陈静 王鸿程 马跃荣 《Chinese Journal of Integrative Medicine》 SCIE CAS 1996年第3期170-173,共4页
Seventy-two patients of chronic obstructive pulmonary disease (COPD) of Qi deficiency syn-drome with abnormal immune indices were treated with Yiqi Mianyi Granule (YQMYG) and the efficacy wascompared with that of 30 c... Seventy-two patients of chronic obstructive pulmonary disease (COPD) of Qi deficiency syn-drome with abnormal immune indices were treated with Yiqi Mianyi Granule (YQMYG) and the efficacy wascompared with that of 30 cases treated with Zhenqi fuzheng Granule (ZQFZG) for control. Results showedthat the markedly effective rate of symptomatic improvement ot Qi deficiency in YQMYG group was 65. 3%,the total effective rate 93. 1 % . 88. 6% of the immune indices lower than normal were corrected and 43. 7%ot them were normalized, while for indices that were higher than normal the rate were 78. 2 % and 52 . 9% re-spectively. These results suggested that YQMYG could improve symptom of Qi Deficiency markedly,strengthen cellutar immunity and regulate immune dysfunction. its therapeutic efficacy was obvfously superiorto ZQFZG ( P < 0 . 05 ). 展开更多
关键词 Yiqi Mianyi Granule Qi Deficiency syndrome chronic obstructive pulmonary disease bidirectional regulation
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Expression of airway mucus-associated proteins in rats with chronic obstructive pulmonary disease with a cold-dryness symptom pattern 被引量:1
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作者 Gao Zhen Halmurat Upur +4 位作者 Wang Jing Jing Jing Li Zheng Xu Dan Li Fengsen 《Journal of Traditional Chinese Medicine》 SCIE CAS CSCD 2016年第5期671-677,共7页
OBJECTIVE: To reveal the effects on expression of airway mucus-associated proteins in rats with chronic obstructive pulmonary disease(COPD) and a cold-dryness symptom pattern induced by elastase and smoking.METHODS: T... OBJECTIVE: To reveal the effects on expression of airway mucus-associated proteins in rats with chronic obstructive pulmonary disease(COPD) and a cold-dryness symptom pattern induced by elastase and smoking.METHODS: The COPD model was established with an elastase dose into the trachea combined with exposure to smoking; the