本文選題：加味麻辛附子湯 + 慢性阻塞性肺疾病急性加重期��； 參考：《云南中醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:通過(guò)對(duì)具有溫腎補(bǔ)肺、化痰止咳平喘之功的加味麻辛附子湯配合西藥治療慢阻肺急性加重期(肺腎陽(yáng)虛型)患者的炎性指標(biāo)干預(yù)性臨床觀察,進(jìn)一步驗(yàn)證加味麻辛附子湯治療慢阻肺急性加重期的有效性,從而彰顯中醫(yī)藥在急性病治療方面的優(yōu)勢(shì)。方法:本課題在云南省中醫(yī)醫(yī)院肺病科住院部按預(yù)期納入標(biāo)準(zhǔn)選擇病例72例作為選受試對(duì)象,告知其本次試驗(yàn)性質(zhì)及目的,并得到受試者本人及家屬的同意,承諾按試驗(yàn)的方法規(guī)律服藥,直到試驗(yàn)結(jié)束,納入觀察的患者采用隨機(jī)分組法,隨機(jī)分為治療組36例和對(duì)照組36例。對(duì)照組在基礎(chǔ)治療上給予西藥治療;治療組與對(duì)照組采用相同西醫(yī)常規(guī)治療,在此基礎(chǔ)上加用加味麻辛附子湯治療組療程15天,15天后觀察兩組患者在治療前和治療后的綜合臨床療效,并對(duì)兩組患者治療前后各項(xiàng)指標(biāo)進(jìn)行比較,參照《中藥新藥臨床研究原則》相關(guān)為主要依據(jù)做出評(píng)分標(biāo)準(zhǔn)。結(jié)果:計(jì)劃觀察72例,實(shí)際觀察72例,治療組36例,對(duì)照組36例。治療前兩組患者性別、年齡無(wú)顯著差異,具有可比性。經(jīng)統(tǒng)計(jì)計(jì)算治療組總有效率為88.8%,與對(duì)照組77.8%比較,其差異顯著,具有統(tǒng)計(jì)學(xué)意義。綜合兩組患者治療前后的中醫(yī)證候積分、療效性指標(biāo)、安全性指標(biāo)進(jìn)行比較,可以得出:(1)兩組治療前中醫(yī)癥狀積分、動(dòng)脈血?dú)夥治�、炎性指�?biāo)、血常規(guī)、肺功能、住院時(shí)間、安全性指標(biāo)等無(wú)明顯差異,無(wú)統(tǒng)計(jì)學(xué)意義,具有可比性;(2)治療后兩組安全性指標(biāo)吸、心率、血壓、肝功(AST、ALT)、腎功(Cr、UREA)比較無(wú)明顯差異,無(wú)統(tǒng)計(jì)學(xué)意義,說(shuō)明本次研究觀察安全可靠;(3)治療后兩組中醫(yī)主要癥狀(咳嗽、咳痰、喘息、氣短)及次要癥狀(畏寒、唇甲青紫、腰膝酸冷)積分比較均有顯著差異,具有統(tǒng)計(jì)學(xué)意義;(4)治療后兩組炎性指標(biāo)SAA、hs CRP治療組改善優(yōu)于對(duì)照組,差異顯著,具有統(tǒng)計(jì)學(xué)意義;PCT治療前后無(wú)明顯變化,無(wú)顯著差異,無(wú)統(tǒng)計(jì)學(xué)意義,說(shuō)明本次選擇觀察的慢阻肺急性加重患者PCT無(wú)明顯變化;(5)治療后兩組血常規(guī)比較,治療組WBC(109/L)、NEUT(%)降低明顯優(yōu)于對(duì)照組,差異明顯,具有統(tǒng)計(jì)學(xué)意義;(6)治療后兩組動(dòng)脈血?dú)獗容^,有顯著差異,具有統(tǒng)計(jì)學(xué)意義;(7)治療后兩組住院時(shí)間比較,治療組住院時(shí)間少于對(duì)照組,具有明顯差異,具有統(tǒng)計(jì)學(xué)意義。結(jié)論:通過(guò)本課題的研究,運(yùn)用中西醫(yī)結(jié)合的方法比單純西藥更能有效的控制慢阻肺急性發(fā)作,綜合兩組患者治療前后的中醫(yī)證候積分、療效性指標(biāo)、安全性指標(biāo)進(jìn)行比較分析得出:(1)對(duì)患者呼吸、心率、血壓、肝功、腎功能等安全性指標(biāo)無(wú)明顯影響,說(shuō)明本次觀察安全;(2)在改善患者臨床癥狀、炎性指標(biāo)、血常規(guī)、動(dòng)脈血?dú)�、肺功能等方面治療組優(yōu)于對(duì)照組;(3)在縮短應(yīng)用抗菌素和住院時(shí)間上治療組明顯優(yōu)于對(duì)照組;(4)證實(shí)了說(shuō)明中醫(yī)中藥在治療急性病方面的有效性。
[Abstract]:Objective: to observe the inflammatory indexes of the patients with chronic obstructive pulmonary disease (COPD) in acute exacerbation (deficiency of lung and kidney yang) treated by modified Maxinfuzi decoction and western medicine, which has the function of warming the kidney and tonifying the lung, eliminating phlegm and relieving cough and relieving asthma. To further verify the effectiveness of modified Maxinfuzi decoction in the treatment of acute exacerbation of chronic obstructive pulmonary disease, thus highlighting the advantages of traditional Chinese medicine in the treatment of acute diseases. Methods: according to the expected inclusion criteria, 72 cases were selected from the Department of Lung Disease of Yunnan traditional Chinese Medicine Hospital as subjects, and the nature and purpose of the trial were informed, and the consent of the subjects and their families was obtained. The patients were randomly divided into treatment group (n = 36) and control group (n = 36). The control group was treated with western medicine on the basis of basic treatment, while the treatment group and the control group were treated with the same routine western medicine. On this basis, the comprehensive clinical efficacy of the two groups before and after treatment was observed after 15 days and 15 days of treatment, and the indexes before and after treatment were compared between the two groups. According to the principles of Clinical Research of New Chinese Medicine, the main basis of scoring criteria was made. Results: 72 cases were planned, 72 cases were observed, 36 cases in treatment group and 36 cases in control group. There was no significant difference in sex and age between the two groups before treatment. The total effective rate of the treatment group was 88.8%, which was significantly higher than that of the control group (77.8%). By comparing the TCM syndromes, curative indexes and safety indexes before and after treatment, we can draw the following conclusions: (1) before and after treatment, the TCM symptom score, arterial blood gas analysis, inflammatory index, blood routine examination, lung function, hospitalization time, There was no significant difference in safety indexes between the two groups. (2) there was no significant difference between the two groups in terms of inhaling, heart rate, blood pressure, liver function (alt), renal function (Crus UREA), and there was no significant difference between the two groups. The results showed that this study was safe and reliable. (3) there were significant differences in scores of main symptoms (cough, expectoration, wheezing, shortness of breath) and secondary symptoms (chills, bluish lips, cold waist and knee acid) between the two groups after treatment. (4) after treatment, the inflammatory index SAAHs CRP in the two groups was improved better than that in the control group, the difference was significant, and there was no significant change, no significant difference and no statistical significance before and after treatment with PCT. The results showed that PCT had no significant change in patients with acute exacerbation of chronic obstructive pulmonary disease. (5) after treatment, the WBC (109 / L) net (%) in the treatment group was significantly lower than that in the control group, and the difference was significant. (6) the arterial blood gas of the two groups after treatment was significantly lower than that of the control group. There are significant differences, with statistical significance; (7) after the treatment of the two groups of hospitalization time comparison, the treatment group is less than the control group, there is a significant difference, with statistical significance. Conclusion: through the research of this subject, the method of combination of traditional Chinese and western medicine is more effective than western medicine in controlling acute attack of chronic obstructive pulmonary disease (COPD), and synthesizing TCM syndromes integral and curative effect index of two groups before and after treatment. The safety indexes were compared and analyzed: (1) there was no significant effect on the safety indexes such as respiration, heart rate, blood pressure, liver function and renal function, which indicated that this observation was safe; (2) it was improving the clinical symptoms, inflammatory indexes, blood routine examination, arterial blood gas, etc. The treatment group was superior to the control group in terms of lung function; (3) the treatment group was superior to the control group in shortening the use of antibiotics and hospital stay; (4) proved the effectiveness of TCM in the treatment of acute diseases.
【學(xué)位授予單位】：云南中醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R259

