Systematic review and meta-analysis of additional Yupingfeng powder combined with western medicine treatment at stable period of chronic obstructive pulmonary disease

Objective:To systematically evaluate the effect and safety of additional Yupingfeng powder combined with western medicine for the stable period of chronic obstructive pulmonary disease(COPD).Method:Databases including Pubmed、Web of Science、Cochrane Library、CNKI、VIP、CBM and Wanfang Data base,were searched for relevant randomized controlled trials.for Chinese and English literature about randomized controlled trials of additional Yupingfeng in the treatment of COPD on stable stage which were published from the establishment of the database to December 2019.Two researchers independently screened for,selected studies according to the inclusion and exclusion criteria and extracted data.Methodological quality was evaluated using the Cochrane Risk of Bias tool.Meta-analysis was performed using Revman 5.3 software.Results:Ninetine randomized controlled trials including 1511 patients with COPD were meta-analyzed.The total sample size was 1511.The results showed that the treatment grop with additional Yupingfeng powder could improve the clinical efficacy[OR=0.26,95%CI(0.18,0.37)],FEV1 percentage of the estimated value[MD=4.61,95%CI(2.43,6.79)],6MWD[MD=43.90,95%CI(29.48,58.32)]and patient's immunity IgA[MD=0.25,95%CI(0.17,0.34)]and can mitigate cough effectively[MD=-0.34,95%CI(-0.46,-0.23)].Conclusion:Additional Yupingfeng powder combined with routine treatment for COPD has more advantages than conventional treatment alone in improving the clinical efficacy,lung function,immune function and have less adverse events.As most of the included studies in this systematic evaluation had poor quality,the evidence to support conclusion was weak,so it was necessary to conduct more multi-center clinical trials with high quality methods and rigorous design.

Application of "dredging meridians and dispersing lung exercises" based on meridian theory of traditional Chinese medicine in patients with stable chronic obstructive pulmonary disease

Objective:To investigate the effects of Tongjing xuanfei exercise on clinical symptoms,pulmonary function and exercise endurance of patients with Chronic obstructive pulmonary disease at stable stage.Methods:A total of 130 patients with Chronic obstructive pulmonary disease at stable stage from the Department of Pulmonary Diseases,Qingdao Haici Medical Group during September 2018 to September 2020 were collected and randomly divided into a observation group and a control group,with 65 patients in each group.The control group was given routine pulmonary rehabilitation nursing,and the observation group was given Tongjing Xuanfei exercise treatment combined with routine pulmonary rehabilitation nursing,12 months for treatment.The changes of symptoms and pulmonary function index were observed before and after treatment.Results:FEV1,FVC,FEV1%pred,FEV1/FVC,exercise endurance and CAT score,mMRC dyspnea index score and TCM clinical symptom score in the observation group were significantly higher than those in the control group(P<0.05).Conclusion:Tongjing Xuanfei exercise is helpful to improve the clinical symptoms,pulmonary function and exercise endurance of patients with Chronic obstructive pulmonary disease at stable stage.

Advances in clinical research of Chinese and Western medicine pulmonary rehabilitation for chronic obstructive pulmonary disease

Objective:Chronic obstructive pulmonary disease (COPD) is one of the common respiratory diseases characterized by restricted airflow, incomplete reversibility, and expiratory dyspnea. It has become a major public health problem worldwide.Through the research of COPD Chinese and Western medicine pulmonary rehabilitation training by domestic and foreign scholars in the past 5 years, it is found that the emphasis on stable lung rehabilitation can delay the further deterioration of lung function in patients with COPD, effectively improve skeletal muscle fiber and structure, improve exercise capacity, improve breathing difficulties, and hope for pulmonary rehabilitation. It is one of the main methods of treatment for patients with COPD.

