本文選題：慢性阻塞性肺疾病急性加重 + 麻桔喘咳方�。� 參考：《成都中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的：評(píng)價(jià)麻桔喘咳方治療AECOPD急診留觀病人的臨床療效和安全性,客觀分析麻桔喘咳方在A ECOPD治療中的應(yīng)用價(jià)值,推動(dòng)我科驗(yàn)方的實(shí)用性轉(zhuǎn)化,為中藥新藥研發(fā)提供前期準(zhǔn)備和數(shù)據(jù)支撐。方法：采用隨機(jī)對(duì)照方法,選擇AEOPD患者102例(對(duì)照組46例,治療組56例),治療組給予西醫(yī)標(biāo)準(zhǔn)治療的基礎(chǔ)上加用麻桔喘咳方,對(duì)照組給予西醫(yī)標(biāo)準(zhǔn)治療,觀察治療前后的中醫(yī)癥狀積分、痰液變化情況、CAT評(píng)分、實(shí)驗(yàn)室檢查、綜合療效評(píng)價(jià)等指標(biāo)。結(jié)果：1.可比性分析：兩組患者治療前一般資料(年齡、性別、吸煙史)、一般情況(收縮壓、舒張壓、呼吸、心率、體溫、BMI)、病情嚴(yán)重程度(病程、CAT評(píng)分、中醫(yī)癥狀總分、急性發(fā)作次數(shù)、mMRC評(píng)分)差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),兩組問(wèn)具有可比性。2.中醫(yī)證候分析：兩組均可使中醫(yī)癥狀明顯改善,治療組療效明顯優(yōu)于對(duì)照組(P0.05)�？傮w趨勢(shì)上,各時(shí)間節(jié)點(diǎn)中醫(yī)證候積分呈遞減趨勢(shì),并且治療組優(yōu)于對(duì)照組。在痰液變化(痰質(zhì)、色、量)方面,治療組也明顯優(yōu)于對(duì)照組(P0.05)。中醫(yī)證候療效評(píng)價(jià)方面,治療組總有效率85.71%,對(duì)照組總有效率65.21%,治療組明顯高于對(duì)照組(P0.05)。3.CAT評(píng)分分析：治療組治療前后各指標(biāo)均有顯著改善(P0.01)。除家務(wù)、外出指標(biāo)外,對(duì)照組其他各指標(biāo)及CAT總分均有明顯減少(P0.05)。除胸悶、爬樓兩個(gè)癥狀外,其他各指標(biāo)治療組均優(yōu)于對(duì)照組(P0.05)�？傮w趨勢(shì)上,各時(shí)間節(jié)點(diǎn)上CAT評(píng)分呈遞減趨勢(shì),并且治療組優(yōu)于對(duì)照組。4.實(shí)驗(yàn)室檢查指標(biāo)分析：兩組均可使WBC、N%明顯改善(P0.05),但組間比較未見(jiàn)明顯差異(P0.05)。血?dú)夥治鲋笜?biāo)PH、PaCO2、PaO2明顯改善(P0.05),治療組優(yōu)于對(duì)照組(P0.05)。5.綜合療效評(píng)價(jià)：治療組總有效率82.14%,對(duì)照組總有效率67.39%,治療組綜合療效明顯高于對(duì)照組(P0.05)。6.入院情況比較：治療組共有10例患者入院治療,對(duì)照組共17例患者入院治療,減少入院情況比較,治療組明顯優(yōu)于對(duì)照組。7.安全性評(píng)價(jià)：治療后兩組患者血常規(guī)、肝腎功、心電圖及大小便常規(guī)檢測(cè)組內(nèi)比較,未發(fā)現(xiàn)明顯異常(P0.05),說(shuō)明兩種治療方案對(duì)血常規(guī)、肝腎功、心電圖均無(wú)明顯影響。結(jié)論：1.研究證實(shí)在西醫(yī)標(biāo)準(zhǔn)治療基礎(chǔ)上加用麻桔喘咳方,在改善患者咳嗽、咳痰、喘息、哮鳴等主要癥狀方面優(yōu)于西醫(yī)對(duì)照組,并且有助于腹脹、自汗、氣短等次要癥狀緩解。對(duì)于中醫(yī)證候總分及中醫(yī)癥狀療效率的改善亦有明顯優(yōu)勢(shì)。從整體趨勢(shì)上看,治療組與對(duì)照組無(wú)論是主要癥狀積分、次要癥狀積分還是癥狀總積分上,呈遞減趨勢(shì)。隨著治療時(shí)間的延長(zhǎng),無(wú)論對(duì)照組還是治療組,療效越來(lái)越好,并且治療組優(yōu)于對(duì)照組。2.研究發(fā)現(xiàn)麻桔喘咳方在痰液質(zhì)色量改善方面均具有明顯效果,西醫(yī)標(biāo)準(zhǔn)治療加用麻桔喘咳方在促進(jìn)痰液稀釋、痰色改變、痰液的排出等方面明顯優(yōu)于西醫(yī)對(duì)照組。3.本研究選用CAT評(píng)分作為AECOPD療效評(píng)價(jià)指標(biāo),多項(xiàng)研究證明CAT評(píng)分與SGRQ評(píng)分具有良好的相關(guān)性,且簡(jiǎn)便易行。研究結(jié)果顯示,西醫(yī)標(biāo)準(zhǔn)治療加用麻桔喘咳方在緩解咳嗽、咳痰等單項(xiàng)指標(biāo)及CAT總分方面優(yōu)于單純西醫(yī)組。在改善胸悶、爬樓兩指標(biāo)上與對(duì)照組療效相當(dāng)。從整體趨勢(shì)上看,治療組與對(duì)照組CAT積分呈遞減趨勢(shì),隨著治療時(shí)間的延長(zhǎng),其療效越來(lái)越好,并且治療組優(yōu)于對(duì)照組。4.實(shí)驗(yàn)室檢查方面,治療組在WBC、N%的改善上與對(duì)照組相當(dāng)。在改善血?dú)夥治鲋笜?biāo)上治療組優(yōu)于對(duì)照組,這可能跟治療組呼吸困難情況緩解較快有關(guān)。5.在綜合療效分析上,治療組有效率明顯優(yōu)于對(duì)照組,并能夠明顯減少病人的住院率。6.入院情況比較：治療組共有10例患者入院治療,對(duì)照組共17例患者入院治療,減少入院情況比較,治療組明顯優(yōu)于對(duì)照組。7.安全性評(píng)價(jià)：麻桔喘咳方用于治療慢性阻塞性肺疾病急性加重安全可靠。