COPD model cold-dryness symptom pattern was further developed by exposure to a cold, dry environment. After 90 days,pathologic lung sections, inflammatory cytokine levels(measured by enzyme linked immunosorbent assay), m RNA and protein expression of mucus-associated proteins and aquaporins(measured by real-time polymerase chain reaction and western blots) were examined.RESULTS: Cytokines interleukin-6(IL-6), interleukin-8(IL-8), and tumor necrosis factor-α(TNF-α) in the COPD and the cold-dryness symptom pattern COPD groups were all significantly higher than in controls(each P < 0.01). IL-6 and IL-8 levels were higher in the cold-dryness symptom pattern COPD group than in the COPD group(each P < 0.05). The AQP5 m RNA expression in the cold-dryness symptom pattern COPD and COPD groups was lower than in the control group(P < 0.01), and that in the cold-dryness symptom pattern COPD group was lower than the COPD group(P < 0.05). The expression of MUC5 AC and MUC5 B m RNAs in the cold-dryness symptom pattern COPD group and COPD group was higher than in the control group(each P < 0.01), and that in the cold-dryness symptom pattern COPD group was higher than the COPD group(P < 0.01, and P < 0.05, respectively).The ratio of MUC5 AC m RNA/MUC5 B m RNA was COPD group < the cold-dryness symptom pattern COPD group < the control group. AQP4 and AQP5 protein expression in the cold-dryness symptom pattern COPD group was lower than that in the COPD group which was lower again than in the control group. MUC5 AC and MUC5 B expression in the cold-dryness symptom pattern COPD group was higher than in the COPD group and higher again than in the control group.CONCLUSION: Cold-dryness affects the expression of mucus-associated protein m RNA and its corresponding proteins, reducing the secretion of aquaporins and increasing the secretion of mucins. Imbalance in aquaporins and mucins can affect the function of mucus, increasing airway obstruction. 展开更多
关键词 pulmonary disease chronic obstructive Cold-dryness syndrome AQUAPORINS MUCINS
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自拟清肺定喘贴联合宣白承气汤治疗哮喘-慢性阻塞性肺疾病重叠综合征的效果及对肺功能、炎症因子的影响