The effect of adjuvant N-acetylcysteine effervescent tablets therapy on cardiopulmonary function and airway remodeling in patients with stable COPD

Objective:To study the effect of adjuvant N-acetylcysteine (NAC) effervescent tablets therapy on cardiopulmonary function and airway remodeling in patients with stable chronic obstructive pulmonary disease (COPD).Methods: Patients with stable COPD treated in Zigong Third People's Hospital and West China Hospital, Sichuan University between May 2014 and October 2016 were selected and randomly divided into two groups, NAC group received N-acetylcysteine effervescent tablets combined with routine treatment, and control group received routine treatment. Before treatment as well as 2 weeks and 4 weeks after treatment, oxidative stress indexes and airway remodeling indexes in serum as well as inflammatory response indexes in peripheral blood were determined.Results: MDA, PC, 8-OHdG, MMP2, MMP3 and MMP9 contents in serum as well as NLRP3, ASC, p38MAPK and TREM-1 mRNA expression levels in peripheral blood mononuclear cells of both groups of patients after treatment were significantly lower than those before treatment while TAC levels as well as TIMP1 and TIMP2 contents in serum were significantly higher than those before treatment, and MDA, PC, 8-OHdG, MMP2, MMP3 and MMP9 contents in serum a well as NLRP3, ASC, p38MAPK and TREM-1 mRNA expression levels in peripheral blood mononuclear cells of NAC group after treatment were significantly lower than those of control group while TAC levels as well as TIMP1 and TIMP2 contents in serum were significantly higher than those of control group.Conclusion:Adjuvant NAC effervescent tablets treatment of stable COPD can improve the effect of oxidative stress and inflammatory response on cardiopulmonary function, and inhibit the airway remodeling caused by protease activation.

Effect of warming needle moxibustion on pulmonary function of elderly patients with stable chronic obstructive pulmonary disease

Objective To observe the therapeutic effects of warming needle moxibustion on pulmonary function of elderly patients with stable chronic obstructive pulmonary disease. Method Eighty elderly patients with stable chronic obstructive pulmonary disease were divided randomly into an acupuncture group and a drug group, with forty cases in each group. The patients in the acupuncture group were treated with warming needle moxibustion on specific acupoints. Main acupoints include Zusanli （足三里 ST 36）, Feishu （肺俞 BL 13） and Dingchuan （定喘 EX-B 1）. Matching acupoints include Gaohuang （膏肓 BL 43）, Xinshu （心俞 BL 15）, Dazhui （大椎 GV 14） and Fangmen （风门 BE 12）. The acupoints were punctured with even reinforcing and reducing method. Meanwhile, two moxa stick of warming needle moxibustion were applied separately at the acupoints at back and ST 36. The needles were retained for approximately 0.5 h each time. The treatment was given every other day, 3 times a week and the course of treatment was 8 weeks. Patients in the drug group were treated by seretide inhalation （50 μg salmeterol and 250 μg fluticasone propionate）, twice a day for 8 weeks. The improvement in pulmonary function and the symptom of chills and fever were compared between the two groups. Results After treatment, pulmonary function indices [forced expiratory volume in one second （FEV1）, forced expiratory volume in one second to forced vital capacity （FEVl/FVC）, forced expiratory volume in one second to predicted value ratio （FEV1%） and peak expiratory flow （PEF）] of the patients in both groups were improved significantly compared with that before treatment （P〈0.05）. There was no statistically significant difference between the two groups （all P〉0.05）. Improvement in comprehensive scores of the symptom of chill and fever in the acupuncture group was significantly superior to that in the drug group after 4 and 8 weeks of the treatment, respectively （P〈0.05）. Conclusion Warming needle moxibustion was obviously effective on the improvement in pulmonary function of elderly patients with stable chronic obstructive pulmonary disease.