[Abstract]:Objective: To evaluate the clinical efficacy and safety of matangchuan cough prescription in the treatment of AECOPD emergency patients, objectively analyze the application value of Ma tangchuan prescription in the treatment of A ECOPD, promote the practical transformation of my laboratory, provide early preparation and data support for the research and development of Chinese medicine new drugs. Method: 102 cases of AEOPD patients were selected by random control method. (46 cases in the control group, 56 cases in the treatment group), the treatment group was given the standard treatment of Western Medicine on the basis of Ma orange Chuan Fang, and the control group was given the standard treatment of Western medicine. The score of TCM symptoms, the change of sputum, the CAT score, the laboratory examination, the comprehensive therapeutic evaluation and so on were observed before and after the treatment. Results: 1. comparability analysis: two groups of patients were treated before treatment. The general conditions (age, sex, smoking history), general conditions (systolic pressure, diastolic pressure, respiration, heart rate, body temperature, BMI), the severity of the disease (course of disease, CAT score, TCM symptoms total, acute attack times, mMRC score) were not statistically significant (P0.05), the two groups were comparable to.2. syndrome analysis: the two groups could make the symptoms of traditional Chinese medicine obviously changed The curative effect of the treatment group was obviously better than the control group (P0.05). On the general trend, the TCM syndrome score of each time node was reduced, and the treatment group was better than the control group. The treatment group was obviously superior to the control group (P0.05) in the change of sputum (phlegm quality, color and quantity). The total effective rate of the treatment group was 85.71% in the treatment group, and the control group was always in the control group. Efficiency 65.21%, the treatment group was significantly higher than the control group (P0.05).3.CAT score analysis: the treatment group had significant improvement (P0.01) before and after treatment. Except for housework and outgoing index, the other indexes and the total score of CAT in the control group were significantly decreased (P0.05). Except for chest tightness and two symptoms of climbing the building, all the other indexes were better than the control group (P0.05). On the overall trend, the CAT score on each time node was reduced, and the treatment group was better than the control group.4. laboratory examination index analysis: the two groups could make WBC and N% obviously improve (P0.05), but there was no significant difference between the groups (P0.05). The blood gas analysis index PH, PaCO2, PaO2 obviously improved (P0.05), the treatment group was superior to the control group (P0.05).5. comprehensive therapy. Efficacy evaluation: the total effective rate of the treatment group was 82.14%, the total effective rate of the control group was 67.39%. The comprehensive curative effect of the treatment group was obviously higher than that of the control group (P0.05).6. admission. There were 10 patients in the treatment group, and 17 patients in the control group were admitted to hospital. The treatment group was significantly better than the control group.7. safety evaluation: the treatment group was obviously better than the control group. In the latter two groups, the blood routine, liver and kidney work, electrocardiogram and stool routine