肺康顆粒對COPD穩(wěn)定期肺腎虧虛證患者生存質(zhì)量影響的臨床研究
發(fā)布時間：2019-03-23 15:59
【摘要】：目的:觀察評估肺康顆粒對COPD穩(wěn)定期肺腎虧虛證患者中醫(yī)證候積分、急性加重次數(shù)及程度、肺功能、生存質(zhì)量及六分鐘步行距離的影響,以進一步科學評判肺康顆粒對COPD穩(wěn)定期的臨床療效。方法:本試驗將符合納入標準的COPD穩(wěn)定期肺腎虧虛證患者隨機分為肺康治療組及對照組。對照組根據(jù)患者病情予以西醫(yī)常規(guī)治療,肺康治療組在西醫(yī)常規(guī)治療基礎上給予肺康顆粒沖服,療程均為6個月。以治療前、治療3月、治療6月為觀測節(jié)點,觀察兩組中醫(yī)證候積分、急性加重次數(shù)及程度、肺功能、圣喬治呼吸問卷(St.George Respiratory Questionnaire,SGRQ)、六分鐘步行距離(Six Minutes Walking Distance,6MWD)的變化情況。結果:1.經(jīng)SPSS 21.0統(tǒng)計學分析處理,兩組患者一般資料包括年齡、性別、病程及病情嚴重程度等指標相比較,差異均無統(tǒng)計學意義(P0.05),具有可比性。2.對中醫(yī)證候積分的影響:經(jīng)重復測量方差分析顯示,兩組咳嗽、乏力、腰膝酸軟癥狀積分及總積分的時間變化趨勢組間比較,差別有統(tǒng)計學意義(P0.05)。肺康組各個癥狀積分及證候總分比較,治療3個月比治療前下降,差異有統(tǒng)計學意義(P0.016);治療6個月與治療前比較,除自汗積分外,其余癥狀積分下降均有統(tǒng)計學意義(P0.016);治療6個月與治療3個月對比,氣短、乏力、腰膝酸軟及證候總分差別有統(tǒng)計學意義(P0.016)。對照組治療3個月與治療前比較,除咳嗽、乏力外,其余癥狀改變均有統(tǒng)計學意義(P0.016),治療6個月與治療前比較,各癥狀積分改變均有統(tǒng)計學意義(P0.016),治療6個月與治療3個月對比,僅咯痰、易感冒及總分的差別具有統(tǒng)計學意義(P0.016)。在不同時點進行組間比較,治療3月時,肺康組咳嗽、乏力、中醫(yī)證候總分低于對照組,差異有統(tǒng)計學意義(P0.016);治療6月時,肺康組咳嗽、乏力、腰膝酸軟以及證候總分變化低于對照組,差異有統(tǒng)計學意義(P0.016)。3.對臨床療效的影響:治療3月后肺康組總有效率為68.97%,對照組總有效率僅13.79%,治療6月后肺康組總有效率達93.10%,而對照組有51.72%,盡管兩組均能改善患者中醫(yī)證候(P0.05),但對同一時點組間療效進行對比,提示肺康組要勝過對照組(P0.05)。4.對肺功能的影響:經(jīng)重復測量方差分析顯示FEV1、FEV1%及FEV1/FVC的時間變化趨勢沒有組間差異(P0.05)。肺康組各項指標與治療前比較有上升趨勢,但差異無統(tǒng)計學意義,而西醫(yī)對照組中各參數(shù)變化趨勢不明顯,但兩組間各指標比較差異仍無統(tǒng)計學意義。5.對急性加重次數(shù)及程度的影響:治療期間肺康組急性加重次數(shù)低于對照組,差異有統(tǒng)計學意義(P0.05),治療期間兩組急性加重程度比較,差異無統(tǒng)計學意義(P0.05)。6.對生存質(zhì)量的影響:經(jīng)重復測量方差分析顯示,SGRQ總分、呼吸癥狀積分、活動受限積分及疾病影響積分的時間變化趨勢沒有組間的差異(P0.05)。各時間點上兩組對比,治療3月時兩組間差異無統(tǒng)計學意義(P0.016),治療6月時兩組間差異有統(tǒng)計學意義(P0.016),肺康組改善更明顯。肺康組在治療3月和治療6月后較治療前改善,差異有統(tǒng)計學意義(P0.016),治療6個月較治療3個月改善,差異有統(tǒng)計學意義(P0.016);對照組治療3個月和治療6個月后均較治療前有所改善,差異有統(tǒng)計學意義(P0.016),治療6月與治療3月比較無明顯改善,差異無統(tǒng)計學意義(P0.016)。7.對六分鐘步行距離的影響:經(jīng)重復測量方差分析顯示,6MWD的時間變化趨勢組間差異不明顯(P0.05)。肺康組治療3月和治療6月皆比治療前顯著提高,差異有統(tǒng)計學意義(P0.016),且治療6月比治療3月下降更明顯,差異具有統(tǒng)計學意義(P0.016),對照組僅在治療6月的時間結點上較基線水平上升(P0.016)。結論:1.肺康顆粒聯(lián)合西醫(yī)常規(guī)方案治療COPD穩(wěn)定期肺腎虧虛證患者與單純西藥治療相比,能有效緩解COPD患者的癥狀表現(xiàn),尤其在咳嗽、乏力、腰膝酸軟等癥狀方面,緩解更明顯。2.肺康顆粒能改善患者生存質(zhì)量,減輕疾病對患者的影響。3.肺康顆粒一定程度上能延緩肺功能下降趨勢、減少急性發(fā)作次數(shù)及提高日常活動能力。
[Abstract]:Objective: To evaluate the effect of Feikang granule on the syndrome of TCM syndrome, the number of times and the degree of acute exacerbation, the function of the lung, the quality of life and the distance of the six-minute walk in the patients with chronic obstructive pulmonary kidney deficiency of COPD, and to further study the clinical effect of Feikang granule on the stable period of COPD. Methods: The patients with lung and kidney deficiency of the stable period of COPD were randomly divided into the treatment group of the lung and the control group. The control group was treated by western medicine according to the condition of the patient, and the lung-kang treatment group was treated with the lung-kang granules on the basis of the routine treatment of western medicine, and the course of treatment was 6 months. The changes of the two groups of TCM syndrome, the number and degree of acute exacerbation, the lung function, the St. George's Respiratory Questionnaire (SGRQ) and the six-minute walk distance (6MWD) were observed. Results:1. The data of the two groups, including age, sex, course of course and severity of the disease, were not statistically significant (P0.05). The effect of the integration of the syndrome of TCM syndrome: The results of variance analysis showed that there was a significant difference between the two groups of cough, weakness, soft symptom of the waist and knees and the time of total integration (P0.05). The total score of the symptoms and the total score of the symptoms in the treatment group was lower than that of the treatment before treatment (P.016), and the total score of the other symptoms decreased after 6 months (P.016). Compared with the treatment for 3 months, the difference of the total score of short, weak, and soreness of the waist and knees and the total score of the syndrome in the treatment for 6 months was of statistical significance (P.016). The control group was compared with the treatment before and after the treatment for 3 months, except for cough and weakness, the rest of the symptoms were statistically significant (P0.05). The treatment was compared with the treatment before the treatment for 6 months, and the integral change of each symptom was statistically significant (P.016), and the treatment for 6 months was compared with the treatment for 3 months, and only the sputum was obtained. The difference of common cold and total score was of statistical significance (P.016). In the treatment of 3 months, the total score