Effect of noninvasive, positive pressure ventilation on patients with severe, stable chronic obstructive pulmonary disease： a meta-analysis

Background This meta-analysis evaluated the effect of noninvasive, positive pressure ventilation on severe, stable chronic obstructive pulmonary disease （COPD）. Methods PUBMED, CNKI, Wanfang, EMBASE and the Cochrane trials databases were searched. Randomized controlled trials of patients with severe, stable COPD and receiving noninvasive positive pressure ventilation, compared with sham ventilation or no ventilation, were reviewed. The mortality, physiological and health related parameters were pooled to yield odds ratio （OR）, weighted mean differences or standardized mean differences （SMD）, with 95% confidence interval （CI）. Results Eight parallel and three crossover randomized controlled trials met the inclusion criteria. Pooled analysis for parallel, randomized controlled trials showed noninvasive positive pressure ventilation： （1） Did not affect the 12- or 24-month mortality （OR 0.82, 95% Ch 0.48 to 1.41）; （2） Improved the arterial carbon dioxide tension （SMD -0.88, 95% Ch -1.43 to -0.34）; （3） Did not improve forced expiratory volume in one second （SMD 0.20, 95% CI： -0.06 to 0.46）, maximal inspiratory pressure （SMD 0.01, 95% Ch -0.28 to 0.29） or 6-minute walk distance （SMD 0.17, 95% Ch -0.16 to 0.50）; （4） Subgroup analysis showed noninvasive positive pressure ventilation improved the arterial carbon dioxide tension in hypercapnic patients. Pooled analysis for crossover randomized controlled trials did not show improvement in arterial blood gas or forced expiratory volume in one second with noninvasive positive pressure ventilation. Conclusions Noninvasive positive pressure ventilation improves the arterial carbon dioxide tension but does not improve the mortality, pulmonary function, or exercise tolerance and should be cautiously used in severe stable chronic obstructive pulmonary disease.

Effect of Bufei granule on stable chronic obstructive pulmonary disease: a randomized, double blinded, placebo-controlled, and multicenter clinical study

OBJECTIVE: To study the therapeutic effect Bufei granule, which is a traditional Chinese drug that can enhance the immune function of the lung, on patients with stable chronic obstructive pulmonary disease(COPD).METHODS: This is a randomized, double blinded,placebo-controlled, and multicenter clinical study.Three medical centers in Tianjin, China, participated in the trial. A total of 140 patients with stable COPD were enrolled and randomized into two groups, with 70 patients in each. The treatment group was treated with Bufei granule, while the control group received Bufei placebo. The pharmacological treatment lasted for 12 weeks from the date of enrollment. Then, the indexes of patients were observed. Data were analyzed to study the effect of Bufei granule, with the frequency of acute exacerbation as the primary outcome. Traditional Chinese Medicine syndromes,Modified British Medical Research Council dyspnea scale score, St.George's respiratory questionnaire scores, pulmonary function, and serum inflammatory marker levels [including interleukin-6(IL-6), interleukin-8, tumor necrosis factor-α, and transformation growth factor-β1]were the secondary outcomes.RESULTS: During the 12-week treatment, treatment and control groups had no adverse reactions.The analysis of the indexes obtained from all patients showed that the therapeutic effect in the treatment group was significantly better than that in the control group because most of the similar probabilities of primary and secondary outcomes were less than 0.05,except for the level of IL-6.CONCLUSION: Bufei granule can treat patients with stable COPD by lowering the frequency of acute exacerbation, improving the quality of life,and alleviating the severity of inflammation.

Predictive validity of BODE index for anxious and depressive symptoms in patients with chronic obstructive pulmonary disease

