This paper mainly analyzes the application status of TCM rehabilitation in chronic obstructive pulmonary disease(COPD),hoping to provide support and help for clinical staff through this study,and promote the further d...This paper mainly analyzes the application status of TCM rehabilitation in chronic obstructive pulmonary disease(COPD),hoping to provide support and help for clinical staff through this study,and promote the further development of COPD rehabilitation program.展开更多
Objective： This review aimed to examine the effectiveness of clinical nurse specialist （CNS） interventions in patients with chronic obstructive pulmonary disease （COPD）. COPD significantly affects p...Objective： This review aimed to examine the effectiveness of clinical nurse specialist （CNS） interventions in patients with chronic obstructive pulmonary disease （COPD）. COPD significantly affects people＇s health worldwide. With the development in nursing, CNSs are playing increasingly important roles in different departments. However, the studies on the effectiveness of CNSs in COPD are not as well organized as the studies on the effectiveness of CNSs in bronchiectasis and asthma. Therefore, this review aims to find some updated evidence on the CNS interventions for patients with COPD and on whether these interventions are effective.Methods： A narrative analysis of the data was performed for the eligible studies. Four databases were chosen： CINAHL, MEDLINE, British Nursing Index, and Cochrane Library. Other websites such as the National Institute for Health and Clinical Excellence, National Health Service Evidence, Association of Respiratory Nurse Specialists, and National Association of Clinical Nurse Specialist were searched as well. Two reviewers performed study identification independently, and all the retrieved articles were stored using the EndNote X7 software. The risk of bias in the included studies was assessed using the Cochrane Collaboration＇s risk of bias tool. Results： A total of nine studies were included in this review. There were five current interventions by CNSs for patients with COPD. These interventions were home nursing support, CNS]s supported discharge, multidisciplinary cooperation programs, nurse-led care programs, and self-care management education. The effectiveness of these five interventions was evaluated individually. There is low- to moderate-quality evidence indicating that home nursing support interventions may have a positive effect on mortality and quality of life. No significant difference in quality of life has been found between the CNS-supported discharge intervention and the usual service. The multidisciplinary cooperation program probably had a positive effect on quality ot life in patients with COPD. Both nurse-led care and self-care management education intervention had a positive effect on mortality of patients with COPD.Conclusions： The findings of this review provide updated evidence on the effectiveness of CNS interventions for patients with COPD. Although nine trials were included and five types of interventions were identified, there is still lack of high-quality evidence.展开更多