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作者 倪嘉纳 罗华 陈旋 《辽宁中医杂志》 CAS 北大核心 2024年第11期112-115,共4页
目的探讨自拟清肺定喘贴联合宣白承气汤治疗哮喘-慢性阻塞性肺疾病重叠综合征(asthma chronic obstructive pulmonary disease overlap syndrome,ACOS)的效果及对肺功能、炎症因子的影响。方法选择2021年10月—2023年3月该院收治的116例... 目的探讨自拟清肺定喘贴联合宣白承气汤治疗哮喘-慢性阻塞性肺疾病重叠综合征(asthma chronic obstructive pulmonary disease overlap syndrome,ACOS)的效果及对肺功能、炎症因子的影响。方法选择2021年10月—2023年3月该院收治的116例ACOS患者纳入研究,通过随机数表法分为观察组、对照组,各58例。对照组使用噻托溴铵、布地奈德福莫特罗治疗,观察组在对照组基础上,联合自拟清肺定喘贴、宣白承气汤治疗,两组均持续治疗8周。比较两组治疗后临床疗效,治疗前后哮喘症状评分(asthma control test,ACT)、慢性阻塞性肺疾病症状评分(chronic obstructive pulmonary disease assessment test,CAT)、第1秒用力呼气量(forced expiratory volume in the first second,FEV1)、FEV1/用力肺活量(FEV1/FVC)、呼气峰值流速(peak expiratory flow rate,PEFR)及血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(C-reactive protein,CRP)水平的变化及不良反应。结果观察组临床疗效总有效率为91.38%(53/58),高于对照组的75.86%(44/58),差异有统计学意义(P<0.05);观察组ACT评分为(20.61±1.95)分,明显高于对照组的(18.30±1.43)分,CAT评分为(15.02±2.31)分,明显低于对照组的(18.41±2.62)分,差异有统计学意义(P<0.05);且观察组FEV1、FEV1/FVC、PEFR分别为(2.20±0.27)L、(61.21±5.28)%、(3.88±0.36)L/s,均高于对照组的(1.93±0.21)L、(57.33±5.26)%、(3.67±0.41)L/s,差异有统计学意义(P<0.05);观察组血清TNF-α、IL-6、CRP分别为(31.70±5.42)ng/L、(22.05±3.29)ng/L、(9.75±1.60)mg/L,均低于对照组的(43.33±6.05)ng/L、(31.17±3.58)ng/L、(12.83±2.11)mg/L,差异有统计学意义(P<0.05);两组不良反应总发生率分别为10.34%(6/58)、8.62%(5/58),差异无统计学意义(P>0.05)。结论自拟清肺定喘贴联合宣白承气汤治疗ACOS患者疗效明显,能有效改善肺功能、降低炎症因子的表达,值得临床推广。 展开更多
关键词 哮喘-慢性阻塞性肺疾病重叠综合征 中医 肺功能 炎症因子 不良反应
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基于NHANES数据库低氧重叠综合征与心血管病的关联性研究
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作者 胡佳 朱晓庆 +5 位作者 陈韬 王泓森 余蕾蕾 田芳洁 郭军 杨庭树 《中华保健医学杂志》 2024年第1期53-56,共4页
目的探讨阻塞性睡眠呼吸暂停综合征(Obstructive sleep apnea,OSA)、慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)及重叠综合征(overlap syndrome,OS)与心血管疾病的相关性。方法选取2005年~2008年美国国家健康和营... 目的探讨阻塞性睡眠呼吸暂停综合征(Obstructive sleep apnea,OSA)、慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)及重叠综合征(overlap syndrome,OS)与心血管疾病的相关性。方法选取2005年~2008年美国国家健康和营养调查(National health and nutrition examination survey,NHANES)数据,共7716名参与者纳入本研究。按照是否存在OSA、COPD分为4组:无OSA及COPD组(n=3072)、单纯OSA组(n=4062)、单纯COPD组(n=180)、OS组(n=402)。本研究采用多因素logistic回归以探究OSA、COPD及OS与多种心血管疾病的关联。同时探究OSA、COPD和OS与年龄、性别、肥胖等心血管危险因素在心血管疾病中的关联性。