Background Anxiety and depression are two of the commonest and most modifiable comorbidities of chronic obstructive pulmonary disease （COPD） and have an independent effect on health and prognosis. FEV1% has been shown to be a poor predictor of anxiety and depression. The body mass index, degree of airflow obstruction, dyspnea, and exercise capacity （BODE） index is a multidimensional assessment system which may predict health outcome in COPD patients. The purpose of this study was to investigate the predictive validity of the BODE index for anxious and depressive symptoms in COPD patients. Methods This was a multicenter prospective cross-sectional study in 256 patients with stable COPD. Anxious and depressive symptoms were assessed using the Hospital Anxiety and Depression Scale （HADS）. The relationships between anxiety, depression and potential predictors （including the BODE index） were analyzed by a binary Logistic regression model. Results Subjects who were anxious and depressive waJked a shorter sJx-mJnute waJkJng distance （6MWD~, had more dyspnea, a higher BODE index, and lower health-related quality of life （P 〈0.01）. Anxiety and depression score was significantly correlated with BODE index, respectively （r=0.335, P 〈0.001 ; r=0.306, P 〈0.001）. The prevalence of anxiety and depression increased with BODE stage increasing （P 〈0.05）. On the basis of binary Logistic regression, the BODE index was a good and independent predictor of anxiety and depression because it comprised dyspnea and 6MWD, which were shown to be the main determinants. Conclusions The predictive validity of the BODE index for anxiety and depression was demonstrated. We propose that the BODE index should be included in assessment of COPD severity.

皱肺定喘膏对慢性阻塞性肺疾病急性加重及相关炎症介质的临床观察

目的:观察皱肺定喘膏对慢性阻塞性肺疾病(COPD)患者急性加重次数及相关炎症介质的影响。方法:选取2019年4月至2020年4月苏州市中医医院和通安卫生院收治的稳定期COPD患者66例作为研究对象,随机分为对照组(n=32)和膏方组(n=34)。对照组予以噻托溴铵吸入剂治疗,膏方组在对照组治疗的基础上加用皱肺定喘膏,比较2组治疗后急性加重次数及急性加重风险炎症指标白细胞介素-6(IL-6)、IL-8、IL-17a、肿瘤坏死因子-α(TNF-α)的变化情况。结果:膏方组在治疗后COPD急性加重次数低于对照组(P<0.05);膏方组治疗后IL-6、TNF-α、IL-17a水平明显降低,优于对照组(均P<0.05),IL-8水平与对照组比较,差异无统计学意义(P>0.05)。结论:皱肺定喘膏可抑制COPD稳定期患者体内的IL-6、TNF-α、IL-17a水平,减少急性加重次数,从而发挥治疗作用。

行为分阶段转变理论的个案管理模式在慢性阻塞性肺疾病稳定期患者中的应用

目的探讨行为分阶段转变理论的个案管理模式在慢性阻塞性肺疾病(以下简称“慢阻肺”)稳定期患者中的应用效果。方法纳入南京市第一医院2021年6月至2022年6月门诊访视的112例慢阻肺稳定期患者进行前瞻性研究,通过随机数字表法将其分为对照组和观察组,各56例。对照组给予个案管理模式干预,观察组给予行为分阶段转变理论的个案管理模式。两组均连续干预6个月。比较干预前、干预6个月后呼吸功能[圣乔治呼吸问卷(SGRQ)、改良版英国医院研究委员会呼吸困难量表(m MRC)]、自我管理能力[健康行为能力自评量表(SRAHP)]。结果干预后,两组SGRQ、m MRC评分均低于干预前,且观察组低于对照组,差异有统计学意义(P<0.05)。干预后,两组SRAHP评分高于干预前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论行为分阶段转变理论的个案管理模式提高慢阻肺稳定期患者的自我管理能力,改善呼吸功能,具有较好应用效果。

基于保护动机理论的护理干预对慢性阻塞性肺疾病稳定期患者吸入制剂使用依从性的影响

目的探讨基于保护动机理论(protection motivation theory,PMT)的护理干预对稳定期慢性阻塞性肺疾病(chronic obstructive pulmonary diseases,COPD)患者吸入剂使用依从性的影响。方法方便选取2021年1月—2022年1月昆山市第二人民医院收治的108例COPD稳定期患者为研究对象,根据不同护理方法分为干预组(55例)与对照组(53例)。对照组给予常规护理干预,干预组在此基础上实施基于PMT的护理干预。比较两组护理干预3个月后的服药依从性、PMT问卷得分和呼吸道疾病量表(Airways Questionnaire 20,AQ20)得分情况。结果干预后3个月,干预组PMT评分为(47.05±7.76)分,高于对照组的(43.16±6.43)分,差异有统计学意义(t=2.831,P=0.006)。干预后3个月,干预组服药依从率高于对照组,差异有统计学意义(P<0.05)。干预后,干预组AQ20得分低于对照组,差异有统计学意义(P<0.05)。结论基于PMT的护理干预可激发COPD稳定期患者的保护动机,提高吸入制剂使用依从性并提高生活质量。

