本文選題：慢性阻塞性肺疾病急性發(fā)作　切入點(diǎn)：蘇子降氣湯　出處：《南京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:本研究在常規(guī)治療基礎(chǔ)上,運(yùn)用蘇子降氣湯加全蝎、地龍加減(組方)對(duì)慢性阻塞性肺疾病(chronic obstructive pulmonary disease,簡(jiǎn)稱COPD)急性加重期中咳痰困難、中醫(yī)辨證為痰濁阻肺型的患者的臨床療效,觀察其臨床癥候得分、血?dú)獾闹笜?biāo),并探討年齡、性別、低氧血癥與療效的相關(guān)性,為中醫(yī)治療緩解氣道高分泌癥狀提供有效的臨床依據(jù)。研究方法:選擇納入標(biāo)準(zhǔn)的60例痰濁阻肺型AECOPD患者作為研究對(duì)象,隨機(jī)分為對(duì)照組與治療組各30例。對(duì)照組:常規(guī)抗生素、祛痰藥、平喘藥、氧噴治療;治療組:在對(duì)照組治療基礎(chǔ)上加服蘇子降氣湯加全蝎、地龍加減。以14天為療程,在第1、3、5、7、10、14天記錄患者臨床癥候得分,檢測(cè)治療前后血?dú)夥治?并監(jiān)測(cè)血常規(guī)、肝腎功能及生命體征,記錄結(jié)束后運(yùn)用SPSS20.0進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:1.治療前兩組性別、年齡經(jīng)統(tǒng)計(jì)學(xué)計(jì)算均有可比性。2.兩組總積分治療前后均有降低(P=0.000.05);治療后積分比較有統(tǒng)計(jì)學(xué)差異(P=0.0230.05);治療后咳嗽積分比較有統(tǒng)計(jì)學(xué)差異(P=0.0140.05);對(duì)照組平均秩次均大于治療組。3.兩組臨床癥狀總療效治療后控顯率比較有統(tǒng)計(jì)學(xué)差異(P=0.0350.05),治療組優(yōu)于對(duì)照組;單項(xiàng)療效上咳痰與哮鳴音兩組治療后控顯率比較有統(tǒng)計(jì)學(xué)差異(分別為P=0.028、0.038均0.05),治療組優(yōu)于對(duì)照組。4.與咳痰療效相關(guān)比較中兩組男性患者比較治療組優(yōu)于對(duì)照組,有統(tǒng)計(jì)學(xué)差異(P=0.0350.05);70-80歲年齡段的患者比較治療組優(yōu),有統(tǒng)計(jì)學(xué)差異(P=0.0320.05);兩組B組患者治療組優(yōu)于對(duì)照組,有統(tǒng)計(jì)學(xué)差異(P=0.0480.05)。5.兩組治療后療效指數(shù)比較有統(tǒng)計(jì)學(xué)差異(P=0.0040.01)。6.不同性別總療效無顯著差異;血?dú)庋醴謮簾o顯著差異,且伴有或不伴有低氧血癥對(duì)于咳痰療效并無顯著差異。結(jié)論:1.蘇子降氣湯加全蝎、地龍加減可提高痰濁阻肺型慢阻肺患者的臨床療效。2.蘇子降氣湯加全蝎、地龍加減能夠較好緩解慢阻肺患者咯痰困難這一癥狀,促進(jìn)痰液排出。3.蘇子降氣湯加全蝎、地龍加減或可通過對(duì)支氣管平滑肌的作用改善哮鳴音情況。4.蘇子降氣湯加全蝎、地龍加減對(duì)于男性吸煙患者療效更佳。5.蘇子降氣湯加全蝎、地龍加減對(duì)于老年的慢阻肺患者療效較好,推論或能改善其功能,調(diào)節(jié)免疫,有較好的補(bǔ)益功效。6.蘇子降氣湯加全蝎、地龍加減對(duì)于慢阻肺患者通氣功能無顯著效果,且伴有或不伴有低氧血癥對(duì)于咯痰困難這一癥狀并無顯著影響。
[Abstract]:Objective: on the basis of routine treatment, the treatment of chronic obstructive pulmonary disease (pulmonary) with Suzi Jiangqi decoction (Scorpion) and Rhizoma Rehmanniae (prescription) in acute exacerbation of sputum dysphonia during the period of chronic obstructive pulmonary disease (COPD) was studied. The clinical curative effect of patients with phlegm turbid obstruction of lung syndrome was observed, the clinical symptom score and blood gas index were observed, and the correlation between age, sex, hypoxemia and curative effect was discussed. Methods: 60 cases of AECOPD with phlegm turbid obstruction and lung obstruction were selected as the research objects. The control group was randomly divided into control group (n = 30) and treatment group (n = 30). The control group was treated with routine antibiotics, expectorant, antiasthmatic medicine and oxygen spray. Clinical symptom scores, blood gas analysis, blood routine examination, liver and kidney function and vital signs were recorded on day 1, 3, 5, 7, 10, 14, respectively. SPSS20.0 was used for statistical analysis after recording. Results: 1. Sex of two groups before treatment. Age was comparable by statistical calculation. 2.The total integral of the two groups were decreased before and after treatment, there were significant differences in the score after treatment (P < 0.05), there was significant difference in the score of cough after treatment (P < 0.0140.05), and the average rank of the control group was greater than that of the treatment. Group 3.There was statistical difference between the two groups in the total curative effect of clinical symptom control after treatment, the treatment group was better than the control group. There was statistical difference between the two groups (P < 0.028, 0.038, respectively), and the treatment group was superior to the control group (.4.Compared with the curative effect of expectoration), the treatment group was better than the control group in comparison with the curative effect of expectoration. There was statistical difference between the two groups (P < 0. 035, 0. 05, P < 0. 035, P = 0. 035, P = 0. 035, P = 0. 035, P = 0. 035, P = 0. 035, P = 0. 035, P = 0. 035). There was significant difference in the curative effect index between the two groups after treatment. There was no significant difference in the total curative effect between the two groups, and there was no significant difference in the partial pressure of oxygen in blood gas. There was no significant difference between patients with or without hypoxemia in expectoration. Conclusion: 1. The effect of Scorpion decoction and the addition and subtraction of Dilong can improve the clinical efficacy of Scorpion in patients with obstructive pulmonary disease with turbid phlegm and obstruction of lung. 2. The addition and subtraction of Rehmannia can better relieve the symptoms of difficulty of sputum in patients with chronic obstructive lung, promote sputum excretion .3.Scorpion from the whole Scorpio of Su Zi Jiang Qi decoction, and improve the wheezing condition by the effect on bronchial smooth muscle .4.The whole scorpion of Su Zi Jiang Qi Tang can be improved by its effect on bronchial smooth muscle. The effect of the addition and subtraction of Rehmannia is better for the male smoking patients. 5. Suzi jiangqi decoction whole scorpion, the addition and subtraction of the dragon is better for the elderly patients with chronic obstructive pulmonary disease, inference or can improve its function, regulate immunity, There was no significant effect on ventilation function in patients with chronic obstructive pulmonary disease, and there was no significant effect on the symptoms of dyspnea with or without hypoxemia.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R259