结果相较于无OSA及COPD组,OS组心肌梗死(OR=2.85,95%CI=1.94~4.21)、充血性心力衰竭(OR=4.32,95%CI=2.73~6.84)、心绞痛(OR=3.07,95%CI=1.92~4.91)、卒中(OR=2.52,95%CI=1.61~3.97)、冠心病(OR=3.1,95%CI=2.22~4.31)及总体心血管疾病(OR=3.43,95%CI=2.54~4.63)的风险增加显著相关。单纯OSA症状人群中卒中发生率为无OSA及COPD组的1.46倍(OR=1.46,95%CI=1.07~1.99),充血性心力衰竭(OR=3.27,95%CI=1.77~6.07)、冠心病(OR=1.68,95%CI=1.03~2.73)和总体心血管疾病(OR=1.93,95%CI=1.25~3.00)的风险也显著升高。未观察到单纯OSA症状与心血管疾病的风险增加的相关性。OSA、COPD及重叠综合征与总体心血管疾病、冠心病和心肌梗死的关联在各亚组人群中稳定。结论OSA-COPD综合征与心肌梗死、充血性心力衰竭、心绞痛、卒中、冠心病及总体心血管疾病的发生风险增高存在显著相关性。监测及控制OSA-COPD重叠综合征对心血管疾病的预防有着重要意义。 展开更多
关键词 阻塞性睡眠呼吸暂停综合征 慢性阻塞性肺病 重叠综合征 心血管疾病
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糠酸氟替卡松/乌美溴铵/维兰特罗三联疗法与传统ICS/LAMA疗法对ACO患者的临床疗效差异分析
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作者 张勇 党垚 +1 位作者 陈萍 刘元明 《广东医学》 CAS 2024年第6期751-756,共6页
目的探讨糠酸氟替卡松/乌美溴铵/维兰特罗(FF/UMEC/VI)三联疗法对哮喘-慢性阻塞性肺疾病重叠综合征(ACO)患者的临床疗效及与吸入型糖皮质激素(ICS)/长效抗胆碱能拮抗剂(LAMA)联合疗法的差异性。方法纳入2019年6月至2022年6月呼吸与危重... 目的探讨糠酸氟替卡松/乌美溴铵/维兰特罗(FF/UMEC/VI)三联疗法对哮喘-慢性阻塞性肺疾病重叠综合征(ACO)患者的临床疗效及与吸入型糖皮质激素(ICS)/长效抗胆碱能拮抗剂(LAMA)联合疗法的差异性。方法纳入2019年6月至2022年6月呼吸与危重症医学科收治的90例ACO患者,随机分为研究组与对照组,各45例。对照组患者予以ICS/LAMA治疗,研究组患者予以FF/UMEC/VI三联疗法治疗,治疗12周后比较两组患者用药前后肺功能指标变化、症状改善情况及疗效评价。结果治疗前研究组与对照组患者基础临床资料及各项肺功能指标差异无统计学意义(P>0.05)。治疗12周后研究组患者各项肺功能指标及血气分析指标较治疗前均显著改善(P<0.05)。不同方案治疗12周后,研究组患者各项肺功能改善程度均高于对照组患者(P<0.05)。治疗12周后研究组患者症状改善指标及治疗有效率均高于对照组患者(P<0.05)。结论FF/UMEC/VI三联疗法对于ACO患者具有显著治疗效果,能够改善患者肺功能,缓解患者临床症状,具有较为广阔的应用前景。 展开更多
关键词 哮喘-慢性阻塞性肺疾病重叠综合征 糠酸氟替卡松 乌美溴铵 维兰特罗
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黏蛋白1与呼吸系统疾病关系的研究进展
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作者 吴静 程梓荷 +5 位作者 王蒙蒙 孙亚楠 王巧云 李田田 姚杨 王胜昱 《医学综述》 CAS 2024年第3期279-283,共5页
慢性黏液高分泌导致的气道炎症可能会逐渐进展并影响患者的肺功能。黏液蛋白是黏液层的关键成分,其中黏蛋白1是一种重要的膜结合型黏蛋白,目前的研究聚焦于评估黏蛋白1在肺纤维化、肺癌和间质性肺疾病等肺部疾病中的临床应用,尤其是作... 慢性黏液高分泌导致的气道炎症可能会逐渐进展并影响患者的肺功能。黏液蛋白是黏液层的关键成分,其中黏蛋白1是一种重要的膜结合型黏蛋白,目前的研究聚焦于评估黏蛋白1在肺纤维化、肺癌和间质性肺疾病等肺部疾病中的临床应用,尤其是作为诊断、预测进展和评估治疗效果的生物标志物。因此,深入了解黏蛋白1在肺部疾病中的生物学机制和作用方式,特别是与疾病发展和进展的关联,探索黏蛋白1在肺部疾病早期诊断和预后评估中的预测价值,将为肺部疾病的诊断和治疗提供新的理论依据。 展开更多
关键词 急性呼吸窘迫综合征 间质性肺疾病 慢性阻塞性肺疾病 肺癌 黏蛋白1
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基于态靶辨治理论诊疗慢性阻塞性肺疾病
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作者 王敏 朱蔚 +3 位作者 王文洁 林轶群 田传玺 王蕾 《长春中医药大学学报》 2024年第5期495-498,共4页