综合呼吸康复训练对慢性阻塞性肺疾病急性期患者肺康复的影响

目的探讨综合呼吸康复训练对老年慢性阻塞性肺疾病急性期(AECOPD)患者的临床症状、生活质量、活动能力、肺功能、肺康复依从性的影响。方法纳入70例AECOPD患者,随机数字分为对照组(n=35)和干预组(n=35),对照组在常规治疗基础上予缩唇腹式呼吸功能锻炼,干预组在常规治疗基础上进行综合呼吸康复训练,干预前后采用慢性阻塞性肺疾病评估测试(CAT)调查问卷、改良版英国医学研究委员会呼吸问卷(mMRC)、肺功能第一秒用力呼气容积(FEV1)预计值进行评估。结果对照组呼吸康复训练前后CAT评分、mMRC量表呼吸困难评级比较差异均有统计学意义(t=16.781,t=8.103,均P<0.001);干预组呼吸康复训练前后CAT评分、mMRC呼吸困难评级比较差异也均有统计学意义(t=24.035,t=15.938,均P<0.001);干预组患者的CAT评分、mMRC量表呼吸困难评级较对照组下降明显。结论综合呼吸康复训练能有效改善AECOPD患者临床症状、增强患者活动能力、提高生活质量、提高肺康复依从性。

连续性、多元化院外健康管理在氟替美维吸入粉雾剂治疗COPD稳定期患者中的应用价值

目的 探讨连续性、多元化院外健康管理在氟替美维吸入粉雾剂治疗慢性阻塞性肺疾病(COPD)稳定期患者中的应用价值。方法 选取南阳市第一人民医院2022年6月~2023年6月收治的112例COPD稳定期患者,依据随机数字表法分成多元化管理组(56例)、常规管理组(56例)。常规管理组接受常规健康管理,多元化管理组接受连续性、多元化院外健康管理,干预3个月,对比两组知识掌握情况、依从性、肺功能改善情况[用力肺活量(VC)、第1秒用力呼气量(FEV1)、第1秒用力呼气量占用力肺活量比率(FEV1/FVC)]、自我效能感[一般自我效能感量表(GSES)]、心理状况[正性与负性情绪量表(PANAS)]及生活质量[慢性阻塞性肺疾病评估测试问卷(CAT)]。结果 干预3个月后,多元化管理组功能锻炼、用药、疾病知识评分高于常规管理组(P<0.05);多元化管理组依从率(96.43%)高于常规管理组(83.93%)(P<0.05);干预3个月后,多元化管理组VC、FEV1、FEV1/FVC均高于常规管理组(P<0.05);干预3个月后,多元化管理组GSES、PANAS-正性评分明高于常规管理组,CAT、PANAS-负性评分低于规管理组(P<0.05)。结论 对于氟替美维吸入粉雾剂治疗的COPD稳定期患者,连续性、多元化院外健康管理可提升患者对疾病的认知、依从性和自我效能,调节负性心理状态,进而改善肺功能,提高生活质量。

