本文選題：慢性阻塞性肺疾病 + 肺脾氣虛證��； 參考：《遼寧中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:通過圍貼敷期內(nèi)外同治法驗(yàn)證伏九穴位貼敷結(jié)合內(nèi)服膏方在治療COPD穩(wěn)定期肺脾氣虛證的有效性,確定培土生金理論指導(dǎo)下的內(nèi)外同治法在COPD防治中的地位和作用。資料與方法:根據(jù)納排標(biāo)準(zhǔn),對2014年11月-2015年5月曾在遼寧中醫(yī)藥大學(xué)附屬第二醫(yī)院肺病科門診及病房住院治療,中醫(yī)診斷為肺脹病,肺脾氣虛證的患者進(jìn)行電話隨訪,對于目前處于穩(wěn)定期肺脾氣虛證的患者告知研究相關(guān)情況,告知愿意參加研究的患者于2015年一伏前十天至門診就診,對前來門診就診患者按照隨機(jī)數(shù)字表法進(jìn)行隨機(jī)分組。共納入104例,治療組與對照組各52例。治療組予沙美特羅替卡松粉吸入劑(商品名:舒利迭,葛蘭素史克公司,50ug/500ug)每次1吸,每日2次,同時配合圍貼敷期伏九穴位貼敷結(jié)合內(nèi)服健脾益肺膏。對照組:沙美特羅替卡松粉吸入劑每次1吸,每日2次。療程均為86天,隨訪6個月。分別比較兩組治療前后、治療前與隨訪后及隨訪后治療組與對照組在肺功能,臨床癥狀評分,呼吸困難評分,CAT評分,急性加重次數(shù)等方面的差異。結(jié)果:1.臨床癥狀積分、生活質(zhì)量評分(CAT)、呼吸困難程度方面,治療組與對照組治療后較治療前均有所好轉(zhuǎn)(P0.05);三者治療組隨訪后與治療前均有明顯好轉(zhuǎn)(P0.01),對照組隨訪后與治療前均無明顯差異(P0.05);三者隨訪后治療組均優(yōu)于對照組(P0.05)。2.肺功能:治療組隨訪后與治療前比較,FEV1%明顯升高(P0.01),FEV1/FVC無明顯差異(P0.05),對照組FEV1%,FEV1/FVC隨訪后與治療前無明顯差異(P0.05);隨訪后兩組比較FEV1%治療組高于對照組(P0.01)。3.急性加重次數(shù):治療組隨訪后與治療前加重次數(shù)明顯減少(P0.01);對照組隨訪后與治療前加重次數(shù)無明顯變化(P0.05);隨訪后治療組急性加重次數(shù)明顯少于對照組(P0.01)。4.安全性方面:兩組治療前后血常規(guī),肝功,腎功均未見明顯異常(P0.05)。結(jié)論:圍貼敷期伏九穴位貼敷結(jié)合內(nèi)服健脾益肺膏聯(lián)合常規(guī)西醫(yī)治療COPD穩(wěn)定期肺脾氣虛型患者可明顯改善患者呼吸困難程度,緩解臨床癥狀,減緩肺功能下降,降低急性加重次數(shù),從而提高患者生活質(zhì)量,并且具有很好的長期療效,安全性較高,值得臨床推廣應(yīng)用。
[Abstract]:Objective: to verify the effectiveness of Fujiu acupoint application combined with internal plaster ointment in the treatment of lung and spleen qi deficiency syndrome in the stable period of COPD, and to determine the position and role of the internal and external treatment under the guidance of the theory of native gold in the prevention and treatment of COPD. Materials and methods: from November 2014 to May 2015, patients who had been hospitalized in the Department of Pulmonary Diseases and the second affiliated Hospital of Liaoning University of traditional Chinese Medicine, diagnosed as lung distension and deficiency of lung and spleen qi, were followed up by telephone. For the patients with lung and spleen qi deficiency syndrome in stable period, the patients who are willing to take part in the study will go to the outpatient clinic ten days before one volt in 2015. The patients who come to the clinic will be randomly divided according to the method of random digital table. 104 cases were included, 52 cases in the treatment group and 52 cases in the control group. The treatment group was treated with salmeterolticasone powder inhalant (commercial name: Schuliday, GlaxoSmithKline 50ugr / 500ug), 2 times a day, at the same time, combined with Nine acupoints and Jianpi Yifei ointment. Control group: salmeterol ticasone powder inhalation 1 time, 2 times a day. The course of treatment was 86 days, followed up for 6 months. The difference of pulmonary function, clinical symptom score, cat score and acute exacerbation were compared between the two groups before and after treatment, before and after treatment and after follow-up. The result is 1: 1. Clinical symptom score, quality of life score, degree of dyspnea, The treatment group and control group were all improved after treatment than before treatment, the three treatment groups had obvious improvement after follow-up and before treatment, the control group had no significant difference after follow-up and before treatment, the treatment group was better than the control group after follow up and before treatment, the treatment group was better than the control group. Pulmonary function: compared with before treatment, FEV1% in treatment group was significantly higher than that before treatment. There was no significant difference in FEV1 / FVC between treatment group and control group (P 0.05), but there was no significant difference in FEV1 / FVC in control group (P 0.05), and FEV1% in treatment group was higher than that in control group (P0.01 路3) after follow up. The times of acute aggravation: the times of aggravation after follow-up and before treatment in the treatment group were significantly decreased, while in the control group there was no significant change in the times of exacerbation after follow-up and before treatment, and after follow-up, the times of acute aggravation in the treatment group was significantly less than that in the control group. Safety: blood routine, liver function and renal function were not significantly abnormal before and after treatment in both groups. Conclusion: the combination of Fujiu acupoint application and internal administration of Jianpi Yifei ointment combined with routine western medicine can obviously improve the degree of dyspnea, relieve clinical symptoms and slow down the decline of pulmonary function in patients with lung and spleen qi deficiency in COPD stable period. Reducing the times of acute exacerbation, thus improving the quality of life of patients, and has a good long-term efficacy, high safety, worthy of clinical application.
【學(xué)位授予單位】：遼寧中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R246.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 李鴻霖;楊s，

本文編號：1899150