of cough, weakness and TCM syndrome in the lung-kang group was lower than that of the control group at the time of the treatment for 3 months (P.016). In the treatment of June, the total score of cough, weakness, soreness of the waist and knees and the total score of the syndrome was lower than that of the control group. The difference was significant (P0.05). The total effective rate of the treatment group was 68.97% in the treatment group, the total effective rate of the control group was 13.79%, the total effective rate of the lung and kang group was 93.10% after June, and 51.72% in the control group, although both groups could improve the TCM syndrome of the patients (P0.05). However, the curative effect of the group was compared with that of the control group (P0.05). Effects on lung function: The time trend of FEV1, FEV1% and FEV1/ FVC was shown to be no difference between groups (P0.05). The indexes of the lung-kang group were higher than that before treatment, but there was no significant difference in the difference between the two groups, but there was no significant difference between the two groups. The number and degree of acute exacerbations: the number of acute exacerbations of the lung in the treatment period was lower than that of the control group (P <0.05), and the difference between the two groups in the treatment period was not statistically significant (P0.05). The effect of variance analysis of variance, the total score of SGRQ, the integral of respiratory symptoms, the limited integral of the activity and the time of the disease-affected integration was not significantly different between the groups (P0.05). There was no significant difference between the two groups at each time point (P 0.016), and the difference between the two groups was statistically significant at the end of June (P0.05). In the treatment of 3-month and 6-month treatment, the treatment of the lung-kang group was improved and the difference was statistically significant (P0.05). The control group was treated for 3 months and the treatment for 6 months, and the difference was improved. There was no significant difference in the difference between the treatment of June and the treatment in March, and there was no significant difference in the difference (P.016). The effect of six-minute walk distance: The variance of 6MWD was not significant between the two groups (P0.05). The treatment of the patients with Feikang group was significantly higher than that in the treatment group (P.016), and the treatment for June was more obvious than that of the treatment in March. The difference was of statistical significance (P.016). The control group only increased from the baseline in the time node of the treatment for June (P.016). Conclusion:1. Compared with the traditional western medicine, the patients with the lung-kidney-deficiency syndrome in the stable period of COPD can effectively relieve the symptoms of the patients with COPD, especially in the symptoms of cough, weakness, soreness of the waist and knees, and the like. Feikang granule can improve the quality of the patient's life and reduce the influence of the disease on the patient. Feikang granule can delay the function of the lung function to a certain extent, reduce the number of acute attack and improve the daily activity.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R563.9
本文編號：2445987
[Abstract]:Objective: To evaluate the effect of Feikang granule on the syndrome of TCM syndrome, the number of times and the degree of acute exacerbation, the function of the lung, the quality of life and the distance of the six-minute walk in the patients with chronic obstructive pulmonary kidney deficiency of COPD, and to further study the clinical effect of Feikang granule on the stable period of COPD. Methods: The patients with lung and kidney deficiency of the stable period of COPD were randomly divided into the treatment group of the lung and the control group. The control group was treated by western medicine according to the condition of the patient, and the lung-kang treatment group was treated with the lung-kang granules on the basis of the routine treatment of western medicine, and the course of treatment was 6 months. The changes of the two groups of TCM syndrome, the number and degree of acute exacerbation, the lung function, the St. George's Respiratory Questionnaire (SGRQ) and the six-minute walk distance (6MWD) were observed. Results:1. The data of the two groups, including age, sex, course of course and severity of the disease, were not statistically significant (P0.05). The effect of the integration of the syndrome of TCM syndrome: The results of