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 陳亞紅;;2017年GOLD慢性阻塞性肺疾病診斷、治療及預(yù)防的全球策略解讀[J];中國醫(yī)學(xué)前沿雜志(電子版);2017年01期

2 王蕾;楊汀;王辰;;2017年版慢性阻塞性肺疾病診斷、處理和預(yù)防全球策略解讀[J];中國臨床醫(yī)生雜志;2017年01期

3 鄭玉蘭;曾憲升;;氨溴索聯(lián)合異丙托溴銨治療慢性阻塞性肺疾病急性加重期的療效分析[J];中華老年醫(yī)學(xué)雜志;2014年11期

4 王志英;周學(xué)平;李國春;徐立然;許立;郭立中;金路;楊繼兵;蔡敏;朱佳;;補(bǔ)益肺腎、祛風(fēng)化痰法治療慢性持續(xù)期哮喘的臨床研究[J];南京中醫(yī)藥大學(xué)學(xué)報(bào);2014年04期

5 盧峰;王世聰;;六君子湯對(duì)慢性阻塞性肺疾病患者內(nèi)源性抗炎機(jī)制影響[J];遼寧中醫(yī)藥大學(xué)學(xué)報(bào);2013年07期

6 張偉;谷明明;孫璐璐;韓佳;姚玉強(qiáng);;活血化瘀中藥對(duì)COPD血管重塑的干預(yù)作用[J];中國實(shí)驗(yàn)方劑學(xué)雜志;2013年08期

7 倪圣;丁建中;;氣道黏液高分泌機(jī)制研究進(jìn)展[J];長(zhǎng)江大學(xué)學(xué)報(bào)(自科版);2013年09期

8 嵇冰;凌春華;艾宗耀;姚麗娟;成一星;許增寶;邱鑫水;柯為洵;;平喘固本湯對(duì)慢性阻塞性肺病患者肺功能的影響[J];中華中醫(yī)藥學(xué)刊;2011年10期

9 鐘相根;李宇航;祝小惠;;慢性阻塞性肺疾病氣道黏液高分泌機(jī)制及中醫(yī)藥干預(yù)作用[J];中華中醫(yī)藥雜志;2011年08期

10 周卜全;李新科;;厄多司坦對(duì)老年支氣管擴(kuò)張癥及黏液分泌過多患者的治療效果[J];實(shí)用醫(yī)學(xué)雜志;2011年06期

，

本文編號(hào)：1600069