發(fā)布時(shí)間：2018-03-17 23:11

  本文選題：宣肺平喘膠囊　切入點(diǎn)：慢性阻塞性肺疾病急性加重期　出處：《山西中醫(yī)學(xué)院》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的通過(guò)觀察宣肺平喘膠囊治療慢性阻塞性肺疾病急性加重期(AECOPD)患者的臨床療效,進(jìn)一步探討該藥治療AECOPD的安全性及有效性,為其臨床應(yīng)用提供科學(xué)的依據(jù),為開發(fā)新藥及申請(qǐng)專利奠定基礎(chǔ),同時(shí),也為AECOPD患者提供一種新的有可靠療效的中草藥制劑。方法收集2014年1月至2015年6月就診于山西省中醫(yī)院肺病科的AECOPD患者,采用隨機(jī)數(shù)字表法將符合納入標(biāo)準(zhǔn)的患者隨機(jī)分為兩組,每組各40例。對(duì)照組給予抗感染、解痙平喘、止咳化痰等常規(guī)治療,治療組加用宣肺平喘膠囊,療程均為14天,觀察兩組患者治療前后中醫(yī)證候評(píng)分、肺功能、血?dú)夥治�、血常�?guī)及安全性指標(biāo)的變化。結(jié)果1.臨床總體療效評(píng)價(jià),宣肺平喘膠囊治療后,臨床總有效率為95.00%,與對(duì)照組有效率(76.90%)比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。2.中醫(yī)證候方面,主要癥狀組間比較,治療組在改善咳嗽、咳痰、氣喘、胸悶、胸痛方面明顯優(yōu)于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。次要癥狀組間比較,治療組在改善腹脹、便秘、紫紺、干濕性Up音方面明顯優(yōu)于對(duì)照組(P0.05),而在改善納呆方面無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。3.肺功能方面,與對(duì)照組比較,治療組治療后患者肺活量占預(yù)計(jì)值的百分比(VC%)、第一秒用力呼氣容積占用力肺活量的百分比(FEV1.0/FVC)、第一秒用力呼氣容積占預(yù)計(jì)值的百分比(FEV1.0%)、最大自主通氣量占預(yù)計(jì)值的百分比(MVV%)均升高,其中FEV1.0/FVC、FEV1.0%改善程度有統(tǒng)計(jì)學(xué)意義(P0.05),而VC%、MVV%無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。4.血?dú)夥治龇矫?治療后,治療組患者動(dòng)脈血氧分壓(PaO2)及血氧飽和度(SaO2)較對(duì)照組明顯升高,差異有統(tǒng)計(jì)學(xué)意義(P0.05),二氧化碳分壓(PaCO2)降低,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。5.抗感染方面,治療后組間比較,治療組患者白細(xì)胞計(jì)數(shù)(WBC)、中性粒細(xì)胞百分比(NE%)明顯降低,淋巴細(xì)胞百分比(LY%)明顯升高,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。6.安全性指標(biāo)方面,兩組治療前后肝腎功能、尿常規(guī)、便常規(guī)、心電圖等各項(xiàng)安全檢查均未見(jiàn)異常改變。結(jié)論1.宣肺平喘膠囊能明顯改善患者的中醫(yī)證候,提高肺通氣功能,改善缺氧和緩解二氧化碳潴留,且未見(jiàn)明顯不良反應(yīng),表明宣肺平喘膠囊治療AECOPD是安全有效的;2.從“痰瘀”論治慢性阻塞性肺疾病及多種治肺方法聯(lián)合治療AECOPD療效較好。
[Abstract]:Objective to observe the clinical efficacy of Xuanfei Pingchuan capsule in treating patients with chronic obstructive pulmonary disease (COPD) at acute exacerbation stage, and to further explore the safety and efficacy of Xuanfei Pingchuan capsule in the treatment of AECOPD, so as to provide scientific basis for its clinical application. To lay the foundation for the development of new drugs and patent applications, and to provide a new and reliable Chinese herbal medicine preparation for AECOPD patients. Methods from January 2014 to June 2015, AECOPD patients in the Department of Pulmonary Diseases, Shanxi traditional Chinese Medicine Hospital, were collected. Patients who met the inclusion criteria were randomly divided into two groups with 40 cases in each group. The control group was given routine treatment such as anti-infection, antispasmolysis, relieving cough and resolving phlegm, and the treatment group was treated with Xuanfei Pingchuan capsule for 14 days. Observe the changes of TCM syndrome score, lung function, blood gas analysis, blood routine and safety index before and after treatment. The total clinical effective rate was 95.00, compared with the control group (76.90), the difference was statistically significant (P0.050.2.Compared with the main symptom groups, the treatment group was superior to the control group in improving cough, expectoration, asthma, chest tightness and chest pain. The difference was statistically significant (P 0.05). The treatment group was superior to the control group in improving abdominal distension, constipation, cyanosis, dry and wet up sound, but no significant difference was found in the improvement of anorexia. Pulmonary function was higher in the treatment group than in the control group. In the treatment group, the percentage of vital capacity in the predicted value after treatment was as follows: the percentage of the forced expiratory volume occupied by the forced expiratory volume at 1 second was equal to that of FEV1.0 / FVC1, and the percentage of forced expiratory volume to the predicted value at 1 second was equal to that of FEV1.0, and the maximal autonomic ventilation volume accounted for the predicted value. The percentage of MVV increased, The improvement of FEV1.0 / FVC+ FEV1.0% was significantly higher than that of the control group (P 0.05), but the MVV% had no statistical significance. 4. In blood gas analysis, after treatment, the arterial partial pressure of oxygen (PaO2) and the saturation of oxygen (SaO2) in the treatment group were significantly higher than those in the control group. The difference was statistically significant (P 0.05, P 0.05, Paco 2), but there was no significant difference between the two groups. In the aspect of anti-infection, the white blood cell count and neutrophil percentage of the patients in the treatment group were significantly lower than those in the control group after treatment. The percentage of lymphocytes was significantly increased, the difference was statistically significant (P 0.05). 6. In terms of safety index, the liver and kidney function, urine routine and routine routine were observed in the two groups before and after treatment. Conclusion: Xuanfei Pingchuan capsule can obviously improve TCM syndrome, improve pulmonary ventilation function, improve hypoxia and alleviate carbon dioxide retention, and no obvious adverse reactions. 2. Xuanfei Pingchuan capsule is a safe and effective treatment for AECOPD. From the viewpoint of "phlegm and blood stasis", the treatment of chronic obstructive pulmonary disease (COPD) and combined treatment of multiple methods of lung treatment with AECOPD is better.
【學(xué)位授予單位】：山西中醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R259

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