variance analysis showed that there was a significant difference between the two groups of cough, weakness, soft symptom of the waist and knees and the time of total integration (P0.05). The total score of the symptoms and the total score of the symptoms in the treatment group was lower than that of the treatment before treatment (P.016), and the total score of the other symptoms decreased after 6 months (P.016). Compared with the treatment for 3 months, the difference of the total score of short, weak, and soreness of the waist and knees and the total score of the syndrome in the treatment for 6 months was of statistical significance (P.016). The control group was compared with the treatment before and after the treatment for 3 months, except for cough and weakness, the rest of the symptoms were statistically significant (P0.05). The treatment was compared with the treatment before the treatment for 6 months, and the integral change of each symptom was statistically significant (P.016), and the treatment for 6 months was compared with the treatment for 3 months, and only the sputum was obtained. The difference of common cold and total score was of statistical significance (P.016). In the treatment of 3 months, the total score of cough, weakness and TCM syndrome in the lung-kang group was lower than that of the control group at the time of the treatment for 3 months (P.016). In the treatment of June, the total score of cough, weakness, soreness of the waist and knees and the total score of the syndrome was lower than that of the control group. The difference was significant (P0.05). The total effective rate of the treatment group was 68.97% in the treatment group, the total effective rate of the control group was 13.79%, the total effective rate of the lung and kang group was 93.10% after June, and 51.72% in the control group, although both groups could improve the TCM syndrome of the patients (P0.05). However, the curative effect of the group was compared with that of the control group (P0.05). Effects on lung function: The time trend of FEV1, FEV1% and FEV1/ FVC was shown to be no difference between groups (P0.05). The indexes of the lung-kang group were higher than that before treatment, but there was no significant difference in the difference between the two groups, but there was no significant difference between the two groups. The number and degree of acute exacerbations: the number of acute exacerbations of the lung in the treatment period was lower than that of the control group (P <0.05), and the difference between the two groups in the treatment period was not statistically significant (P0.05). The effect of variance analysis of variance, the total score of SGRQ, the integral of respiratory symptoms, the limited integral of the activity and the time of the disease-affected integration was not significantly different between the groups (P0.05). There was no significant difference between the two groups at each time point (P 0.016), and the difference between the two groups was statistically significant at the end of June (P0.05). In the treatment of 3-month and 6-month treatment, the treatment of the lung-kang group was improved and the difference was statistically significant (P0.05). The control group was treated for 3 months and the treatment for 6 months, and the difference was improved. There was no significant difference in the difference between the treatment of June and the treatment in March, and there was no significant difference in the difference (P.016). The effect of six-minute walk distance: The variance of 6MWD was not significant between the two groups (P0.05). The treatment of the patients with Feikang group was significantly higher than that in the treatment group (P.016), and the treatment for June was more obvious than that of the treatment in March. The difference was of statistical significance (P.016). The control group only increased from the baseline in the time node of the treatment for June (P.016). Conclusion:1. Compared with the traditional western medicine, the patients with the lung-kidney-deficiency syndrome in the stable period of COPD can effectively relieve the symptoms of the patients with COPD, especially in the symptoms of cough, weakness, soreness of the waist and knees, and the like. Feikang granule can improve the quality of the patient's life and reduce the influence of the disease on the patient. Feikang granule can delay the function of the lung function to a certain extent, reduce the number of acute attack and improve the daily activity.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R563.9
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