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
目的:系统评价慢性阻塞性肺疾病(COPD)病人睡眠障碍的影响因素,为早期识别和干预病人睡眠剥夺、提高病人应对能力提供依据。方法:检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、EMbase、Web of Science、the ...目的:系统评价慢性阻塞性肺疾病(COPD)病人睡眠障碍的影响因素,为早期识别和干预病人睡眠剥夺、提高病人应对能力提供依据。方法:检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、EMbase、Web of Science、the Cochrane Library数据库中关于COPD病人睡眠障碍影响因素的相关文献,检索时限为建库至2023年5月4日。结果:共纳入13篇文献,睡眠障碍发生率为52%,其中呼吸困难指数(mMRC)≥2分[OR=2.01,95%CI(1.14,3.53),P<0.05]、COPD病人自我评估测试(CAT)≥10分[OR=1.24,95%CI(1.01,1.53),P<0.05]、肺功能评估(GOLD)分级Ⅲ~Ⅳ级[OR=2.76,95%CI(1.64,4.65),P<0.05]、合并阻塞性睡眠呼吸暂停后通气综合征(OSA)[OR=2.12,95%CI(1.64,2.74),P<0.05]、疲乏[OR=4.56,95%CI(2.47,8.43),P<0.05]、焦虑[OR=1.13,95%CI(1.07,1.18),P<0.05]、抑郁[OR=1.25,95%CI(1.09,1.45),P<0.05]、长期卧床[OR=2.18,95%CI(1.43,3.32),P<0.05]是COPD病人睡眠障碍的主要影响因素。结论:现有证据表明,COPD病人睡眠障碍发生率较高,mMRC≥2分、CAT≥10分、GOLD分级Ⅲ~Ⅳ级、合并OSA、疲乏、焦虑、抑郁、长期卧床是COPD病人睡眠障碍的主要影响因素。展开更多
目的:采用Meta分析方法评估我国慢性阻塞性肺疾病(COPD)病人认知障碍的患病率。方法:从中国知网数据库、万方数据库、维普数据库、PubMed、Web of Science数据库中检索相关文章,根据纳入排除标准筛选文章,由2名研究者进行严格的文献质...目的:采用Meta分析方法评估我国慢性阻塞性肺疾病(COPD)病人认知障碍的患病率。方法:从中国知网数据库、万方数据库、维普数据库、PubMed、Web of Science数据库中检索相关文章,根据纳入排除标准筛选文章,由2名研究者进行严格的文献质量评价,应用Stata 16.0软件进行Meta分析,并根据不同的年龄、性别、文化程度、吸烟史进行亚组分析。结果:共纳入15篇文献,包括2805例COPD病人,其中1415例病人合并认知障碍。Meta分析结果显示:中国COPD病人认知障碍的总患病率为53.0%[95%CI(43.05%,64.0%)]。亚组分析结果:60岁以下COPD病人认知障碍的患病率为40.0%[95%CI(21.0%,58.0%)],60岁及以上COPD病人认知障碍的患病率为59.0%[95%CI(42.0%,76.0%)];男性COPD病人认知障碍的患病率为52.0%[95%CI(38.0%,66.0%)],女性COPD病人认知障碍的患病率为55.0%[95%CI(37.0%,74.0%)];小学及以下学历的COPD病人认知障碍的患病率为66.0%[95%CI(43.0%,88.0%)],初中学历的COPD病人认知障碍的患病率为76.0%[95%CI(64.0%,89.0%)],高中/中专学历的COPD病人认知障碍的患病率为54.0%[95%CI(30.0%,77.0%)],本科/专科学历的COPD病人认知障碍的患病率为35.0%[95%CI(20.0%,50.0%)];无吸烟史的COPD病人认知障碍的患病率为37.0%[95%CI(18.0%,57.0%)],已戒烟的COPD病人认知障碍的患病率为56.0%[95%CI(33.0%,80.0%)],仍未戒烟的COPD病人认知障碍的患病率为64.0%[95%CI(40.0%,87.0%)]。结论:我国COPD病人认知障碍的患病率较高,应早期识别危险因素,积极预防及干预。展开更多
目的:观察金龙蛤蚧平喘加味方对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)稳定期肺肾气虚证合并骨质疏松患者骨密度(bone mineral density,BMD)及骨代谢生化标志物的影响。方法:选取2022年9月至2023年8月安徽中医...目的:观察金龙蛤蚧平喘加味方对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)稳定期肺肾气虚证合并骨质疏松患者骨密度(bone mineral density,BMD)及骨代谢生化标志物的影响。方法:选取2022年9月至2023年8月安徽中医药大学附属滁州中西医结合医院呼吸科门诊及病房收治的COPD稳定期肺肾气虚证合并OP患者58例,根据随机数字表法分为对照组和联合组,每组29例。对照组给予常规西药对症治疗,联合组在对照组治疗的基础上联合金龙蛤蚧平喘加味方治疗。观察两组患者治疗前后肺功能[1秒用力呼气容积(forced expiratory volume in one second,FEV1)用力肺活量(forced vital capacity,FVC)、FEV1/FVC]、COPD评估测试问卷(COPD assessment test,CAT)评分、症状积分、BMD及骨代谢生化标志物[总碱性磷酸酶(alkaline phosphatase,ALP)、骨钙素(osteocalcin,OC)及Ⅰ型胶原C端肽(C-terminal peptide of type 1 collagen,CTX-1)]等指标变化情况。结果:联合组治疗后腰椎BMD高于对照组,差异有统计学意义(P<0.05),股骨颈BMD高于对照组,差异无统计学意义(P>0.05);联合组治疗后ALP、OC、CTX-1水平低于对照组,差异有统计学意义(P<0.05);联合组治疗后腰背疼痛、腰膝酸软、下肢抽筋症状积分均低于对照组,差异有统计学意义(P<0.05);联合组治疗后FEV1高于对照组,CAT评分低于对照组,差异有统计学意义(P<0.05)。结论:金龙蛤蚧平喘加味方能改善COPD稳定期肺肾气虚证合并骨质疏松患者的骨密度、肺功能,降低骨代谢生化标志物ALP、OC、CTX-1水平,减轻患者腰背疼痛、腰膝酸软、下肢抽筋症状。展开更多
基金Supported by Special Research Project of Science and Technology Bureau of Nanchong City,Sichuan Province"Effects of TCM Nursing Based on Syndrome Differentiation on Pulmonary Function and Quality of Life in Patients with Acute Exacerbation of COPD" (22YYJCYJ0057).