胸腺肽α_(1)预防慢性阻塞性肺疾病稳定期急性加重的有效性及安全性Meta分析

目的系统评价胸腺肽α_(1)预防慢性阻塞性肺疾病(COPD)稳定期(SPCOPD)急性加重的有效性及安全性。方法采用计算机检索PubMed,Embase,Medline,The Cochrane Library及中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方(WanFang)、维普(VIP)数据库中胸腺肽α_(1)治疗SPCOPD的随机对照试验(RCT),检索时限为自建库起至2022年12月。参考Cochrane 2.0风险偏倚评估工具对文献进行偏倚风险评估,采用RevMan 5.3软件进行Meta分析。结果最终纳入10项RCT,涉及811例患者。Meta分析结果显示,有效性方面,胸腺肽α_(1)可减少SPCOPD患者的急性加重次数[MD=-0.96,95%CI(-1.59,-0.32),P=0.003]和急性加重天数[MD=-9.14,95%CI(-11.71,-6.56),P<0.00001],改善第1秒用力呼气容积[MD=0.12,95%CI(0.00,0.24),P=0.04],调节T淋巴细胞亚群CD[4 MD=6.66,95%CI(4.39,8.93),P<0.00001],CD[8 MD=-6.00,95%CI(-8.96,-3.04),P<0.0001],CD_(4)/CD_(8)[MD=0.61,95%CI(0.39,0.84),P<0.00001];安全性方面,仅少数患者有轻度恶心、口干、咽部不适等不良反应,可自行缓解。结论胸腺肽α_(1)预防SPCOPD急性加重的有效性和安全性均良好。

益肺灸治疗慢性阻塞性肺疾病稳定期临床疗效及对NF-κB/TGF-β1/Smad2信号通路影响

目的探讨益肺灸治疗慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)稳定期临床疗效及对核因子κB(NF-κB)/转化生长因子-β1(TGF-β1)/Smad2信号通路影响。方法选择河南中医药大学第一附属医院于2022年1月—2024年1月COPD稳定期患者80例,按随机表法分为对照组与观察组40例。对照组常规西医治疗,观察组在对照组基础上结合益肺灸治疗。两组治疗周期3个月。比较两组临床疗效,急性加重次数和住院次数;治疗前后呼吸困难、6 min步行距离(6MWD)和生活质量,肺功能,血清NF-κB、TGF-β1和Smad2水平变化。结果观察组总有效率高于对照组(P<0.05)。观察组急性加重次数和住院次数均少于对照组(P<0.05)。两组治疗后MMRC评分和CAT评分低于治疗前,6MWD高于治疗前(P<0.05);观察组治疗后MMRC评分和CAT评分低于对照组,而6MWD高于对照组(P<0.05)。两组治疗后FVC和FEV_(1)/FVC高于治疗前(P<0.05);且观察组高于对照组(P<0.05)。两组治疗后血清NF-κB、TGF-β1和Smad2水平低于治疗前(P<0.05);且观察组低于对照组(P<0.05)。结论益肺灸治疗COPD稳定期临床疗效显著,其机制可能与下调NF-κB/TGF-β1/Smad2信号通路表达有关。

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

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。

有氧运动联合营养干预在慢性阻塞性肺疾病合并老年衰弱患者康复中的应用效果观察

目的探讨有氧运动联合营养干预在慢性阻塞性肺疾病(COPD)合并老年衰弱患者康复中的应用效果.方法选择2023年1-7月重庆医科大学附属永川医院收治的80例COPD合并老年衰弱患者为研究对象,按照随机数字表法将其分为对照组(n=40)和观察组(n=40).对照组采用常规干预,观察组在对照组基础上采用有氧运动联合营养干预,均持续干预3个月,对比分析两组干预效果.结果干预后,两组第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)均大于干预前,血清白蛋白、血清前白蛋白水平及营养评估简表评分均高于干预前,且观察组FEV_(1)、FVC均大于对照组,血清白蛋白、血清前白蛋白水平及营养评估简表评分均高于对照组,差异有统计学意义(P<0.05).两组Fried衰弱表型评分均低于干预前,且观察组低于对照组,差异有统计学意义(P<0.05).结论有氧运动联合营养干预能够有效恢复COPD合并老年衰弱患者肺功能,改善机体衰弱及营养状况,具有一定的临床应用价值.