慢性阻塞性肺疾病是常见的呼吸系统气道慢性病,严重影响患者的生活质量。传统的中医辨证论治体系存在对疾病的发生发展规律认识不足,对检查化验指标改善欠佳的问题。仝小林院士经过多年的临床实践,提出“态靶辨治”的现代中医诊疗体系,... 慢性阻塞性肺疾病是常见的呼吸系统气道慢性病,严重影响患者的生活质量。传统的中医辨证论治体系存在对疾病的发生发展规律认识不足,对检查化验指标改善欠佳的问题。仝小林院士经过多年的临床实践,提出“态靶辨治”的现代中医诊疗体系,并将其用于慢性疾病临床诊疗过程中。基于此,以“态靶辨治”理论为指导,结合临床经验与现代药理学研究成果,将慢性阻塞性肺疾病发病过程分为“痰、阻、瘀、衰”四态(四期),每态下进行分证,并结合治疗靶点,确定各阶段相应的靶方靶药,构建慢性阻塞性肺疾病的态靶辨治体系,为提高该病的中医治疗效果提供新的路径。 展开更多
关键词 慢性阻塞性肺疾病 态靶辨治 分期识态 靶方靶药
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慢性阻塞性肺疾病急性加重期中医证型结构方程分析
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作者 丁敏 王冰 贾春红 《世界中西医结合杂志》 2024年第3期610-613,共4页
目的为慢性阻塞性肺疾病急性加重期(Acute Exacerbation of Chronic Obstructive Pulmonary Disease,AECOPD)临床辨证诊断和证型的量化标准提供参考依据。方法通过临床调研,应用先进的数理统计方法结构方程对AECOPD中医证候进行系统的... 目的为慢性阻塞性肺疾病急性加重期(Acute Exacerbation of Chronic Obstructive Pulmonary Disease,AECOPD)临床辨证诊断和证型的量化标准提供参考依据。方法通过临床调研,应用先进的数理统计方法结构方程对AECOPD中医证候进行系统的研究。收集病例资料100例,数据分析软件选择R语言,首先经过探索性分析,利用最大方差旋转方法,提取出五个共因子,归纳为F1至F5,依据中医理论进行证型辨证命名。结果通过结构方程初步揭示了AECOPD的疾病的五个常见的证型:风寒证、肾虚证、脾虚证、阴虚证、痰湿证,同时分析出了五大常见证型的辨证要点。AECOPD结构方程中各因子与临床证型间存在着较好的对应关系。结论AECOPD的基础证型是风寒、肾虚、脾虚、阴虚、痰湿证等。 展开更多
关键词 慢性阻塞性肺疾病急性加重期 中医证候结构方程 数理统计
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吴鞠通温病思辨体系治疗慢性阻塞性肺病临证探赜
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作者 宗岩 王云龙 +1 位作者 李丹丹 马千里 《光明中医》 2024年第12期2344-2346,共3页
清代著名温病学家吴鞠通在《温病条辨》中所建立的三焦辨证思辨理论,对于治疗慢性阻塞性肺病具有重要的临证指导作用。其创立的宣白承气汤,肺肠合病,脏腑同治,为后世医者治疗肺系病证提供了理论渊薮。笔者基于其思辨理论和宣白承气汤,... 清代著名温病学家吴鞠通在《温病条辨》中所建立的三焦辨证思辨理论,对于治疗慢性阻塞性肺病具有重要的临证指导作用。其创立的宣白承气汤,肺肠合病,脏腑同治,为后世医者治疗肺系病证提供了理论渊薮。笔者基于其思辨理论和宣白承气汤,应用在慢性阻塞性肺病及肺系其他危急重症发作期的治疗中,临床每获显著疗效。 展开更多
关键词 喘证 慢性阻塞性肺病 宣白承气汤 吴鞠通 三焦辨证
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补肾纳气中药对COPD大鼠膈肌细胞形态及相关肌细胞特异性microRNA下游指标的影响
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作者 李大治 阮诗玮 +2 位作者 王春娥 张铃 陈可强 《中国中医药现代远程教育》 2024年第19期164-168,共5页
目的探讨全真一气汤的作用机制及横膈在肾不纳气证形成中的意义。方法将80只SD大鼠按照随机数字表法分为六组,正常组(A组)10只、慢性阻塞性肺疾病(COPD)肾不纳气证组(B组)60只[模型组(B_(1)组)15只、中药实验组(B_(2)组)15只、中药对照... 目的探讨全真一气汤的作用机制及横膈在肾不纳气证形成中的意义。方法将80只SD大鼠按照随机数字表法分为六组,正常组(A组)10只、慢性阻塞性肺疾病(COPD)肾不纳气证组(B组)60只[模型组(B_(1)组)15只、中药实验组(B_(2)组)15只、中药对照组(B_(3)组)15只、西药对照组(B_(4)组)15只]及COPD非肾不纳气证组(C组)10只,A组、B_(1)组大鼠给予氯化钠,B_(2)组给予全真一气汤,B_(3)组给予六君子汤,B_(4)组给予氨茶碱片,共60 d。