文摘This paper mainly analyzes the application status of TCM rehabilitation in chronic obstructive pulmonary disease(COPD),hoping to provide support and help for clinical staff through this study,and promote the further development of COPD rehabilitation program.
文摘Objective： This review aimed to examine the effectiveness of clinical nurse specialist （CNS） interventions in patients with chronic obstructive pulmonary disease （COPD）. COPD significantly affects people＇s health worldwide. With the development in nursing, CNSs are playing increasingly important roles in different departments. However, the studies on the effectiveness of CNSs in COPD are not as well organized as the studies on the effectiveness of CNSs in bronchiectasis and asthma. Therefore, this review aims to find some updated evidence on the CNS interventions for patients with COPD and on whether these interventions are effective.Methods： A narrative analysis of the data was performed for the eligible studies. Four databases were chosen： CINAHL, MEDLINE, British Nursing Index, and Cochrane Library. Other websites such as the National Institute for Health and Clinical Excellence, National Health Service Evidence, Association of Respiratory Nurse Specialists, and National Association of Clinical Nurse Specialist were searched as well. Two reviewers performed study identification independently, and all the retrieved articles were stored using the EndNote X7 software. The risk of bias in the included studies was assessed using the Cochrane Collaboration＇s risk of bias tool. Results： A total of nine studies were included in this review. There were five current interventions by CNSs for patients with COPD. These interventions were home nursing support, CNS]s supported discharge, multidisciplinary cooperation programs, nurse-led care programs, and self-care management education. The effectiveness of these five interventions was evaluated individually. There is low- to moderate-quality evidence indicating that home nursing support interventions may have a positive effect on mortality and quality of life. No significant difference in quality of life has been found between the CNS-supported discharge intervention and the usual service. The multidisciplinary cooperation program probably had a positive effect on quality ot life in patients with COPD. Both nurse-led care and self-care management education intervention had a positive effect on mortality of patients with COPD.Conclusions： The findings of this review provide updated evidence on the effectiveness of CNS interventions for patients with COPD. Although nine trials were included and five types of interventions were identified, there is still lack of high-quality evidence.
