本文選題：哮喘-慢阻肺重疊綜合征 + 陽和平喘顆粒�。� 參考：《安徽中醫(yī)藥大學》2016年碩士論文

【摘要】：目的初步觀察ACOS中醫(yī)證候分布特點;陽和平喘顆粒治療ACOS非緩解期患者的臨床療效及對血清炎癥因子IL-4、IFN-γ、IL-8、IL-10的影響。方法1采用橫斷面調查方法,填寫ACOS中醫(yī)證候觀察表,對ACOS中醫(yī)證候分布特點進行初步的臨床觀察。2收集符合納入標準的40例ACOS患者,隨機分配到治療組和對照組,每組各20例。對照組以常規(guī)西醫(yī)治療為主,治療組在對照組的基礎上加用陽和平喘顆粒治療。觀察兩組患者治療前后中醫(yī)證候積分、肺功能指標(FEV1、FVC、FEV1/FVC及FEV1%預計值)、血清炎癥因子(IL-4、IFN-γ、IL-8及IL-10)和生活質量評分的變化。結果1 ACOS中醫(yī)證候初步觀察ACOS發(fā)病以男性居多,吸煙史較長,誘發(fā)本病發(fā)作的因素以氣候變化為甚,肺功能分級在重度以上者占82.5%;以咳嗽、咳痰、胸悶所占頻數(shù)最多是本病的主癥;中醫(yī)證型以熱證居多,其中熱夾痰證最多,其次是熱夾瘀證,再者是寒夾虛證。2陽和平喘顆粒對ACOS非緩解期患者中醫(yī)證候積分的影響兩組治療前中醫(yī)證候積分比較差異無統(tǒng)計學意義(P0.05);兩組治療后中醫(yī)證候積分較治療前均明顯降低(P0.01)。治療組治療后中醫(yī)證候積分與對照組治療后比較差異有統(tǒng)計學意義(P0.05)。治療組中醫(yī)證候療效(85%)高于對照組(60%)差異有統(tǒng)計學意義(P0.05)。3陽和平喘顆粒對ACOS非緩解期患者肺功能的影響兩組治療前FVC、FEV1、FEV1%預計值及FEV1/FVC比較差異均無統(tǒng)計學意義(P0.05)。治療后兩組FVC、FEV1、FEV1%預計值及FEV1/FVC較治療前均升高(P0.01或P0.05)。治療組治療后FVC、FEV1、FEV1%預計值及FEV1/FVC與對照組治療后比較差異有統(tǒng)計學意義(P0.05)。4陽和平喘顆粒對ACOS非緩解期患者血清指標的影響兩組治療前血清IL-4、IFN-γ、IL-8及IL-10水平比較差異無統(tǒng)計學意義(P0.05)。治療后兩組血清IL-4、IL-8水平較治療前均降低(P0.01或P0.05),血清IFN-γ、IL-10水平較治療前均升高(P0.01或P0.05)。治療組治療后血清IL-4、IFN-γ、IL-8及IL-10水平與對照組治療后比較差異有統(tǒng)計學差異(P0.05)。5陽和平喘顆粒對ACOS非緩解期患者生活質量評分的影響兩組治療前CAT評分比較差異無統(tǒng)計學意義(P0.05);兩組治療后CAT評分較治療前均降低(P0.01);治療組治療后CAT評分與對照組治療后比較差異無統(tǒng)計學意義(P0.05),但治療組下降更明顯。結論1在40例ACOS患者中,中醫(yī)證型以熱證居多,虛、瘀、痰是重要的兼證。2陽和平喘顆粒在西醫(yī)治療的基礎上可提高ACOS非緩解期患者的中醫(yī)證候積分、生活質量評分,改善患者的肺功能。3陽和平喘顆粒在西醫(yī)治療的基礎上能降低ACOS非緩解期患者血清炎癥因子IL-4、IL-8水平,升高IFN-γ、IL-10水平。
[Abstract]:Objective to observe the distribution of TCM syndromes of ACOS, the clinical effect of Yanghe Pingchuan granule on non-remission ACOS patients and the influence of IL-4, IFN- 緯, IL-8 and IL-10 on serum inflammatory factor IL-4, IFN- 緯, IL-8 and IL-10 in patients with ACOS. Methods 1 A cross-sectional investigation was used to fill out the observation form of TCM syndrome of ACOS. The clinical observation of the distribution of TCM syndromes of ACOS was carried out. 2. 40 ACOS patients who met the inclusion criteria were randomly assigned to the treatment group and the control group. There were 20 cases in each group. The control group was treated mainly by routine western medicine, and the treatment group was treated with Yang and Pingchuan granules on the basis of the control group. The scores of TCM syndromes, pulmonary function indexes, FEV1 / FVC and FEV1% predicted values, serum inflammatory factors (IL-4, IFN- 緯, IL-8 and IL-10) and quality of life (QOL) were observed before and after treatment in both groups. Results 1 Primary observation of TCM syndromes of ACOS showed that the incidence of ACOS was mostly male, smoking history was longer, the factors inducing ACOS attack were climate change, 82.5% of the patients with severe grade of lung function were cough, sputum, cough, phlegm, and so on. The frequency of chest tightness is the main symptom of the disease, heat syndrome is the most common type of TCM syndromes, among which heat clamping phlegm syndrome is the most, followed by heat and stasis syndrome. Furthermore, there was no significant difference in TCM syndromes score between the two groups before treatment (P 0.05N), and after treatment, the TCM syndrome score of the two groups were significantly lower than that of the control group (P 0.01). 