HE染色观察A组、B_(1)组及C组的肺、膈肌病理形态,实时荧光定量聚合酶链式反应(qPCR)检测各组microRNA-1(以下简写为“miR-1”)、组蛋白去乙酰化酶4(HDAC4)及过氧化物酶体增殖物激活受体γ辅助因子1α(PGC-1α)表达,Western blot(WB)法检测以上指标的蛋白含量。结果B_(1)组膈肌纤维细胞排列紊乱、变形、间隙增宽,且重于C组。qPCR结果显示,其他各组miR-1表达皆低于A组(P<0.05),且B_(2)组、B_(4)组低于B_(1)组(P<0.05),B_(2)组低于B_(3)组(P<0.05);B_(2)组、B_(3)组和B_(4)组HDAC4表达高于B_(1)组,且B_(2)组HDAC4、PGC-1α表达皆高于B_(3)组(P<0.01),B_(1)组与C组HDAC4、PGC-1α表达差异均有统计学意义。WB结果显示,B_(2)组HDAC4蛋白表达高于B_(1)组和B_(3)组,PGC-1α蛋白表达高于B_(1)组、C组及B_(3)组、B_(4)组,C组PGC-1α蛋白表达高于B_(1)组。结论膈肌参与肾不纳气证的形成,全真一气汤可通过下调miR-1,影响HDAC4、PGC-1α的蛋白表达,改善COPD膈肌损伤。 展开更多
关键词 慢性阻塞性肺疾病 肾不纳气证 细胞形态 肌细胞特异性miRNAs 实验研究
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哮喘-慢阻肺重叠综合征患者血清SIRT1、α-SMA水平及临床意义研究
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作者 李欣 荣英杰 吕睿冰 《临床肺科杂志》 2024年第1期48-53,共6页
目的检测哮喘-慢阻肺重叠综合征(ACOS)患者血清沉默信息调节因子1(SIRT1)、α-平滑肌肌动蛋白(α-SMA)水平,并分析其临床意义。方法对52例ACOS患者(A组)、50例单纯哮喘患者(B组)、51例单纯慢阻肺患者(C组)、50例健康体检者(健康组)的资... 目的检测哮喘-慢阻肺重叠综合征(ACOS)患者血清沉默信息调节因子1(SIRT1)、α-平滑肌肌动蛋白(α-SMA)水平,并分析其临床意义。方法对52例ACOS患者(A组)、50例单纯哮喘患者(B组)、51例单纯慢阻肺患者(C组)、50例健康体检者(健康组)的资料进行回顾性分析。4组均检测血清SIRT1、α-SMA水平,肺功能[第1s用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC],血清炎症因子水平[肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、白介素-1β(IL-1β)],气道可逆性和气道重塑指标[血清碱性成纤维生长因子(b-FGF)、基质金属蛋白酶9(MMP-9)、神经生长因子(NGF)、基质金属蛋白酶组织抑制因子1(TIMP-1)],对比4组上述指标差异;分析A组患者血清SIRT1、α-SMA水平与上述指标的相关性。结果A组血清SIRT1、α-SMA,血清TNF-α、IL-6、IL-1β水平,血清b-FGF、MMP-9、NGF、TIMP-1水平均高于其余3组,B组和C组均高于健康组,差异均有统计学意义(P均<0.05);A组FEV1%、FVC、FEV1/FVC均低于其余3组,B组和C组均低于健康组,差异均有统计学意义(P<0.05);A组与B组支气管舒张试验阳性率均高于其余2组,C组高于健康组,差异均有统计学意义(P<0.05);A组患者中血清SIRT1、α-SMA水平与FEV1%、FVC、FEV1/FVC均呈负相关性,与血清TNF-α、IL-6、IL-1β水平,血清b-FGF、MMP-9、NGF、TIMP-1水平均呈正相关性。结论在ACOS患者中血清SIRT1、α-SMA水平偏高,且均明显高于单纯哮喘和单纯慢阻肺患者,且与肺功能、血清炎症因子水平及气道重塑指标均相关。 展开更多
关键词 哮喘-慢阻肺重叠综合征 沉默信息调节因子1 Α-平滑肌肌动蛋白
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穴位贴敷联合中药雾化吸入护理在老年慢性阻塞性肺疾病急性加重期患者中的应用效果
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作者 李超 丁霖 +2 位作者 孙星 安红雨 叶春花 《四川中医》 2024年第1期209-213,共5页