【參考文獻(xiàn)】

中國(guó)期刊全文數(shù)據(jù)庫(kù) 前10條

1 王媛;張華麗;張勇;;COPD急性加重期患者血清SAA、PCT、hs-CRP水平變化及意義[J];陜西醫(yī)學(xué)雜志;2015年05期

2 余珈漫;陸怡德;;PCT、hs-CRP及SAA檢測(cè)在感染性疾病診斷中的臨床應(yīng)用價(jià)值[J];實(shí)用檢驗(yàn)醫(yī)師雜志;2014年04期

3 肖義萍;;補(bǔ)中益氣湯對(duì)慢性阻塞性肺疾病急性加重期患者肺功能的影響[J];世界中醫(yī)藥;2013年09期

4 汪遠(yuǎn)明;;陳湯加味治療慢性阻塞性肺疾病急性加重期痰濁阻肺型臨床療效觀察[J];吉林醫(yī)學(xué);2013年24期

5 曾湘;黃磊;伍世葵;;溫腎清肺飲治療慢性阻塞性肺疾病急性加重期30例臨床觀察[J];中醫(yī)藥導(dǎo)報(bào);2013年05期

6 李樹(shù)強(qiáng);何啟揚(yáng);蔡陽(yáng)娥;;從炎癥細(xì)胞因子研究清氣化痰湯對(duì)慢性阻塞性肺疾病急性加重期的作用機(jī)制[J];中國(guó)中醫(yī)藥信息雜志;2013年05期

7 羅志泉;;補(bǔ)中益氣湯聯(lián)合舒利迭治療支氣管哮喘緩解期的臨床療效觀察[J];吉林醫(yī)學(xué);2012年34期

8 李俊;陳弘群;蔣世峰;謝駿;余榮環(huán);曲毅;;血清降鈣素原和超敏C-反應(yīng)蛋白在AECOPD的作用[J];臨床肺科雜志;2012年08期

9 徐新毅;葛正行;;活血化痰苗藥“滇瓜散”對(duì)慢性阻塞性肺疾病急性加重期血栓前狀態(tài)干預(yù)的臨床研究[J];遼寧中醫(yī)雜志;2011年09期

10 梁偉雄;;瀉下通腑法在慢性阻塞性肺疾病急性加重期的應(yīng)用[J];中國(guó)醫(yī)藥指南;2011年19期

中國(guó)碩士學(xué)位論文全文數(shù)據(jù)庫(kù) 前1條

1 楊金星;活血化瘀法對(duì)COPD模型大鼠氣道重塑影響作用的初步探討[D];云南中醫(yī)學(xué)院;2013年

，

本文編號(hào)：2114313