赋权激励教育护理结合呼吸运动康复训练对稳定期慢性阻塞性肺疾病患者的影响

目的探讨赋权激励教育护理结合呼吸运动康复训练对稳定期慢性阻塞性肺疾病(COPD)患者的影响.方法选择2021年6月—2023年8月潍坊市人民医院收治的82例稳定期COPD患者为研究对象.按随机数字表法将患者分为对照组和观察组,各41例.对照组行常规护理干预,观察组行赋权激励教育护理结合呼吸运动康复训练干预.比较两组康复依从性、肺功能及生活质量.结果观察组康复依从性高于对照组,差异有统计学意义(P<0.05).干预后,观察组第1秒用力呼气量为(2.38±0.59)L,用力肺活量为(1.58±0.41)L,最大呼气流量为(197.62±19.85)L/s,均大于对照组的(2.06±0.51)L、(1.26±0.37)L、(184.25±19.63)L/s,圣乔治呼吸问卷评分低于对照组,组间差异有统计学意义(P<0.05).结论赋权激励教育护理结合呼吸运动康复训练应用于稳定期COPD患者中,可增强患者康复依从性,提高生存质量,改善肺功能.

三子养亲汤加减联合针刺对慢性阻塞性肺疾病稳定期合并肌少症患者的临床疗效

目的探讨三子养亲汤加减联合针刺对慢性阻塞性肺疾病稳定期合并肌少症患者的临床疗效。方法94例患者随机分为对照组和观察组,每组47例,对照组给予常规治疗,观察组在对照组基础上加用三子养亲汤加减联合循经针刺,疗程8周。检测临床疗效、中医证候评分、肺功能指标(FVC、FEV1、FEV1/FVC)、炎症因子(CRP、IL-6、TNF-α),肌肉特异性生物标志物(MSTN、IGF-1)、相关量表评分(SARC-F、SPPB)、骨骼肌质量指数变化。结果观察组总有效率高于对照组(P<0.05)。治疗后。2组中医证候评分、炎症因子、MSTN、SARC-F评分降低(P<0.05),肺功能指标、IGF-1、SPPB评分、骨骼肌质量指数升高(P<0.05),以观察组更明显(P<0.05)。结论三子养亲汤加减联合针刺对慢性阻塞性肺疾病稳定期合并肌少症患者临床疗效显著。

个性化针对性护理干预对老年慢性阻塞性肺疾病稳定期患者的影响

目的探讨个性化针对性护理干预在老年慢性阻塞性肺疾病稳定期患者中的应用效果及对微小RNA-146a、微小RNA-146b的影响。方法选取2021年1月—2022年12月收治的80例老年慢性阻塞性肺疾病稳定期患者作为研究对象,按照组间基线资料可比的原则将其分对照组和观察组,各40例。对照组接受常规护理,观察组在对照组基础上接受综合护理干预,比较两组患者负性情绪、肺功能指标、微小RNA-146a、微小RNA-146b、睡眠质量等。结果护理干预前,两组患者SAS、SDS评分比较差异无统计学意义(P>0.05);护理干预后,观察组SAS、SDS评分低于对照组,差异有统计学意义(P<0.05)。护理干预后,观察组用力肺活量(forced vital capacity,FVC)、第1秒用力呼气量(forced ecpiratory volume in the first second,FEV1)、FEV1/FVC高于对照组,差异有统计学意义(P<0.05);观察组患者情感负担、经济负担、照顾负担评分低于对照组,差异有统计学意义(P<0.05);观察组患者匹兹堡睡眠质量量表(Pittsburgh sleep quality scale,PSQI)低于对照组,差异有统计学意义(P<0.05);护理干预后,观察组患者miR-146a及miR-146b水平高于对照组,差异有统计学意义(P<0.05)。结论慢性阻塞性肺疾病稳定期患者接受综合护理干预,能让其保持积极心态接受诊治,降低其自我感受负担,改善肺功能,保持良好的睡眠质量。