目的:探讨穴位贴敷联合中药雾化吸入护理在老年慢性阻塞性肺疾病急性加重期患者中的应用效果。方法:选取2021年6月~2023年6月北京朝阳医院收治的老年慢性阻塞性肺疾病急性加重期患者100例为研究对象,根据随机数表法分为研究组和对照组,... 目的:探讨穴位贴敷联合中药雾化吸入护理在老年慢性阻塞性肺疾病急性加重期患者中的应用效果。方法:选取2021年6月~2023年6月北京朝阳医院收治的老年慢性阻塞性肺疾病急性加重期患者100例为研究对象,根据随机数表法分为研究组和对照组,各50例。研究采用穴位贴敷联合中药雾化吸入护理,对照组采用常规护理,比较两组中医症候积分、肺功能指标、炎症反应、免疫功能及生存质量。结果:研究组干预后咳嗽、喘息气短、咳痰、肺湿啰音中医症候积分低于对照组(P<0.05);研究组治疗有效率高于对照组(P<0.05);研究组干预后呼气峰值体积流量(PEF)、用力呼气容积/用力肺活量(FEV1/FVC)、用力呼气容积占预计值百分比(FEV1%pred)、用力肺活量占预计值百分比(FVC%pre)高于对照组(P<0.05);研究组干预后基质金属蛋白酶-9(MMP-9)、白介素-4(IL-4)、肿瘤坏死因子-α(TNF-α)低于对照组,CD4+/CD8+高于对照组(P<0.05)。结论:穴位贴敷联合中药雾化吸入护理可以改善患者临床症状,降低炎症反应,提高患者免疫功能及肺功能,提高临床治疗效果。 展开更多
关键词 穴位贴敷 中药雾化吸入 慢性阻塞性肺疾病急性加重期 中医证候积分
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姜桂二陈汤治疗慢性阻塞性肺疾病稳定期(寒痰阻肺型)的临床研究
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作者 陈伟涛 苏连华 +2 位作者 曾燕鹏 王惠欣 张娟娟 《辽宁中医药大学学报》 CAS 2024年第7期213-216,共4页
目的 探讨姜桂二陈汤对慢性阻塞性肺疾病稳定期(寒痰阻肺型)患者的临床疗效。方法 选取2020年1月—2022年12月北京中医药大学房山医院肺病科诊治的慢性阻塞性肺疾病稳定期(寒痰阻肺型)患者100例,随机分为观察组和对照组。对照组患者给... 目的 探讨姜桂二陈汤对慢性阻塞性肺疾病稳定期(寒痰阻肺型)患者的临床疗效。方法 选取2020年1月—2022年12月北京中医药大学房山医院肺病科诊治的慢性阻塞性肺疾病稳定期(寒痰阻肺型)患者100例,随机分为观察组和对照组。对照组患者给予以规范西医治疗,观察组在规范西医治疗同时加用姜桂二陈汤,比较两组患者临床疗效、中医症状评分、肺功能及BODE指数。结果 两组患者疗效相比观察组较优(P<0.05);治疗后,两组患者中医症状评分均明显降低,两组相比观察组较低(P<0.05);治疗后,两组患者6 min步行距离(6MWTD)较治疗前升高,且观察组高于对照组;治疗后,两组患者肺功能水平明显提高,两组相比观察组较高;BODE指数较治疗前降低,且观察组低于对照组(P<0.05)。结论 姜桂二陈汤治疗慢性阻塞性肺疾病(寒痰阻肺型),可提高患者临床疗效,缓解患者临床症状,可改善患者肺功能及肺气肿程度,增强患者运动耐量,从而改善患者预后。 展开更多
关键词 慢性阻塞性肺疾病 寒痰阻肺型 姜桂二陈汤 中医证候积分
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补肺息喘方结合常规西药治疗COPD稳定期(肺脾气虚证)患者的效果
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作者 王红燕 陈高瑛 齐红松 《河南医学研究》 CAS 2024年第20期3776-3780,共5页
目的探讨补肺息喘方结合常规西药治疗慢性阻塞性肺疾病(COPD)稳定期(肺脾气虚证)患者的效果及对肺功能和免疫功能的影响。方法本研究纳入2021年8月至2023年1月在河南大学第一附属医院就诊的100例COPD稳定期(肺脾气虚证)患者,以随机数字... 目的探讨补肺息喘方结合常规西药治疗慢性阻塞性肺疾病(COPD)稳定期(肺脾气虚证)患者的效果及对肺功能和免疫功能的影响。方法本研究纳入2021年8月至2023年1月在河南大学第一附属医院就诊的100例COPD稳定期(肺脾气虚证)患者,以随机数字表法分成观察组和对照组。对照组接受乌美溴铵维兰特罗吸入粉雾剂治疗,观察组在此基础上联合补肺息喘方治疗,均治疗2个月。观察两组临床疗效、中医肺脾气虚证证候积分、COPD患者自我评估测试量表(CAT)评分、6 min步行测试(6MWT)、改良英国医学研究学会呼吸困难指数量表(mMRC)评分、肺功能指标[第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、FEV_(1)/FVC]、免疫功能指标[CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)]水平和不良反应。结果治疗2个月后,观察组总有效率、6MWT、FEV_(1)、FVC、FEV_(1)/FVC、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于对照组(P<0.05),肺脾气虚证证候积分、CAT评分、mMRC评分、CD8^(+)低于对照组(P<0.05),两组均未发生与治疗药物相关的不良反应事件。结论补肺息喘方结合常规西药治疗COPD稳定期(肺脾气虚证)的效果显著,能够有效缓解临床症状,减轻呼吸困难程度,提高活动耐力,改善机体免疫功能,安全有效。 展开更多
关键词 慢性阻塞性肺疾病 稳定期 肺脾气虚证 补肺息喘方
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