【摘要】：目的:本課題主要通過(guò)中西醫(yī)診斷標(biāo)準(zhǔn)選取的60例病例,進(jìn)行對(duì)比、觀察臨床療效,合理闡述腸胃濕熱,肺絡(luò)痹阻對(duì)肺痹的影響及其病因病機(jī),進(jìn)一步評(píng)價(jià)瀉濁宣痹湯治療肺痹邪盛痹重期(腸胃濕熱,肺絡(luò)痹阻)的有效性、及時(shí)性及安全性,觀察其治療本病標(biāo)證的可行性;完善導(dǎo)師王檀教授對(duì)于腸胃濕熱對(duì)間質(zhì)性肺疾病影響的理論內(nèi)涵。方法:病例皆來(lái)源于2014年12月至2016年2月長(zhǎng)春中醫(yī)藥大學(xué)附屬醫(yī)院肺病科門診及住院患者,對(duì)符合診斷標(biāo)準(zhǔn)、納入標(biāo)準(zhǔn),經(jīng)剔除標(biāo)準(zhǔn)篩選的入選病例作為受試對(duì)象,共計(jì)納入60例,將患者隨機(jī)分為對(duì)照組(乙酰半胱氨酸泡騰片+羅紅霉素片)和觀察組(在對(duì)照組基礎(chǔ)上,服用瀉濁宣痹湯),每組30例。兩組一般資料及治療前主次癥、理化檢查:肺功能(VC、DLco值);血氧飽和度;六分鐘步行試驗(yàn),經(jīng)統(tǒng)計(jì)學(xué)檢驗(yàn)有無(wú)差異。經(jīng)過(guò)1周的臨床觀察,對(duì)比治療前后的主次癥及理化檢查,評(píng)價(jià)瀉濁宣痹湯治療肺痹邪盛痹重期(腸胃濕熱,肺絡(luò)痹阻)的療效。結(jié)果:經(jīng)臨床觀察及統(tǒng)計(jì)學(xué)分析得出,瀉濁宣痹湯對(duì)肺痹·邪盛痹重期(腸胃濕熱,肺絡(luò)痹阻)的治療,其總療效顯效率,有效率,均優(yōu)于對(duì)照組,且具有顯著差異(P0.05)。通過(guò)此臨床觀察可知,瀉濁宣痹湯對(duì)肺痹·邪盛痹重期(腸胃濕熱,肺絡(luò)痹阻)的主癥及次癥改善均比較明顯,尤其在改善次要癥狀:口中異味,脘腹脹滿,排便困難、便質(zhì)粘膩等方面尤其突出。對(duì)比觀察組及對(duì)照組治療前后的肺功能(VC、DLco)、血氧飽和度、六分鐘步行試驗(yàn),在治療前后均有差異,治療后優(yōu)于治療前。然而兩組之間比較后無(wú)明顯差異,即提示瀉濁宣痹湯在理化檢查方面無(wú)額外優(yōu)勢(shì),中醫(yī)治療重在調(diào)整當(dāng)前腸胃濕熱狀態(tài),改善臨床癥狀。結(jié)論:瀉濁宣痹湯可明顯改善肺痹邪盛痹重期(腸胃濕熱,肺絡(luò)痹阻)患者的臨床癥狀,快速去除加重肺痹進(jìn)展或復(fù)發(fā)的影響因素,使肺痹的本質(zhì)-肺氣不足,肺中虛冷充分暴露,進(jìn)而及早進(jìn)入對(duì)其本質(zhì)治療。其臨床療效確切,安全可靠,發(fā)揮了中醫(yī)藥辨證施治的優(yōu)勢(shì),縮短了治療療程,最大程度地減輕了患者痛苦。
[Abstract]:Objective: to compare 60 cases selected by traditional Chinese and western medicine diagnostic criteria, observe the clinical curative effect, expound the influence of dampness and heat of stomach and the obstruction of lung collaterals on lung arthralgia and its etiology and pathogenesis. To further evaluate the efficacy, timeliness and safety of Xiezhuxuanbi decoction in treating the severe stage of lung arthralgia, including dampness and heat of the stomach and collaterals of the lung, and to observe the feasibility of the treatment of the standard syndrome of this disease. Improve the theoretical implications of tutors Professor Wang Tan on interstitial lung disease caused by intestinal dampness and heat. Methods: all the cases were collected from December 2014 to February 2016 in the Department of Pulmonary Diseases of Changchun University of traditional Chinese Medicine. The patients who met the diagnostic criteria were included in the criteria, and the selected cases selected by the exclusion criteria were selected as the subjects. A total of 60 patients were randomly divided into control group (acetylcysteine effervescent tablets roxithromycin tablets) and observation group (on the basis of control group, taking Xiezhuxuanbi decoction), 30 cases in each group. Physical and chemical examination: pulmonary function (VCU DLCO value); blood oxygen saturation; 6-minute walking test. After 1 week's clinical observation, comparing the primary and secondary symptoms and physical and chemical examination before and after treatment, the curative effect of Xiezhuoxuanbi decoction (XZXB) on the severe stage of lung arthralgia with dampness and heat of the stomach and obstruction of the collaterals of the lung was evaluated. Results: the clinical observation and statistical analysis showed that Xiezhuxuanbi decoction was better than the control group in the treatment of the severe stage of lung arthralgia (enterogastric dampness and heat, obstruction of the lung collaterals and arthralgia), and there was significant difference (P0.05). According to this clinical observation, Xiezhuxuanbi decoction can obviously improve the main symptoms and secondary symptoms of lung arthralgia, especially in improving secondary symptoms, such as peculiar smell in mouth, full abdominal distention, difficulty in defecation, and difficulty in defecation, especially in the improvement of secondary symptoms: peculiar smell in mouth, full abdominal distention, and difficulty in defecation. The fecal quality is sticky and greasy, etc. The pulmonary function (VCU DLco), blood oxygen saturation and six minute walking test before and after treatment in the observation group and the control group were all different before and after treatment, and were better than before and after treatment. However, there is no significant difference between the two groups after comparison, that is, Xiesezhuo Xuanbi decoction has no additional advantages in physical and chemical examination, and TCM treatment focuses on adjusting the current state of intestinal dampness and heat and improving clinical symptoms. Conclusion: Xiezhuxuanbi decoction can obviously improve the clinical symptoms of the patients in the severe stage of lung arthralgia, such as dampness and heat of the stomach, obstruction of the collaterals of the lung, quickly remove the influencing factors that aggravate the progress or relapse of the lung arthralgia, and make the essence of the lung arthralgia-the deficiency of lung qi. Deficiency cold in the lung is fully exposed, and then enter into the treatment of its essence as soon as possible. Its clinical curative effect is exact, safe and reliable, it exerts the advantage of TCM syndrome differentiation and treatment, shortens the course of treatment, and relieves the patient's pain to the greatest extent.
【學(xué)位授予單位】：長(zhǎng)春中醫(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)】：R259

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