test group were compared, no obvious abnormalities were found (P0.05), indicating that the two treatments had no obvious influence on blood routine, liver and kidney work and electrocardiogram. Conclusion: the 1. study confirmed the addition of matangchuan prescription on the basis of standard treatment of Western medicine, and improved the patient's cough, expectoration, wheezing and asthma. The main symptoms are better than the western medicine control group, and it helps to relieve the symptoms of abdominal distention, self perspiration and shortness of breath. It also has obvious advantages for the total score of TCM syndrome and the improvement of the treatment efficiency of TCM symptoms. In the whole trend, the treatment group and the control group are the main symptom score, the secondary symptom score or the total symptom integral, and the presentation of the symptoms. With the prolongation of the treatment time, the curative effect was better and better in both the control group and the treatment group, and the treatment group was better than the control group.2. research found that matangchuan cough prescription had obvious effect on the improvement of the quality of the sputum, and the standard treatment of Western medicine plus matangchuan prescription was in the stimulation of the sputum dilution, the phlegm color change and the excretion of sputum. .3. was obviously better than the western medicine control group. The CAT score was selected as the evaluation index of the curative effect of AECOPD. A number of studies have proved that the CAT score has a good correlation with the SGRQ score, and it is simple and easy. The results of the study show that the standard treatment of Western medicine plus Ma tangchuan prescription is better than the simple western medicine in relieving the single index of cough, expectoration and the total score of the expectoration. On the whole trend, the CAT score of the treatment group and the control group decreased and the curative effect was better and better, and the treatment group was better than the control group.4. laboratory examination. The treatment group was equal to the control group in the improvement of WBC and N% in the improvement of blood. The treatment group was better than the control group on the gas analysis, which may be related to the rapid remission of the dyspnea in the treatment group. The effective rate of the.5. in the treatment group was obviously superior to the control group. The treatment group could obviously reduce the hospitalization rate of the patients with.6. admission. 10 patients in the treatment group were admitted to hospital, and 17 patients in the control group were admitted to hospital. The treatment group was better than the control group.7. safety evaluation. The treatment group was better than the control group. It was safe and reliable for the treatment of acute exacerbation of chronic obstructive pulmonary disease.
【學(xué)位授予單位】：成都中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R256.1

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本文編號(hào)：1941093