2. The effect of Han Jia deficiency Syndrome on TCM syndromes integral in patients with ACOS during non-remission period was not statistically significant (P0.05N), and the scores of TCM syndromes after treatment in two groups were significantly lower than those before treatment. The scores of TCM syndrome in the treatment group were significantly different from those in the control group (P 0.05). The effect of TCM syndromes in the treatment group (85) was higher than that in the control group (60). There was no significant difference in the effect of P0.050.3-Yang and Pingchuan granule on lung function of patients with ACOS during non-remission period before treatment. There was no significant difference in the predicted value of FEV1 / FEV1 and FEV1 / FVC before treatment between the two groups. After treatment, the predicted FEV1 / FEV1% and FEV1 / FVC in both groups were significantly higher than those before treatment (P0.01 or P0.05). There was significant difference in the predicted value of FEV1 / FEV1% and the difference of FEV1 / FVC between the treatment group and the control group after treatment. The effect of P0.05.4 Yang and Pingchuan granule on serum indexes of patients with ACOS during non-remission period had no significant difference between the two groups before treatment. There was no significant difference in the levels of IL-4 IFN- 緯 -IL-8 and IL-10 between the two groups before treatment. After treatment, the serum levels of IL-4, IL-8 and IFN- 緯 -IL-10 in both groups were lower than those before treatment, respectively, and the levels of serum IFN- 緯 -IL-10 were higher than those before treatment (P0.01 or P0.05). Effect of serum IL-4, IFN- 緯 -IL-8 and IL-10 levels after treatment on quality of life score of non-remission ACOS patients in the treatment group and control group, there was no significant difference between the two groups in terms of cat score before treatment. The cat score of the treatment group was lower than that of the control group, but the cat score of the treatment group was lower than that of the control group, but the decrease of the cat score in the treatment group was more obvious than that in the control group. Conclusion (1) in 40 patients with ACOS, heat syndrome, deficiency, blood stasis and phlegm are the most important syndromes in 40 patients with ACOS. On the basis of western medicine treatment, the TCM syndromes integral and quality of life score of ACOS patients with non-remission period can be improved. On the basis of western medicine treatment, the improvement of pulmonary function in patients with ACOS can reduce the level of IL-4 and IL-8, and increase the level of IFN- 緯 -IL-10 in patients with ACOS.
【學位授予單位】：安徽中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R259

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