基金This work was supported by the National Key Research and Development Project(2017YFC1700105).
文摘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.
文摘目的:系统评价慢性阻塞性肺疾病(COPD)病人睡眠障碍的影响因素,为早期识别和干预病人睡眠剥夺、提高病人应对能力提供依据。方法:检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、EMbase、Web of Science、the Cochrane Library数据库中关于COPD病人睡眠障碍影响因素的相关文献,检索时限为建库至2023年5月4日。结果:共纳入13篇文献,睡眠障碍发生率为52%,其中呼吸困难指数(mMRC)≥2分[OR=2.01,95%CI(1.14,3.53),P<0.05]、COPD病人自我评估测试(CAT)≥10分[OR=1.24,95%CI(1.01,1.53),P<0.05]、肺功能评估(GOLD)分级Ⅲ~Ⅳ级[OR=2.76,95%CI(1.64,4.65),P<0.05]、合并阻塞性睡眠呼吸暂停后通气综合征(OSA)[OR=2.12,95%CI(1.64,2.74),P<0.05]、疲乏[OR=4.56,95%CI(2.47,8.43),P<0.05]、焦虑[OR=1.13,95%CI(1.07,1.18),P<0.05]、抑郁[OR=1.25,95%CI(1.09,1.45),P<0.05]、长期卧床[OR=2.18,95%CI(1.43,3.32),P<0.05]是COPD病人睡眠障碍的主要影响因素。结论:现有证据表明,COPD病人睡眠障碍发生率较高,mMRC≥2分、CAT≥10分、GOLD分级Ⅲ~Ⅳ级、合并OSA、疲乏、焦虑、抑郁、长期卧床是COPD病人睡眠障碍的主要影响因素。
文摘目的:采用Meta分析方法评估我国慢性阻塞性肺疾病(COPD)病人认知障碍的患病率。方法:从中国知网数据库、万方数据库、维普数据库、PubMed、Web of Science数据库中检索相关文章,根据纳入排除标准筛选文章,由2名研究者进行严格的文献质量评价,应用Stata 16.0软件进行Meta分析,并根据不同的年龄、性别、文化程度、吸烟史进行亚组分析。结果:共纳入15篇文献,包括2805例COPD病人,其中1415例病人合并认知障碍。Meta分析结果显示:中国COPD病人认知障碍的总患病率为53.0%[95%CI(43.05%,64.0%)]。亚组分析结果:60岁以下COPD病人认知障碍的患病率为40.0%[95%CI(21.0%,58.0%)],60岁及以上COPD病人认知障碍的患病率为59.0%[95%CI(42.0%,76.0%)];男性COPD病人认知障碍的患病率为52.0%[95%CI(38.0%,66.0%)],女性COPD病人认知障碍的患病率为55.0%[95%CI(37.0%,74.0%)];小学及以下学历的COPD病人认知障碍的患病率为66.0%[95%CI(43.0%,88.0%)],初中学历的COPD病人认知障碍的患病率为76.0%[95%CI(64.0%,89.0%)],高中/中专学历的COPD病人认知障碍的患病率为54.0%[95%CI(30.0%,77.0%)],本科/专科学历的COPD病人认知障碍的患病率为35.0%[95%CI(20.0%,50.0%)];无吸烟史的COPD病人认知障碍的患病率为37.0%[95%CI(18.0%,57.0%)],已戒烟的COPD病人认知障碍的患病率为56.0%[95%CI(33.0%,80.0%)],仍未戒烟的COPD病人认知障碍的患病率为64.0%[95%CI(40.0%,87.0%)]。结论:我国COPD病人认知障碍的患病率较高,应早期识别危险因素,积极预防及干预。
文摘目的:观察金龙蛤蚧平喘加味方对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)稳定期肺肾气虚证合并骨质疏松患者骨密度(bone mineral density,BMD)及骨代谢生化标志物的影响。方法:选取2022年9月至2023年8月安徽中医药大学附属滁州中西医结合医院呼吸科门诊及病房收治的COPD稳定期肺肾气虚证合并OP患者58例,根据随机数字表法分为对照组和联合组,每组29例。对照组给予常规西药对症治疗,联合组在对照组治疗的基础上联合金龙蛤蚧平喘加味方治疗。观察两组患者治疗前后肺功能[1秒用力呼气容积(forced expiratory volume in one second,FEV1)用力肺活量(forced vital capacity,FVC)、FEV1/FVC]、COPD评估测试问卷(COPD assessment test,CAT)评分、症状积分、BMD及骨代谢生化标志物[总碱性磷酸酶(alkaline phosphatase,ALP)、骨钙素(osteocalcin,OC)及Ⅰ型胶原C端肽(C-terminal peptide of type 1 collagen,CTX-1)]等指标变化情况。结果:联合组治疗后腰椎BMD高于对照组,差异有统计学意义(P<0.05),股骨颈BMD高于对照组,差异无统计学意义(P>0.05);联合组治疗后ALP、OC、CTX-1水平低于对照组,差异有统计学意义(P<0.05);联合组治疗后腰背疼痛、腰膝酸软、下肢抽筋症状积分均低于对照组,差异有统计学意义(P<0.05);联合组治疗后FEV1高于对照组,CAT评分低于对照组,差异有统计学意义(P<0.05)。结论:金龙蛤蚧平喘加味方能改善COPD稳定期肺肾气虚证合并骨质疏松患者的骨密度、肺功能,降低骨代谢生化标志物ALP、OC、CTX-1水平,减轻患者腰背疼痛、腰膝酸软、下肢抽筋症状。
