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

【摘要】：目的通過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,進一步探討該藥治療AECOPD的安全性及有效性,為其臨床應用提供科學的依據(jù),為開發(fā)新藥及申請專利奠定基礎(chǔ),同時,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,采用隨機數(shù)字表法將符合納入標準的患者隨機分為兩組,每組各40例。對照組給予抗感染、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)證候評分、肺功能、血氣分析、血常規(guī)及安全性指標的變化。結(jié)果1.臨床總體療效評價,宣肺平喘膠囊治療后,臨床總有效率為95.00%,與對照組有效率(76.90%)比較,差異有統(tǒng)計學意義(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)于對照組,差異有統(tǒng)計學意義(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)于對照組(P0.05),而在改善納呆方面無統(tǒng)計學意義(P0.05)。3.肺功能方面,與對照組比較,治療組治療后患者肺活量占預計值的百分比(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計值的百分比(FEV1.0%)、最大自主通氣量占預計值的百分比(MVV%)均升高,其中FEV1.0/FVC、FEV1.0%改善程度有統(tǒng)計學意義(P0.05),而VC%、MVV%無統(tǒng)計學意義(P0.05)。4.血氣分析方面,治療后,治療組患者動脈血氧分壓(PaO2)及血氧飽和度(SaO2)較對照組明顯升高,差異有統(tǒng)計學意義(P0.05),二氧化碳分壓(PaCO2)降低,差異無統(tǒng)計學意義(P0.05)。5.抗感染方面,治療后組間比較,治療組患者白細胞計數(shù)(WBC)、中性粒細胞百分比(NE%)明顯降低,淋巴細胞百分比(LY%)明顯升高,差異有統(tǒng)計學意義(P0.05)。6.安全性指標方面,兩組治療前后肝腎功能、尿常規(guī)、便常規(guī)、心電圖等各項安全檢查均未見異常改變。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,且未見明顯不良反應,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.
【學位授予單位】：山西中醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R259

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