【摘要】：目的:通過觀察補(bǔ)益肺腎法對慢性阻塞性肺疾病穩(wěn)定期肺腎氣虛型患者的臨床療效,驗(yàn)證補(bǔ)益肺腎法的可行性,對中醫(yī)藥治療慢性阻塞性肺疾病穩(wěn)定期提供一種新的有效的方法。材料與方法:本次臨床研究對象均為2014年12月-2016年6月期間于遼寧中醫(yī)藥大學(xué)附屬第二醫(yī)院肺病門診就診的慢性阻塞性肺疾病穩(wěn)定期肺腎氣虛型患者,采用隨機(jī)分組的方法,將65例符合納入標(biāo)準(zhǔn)的患者分為治療組和對照組,治療組32例,對照組33例。對照組采用西醫(yī)常規(guī)治療:沙美特羅替卡松粉吸入劑(商品名:舒利迭),規(guī)格:50ug/500ug,每次1吸,每日2次;治療組在西醫(yī)常規(guī)治療的基礎(chǔ)上加用以補(bǔ)益肺腎為法的保金益腎膏。療程均為三個(gè)月。于治療前后測評兩組單項(xiàng)癥狀評分,中醫(yī)證候總評分,肺功能,生活質(zhì)量評估問卷評分(CAT)等相關(guān)指標(biāo)。于治療前和隨訪后測評兩組急性加重次數(shù)指標(biāo)。并用SPSS17.0統(tǒng)計(jì)軟件包對其結(jié)果進(jìn)行統(tǒng)計(jì)分析。結(jié)果:1.治療組與對照組在性別、年齡、病程、肺功能分級、癥狀評分、生活質(zhì)量問卷評分、急性加重次數(shù)上均無顯著性差異(P0.05),具有可比性。2.急性加重次數(shù)方面:治療組隨訪后急性加重次數(shù)減少(P0.05);對照組隨訪后急性加重次數(shù)沒有減少(P0.05);隨訪后兩組比較有顯著性差異(P0.05)。3.臨床癥狀方面:治療組治療后喘息,氣短,咳嗽,咯痰,惡風(fēng),腰膝酸軟等六項(xiàng)癥狀評分均有所下降(P0.05);對照組治療后喘息,氣短,咳嗽,咯痰,惡風(fēng)等五項(xiàng)癥狀評分均有所下降(P0.05);兩組治療后在咳嗽,氣短,惡風(fēng),腰膝酸軟等四項(xiàng)指標(biāo)方面有顯著性差異(P0.05),治療組優(yōu)于對照組。4.中醫(yī)證候積分方面:治療組治療后中醫(yī)證候總積分有所下降(P0.05);對照組治療后中醫(yī)證候總積分有所下降(P0.05);治療后組間比較有顯著性差異(P0.05),治療組優(yōu)于對照組。5.肺功能方面:治療組治療后FEV1%、FEV1/FVC%指標(biāo)有所改善(P0.05);對照組治療后FEV1%、FEV1/FVC%指標(biāo)有所改善(P0.05);治療后組間比較無顯著性差異(P0.05)。6.生存質(zhì)量方面:治療組治療后生活質(zhì)量評分有所改善(P0.05);對照組治療后生活質(zhì)量評分有所改善(P0.05);治療后組間比較有顯著性差異(P0.05),治療組優(yōu)于對照組。結(jié)論:通過對補(bǔ)益肺腎法治療慢性阻塞性肺疾病穩(wěn)定期肺腎氣虛型患者的臨床觀察,療效顯著,說明補(bǔ)益肺腎法針對慢性阻塞性肺疾病穩(wěn)定期的治療有效。
[Abstract]:Objective: to observe the clinical effect of tonifying the lung and kidney in patients with chronic obstructive pulmonary disease (COPD) during the stable period of lung and kidney qi deficiency, and to verify the feasibility of tonifying the lung and kidney. It provides a new and effective method for the treatment of chronic obstructive pulmonary disease. Materials and methods: the subjects of this clinical study were all patients with chronic obstructive pulmonary disease (COPD) in stable phase of lung and kidney qi deficiency in the second affiliated Hospital of Liaoning University of traditional Chinese Medicine from December 2014 to June 2016. 65 patients were divided into treatment group (n = 32) and control group (n = 33). The control group was treated with routine western medicine: salmeterol fluticasone powder inhaler (commodity name: Schullide), specification: 50ugr / 500ug. once a day, twice a day; Treatment group on the basis of western medicine routine treatment plus to tonify the lung and kidney as the method of Baojin Yishen ointment. The course of treatment was three months. The single symptom score, TCM syndrome score, lung function, quality of life assessment scale (CAT) were evaluated before and after treatment. The indexes of acute exacerbation were measured before treatment and after follow-up. The results were analyzed by SPSS17.0 software package. The result is 1: 1. There was no significant difference between treatment group and control group in sex, age, course of disease, pulmonary function grade, symptom score, quality of life questionnaire score, acute exacerbation times (P0.05). Acute exacerbation times: the treatment group after follow-up acute exacerbation times decreased (P0.05); the control group after follow-up acute exacerbation times did not decrease (P0.05); after follow-up there was a significant difference between the two groups (P0.05). Clinical symptoms: the treatment group after the treatment of wheezing, shortness of breath, cough, sputum, evil wind, waist and knee weakness and other six symptom scores have decreased (P0.05); In the control group, the scores of wheezing, shortness of breath, cough, sputum and evil wind were all decreased after treatment (P0.05). There were significant differences between the two groups in cough, shortness of breath, bad wind, waist and knee weakness and other four indexes (P0.05), the treatment group was better than the control group. 4. TCM syndromes integral: treatment group after treatment the total score of TCM syndromes decreased (P0.05); the control group after treatment of TCM syndromes total score decreased (P0.05); After treatment there was a significant difference between the groups (P0.05), the treatment group was better than the control group. Lung function: treatment group after treatment FEV1%,FEV1/FVC% index improved (P0.05); control group after treatment FEV1%,FEV1/FVC% index improved (P0.05); after treatment there was no significant difference between groups (P0.05). Quality of life: the quality of life score improved after treatment in the treatment group (P0.05), the quality of life score improved after treatment in the control group (P0.05). After treatment there was significant difference between the groups (P0.05), the treatment group was better than the control group. Conclusion: the clinical observation of tonifying the lung and kidney method in treating chronic obstructive pulmonary disease patients with deficiency of lung and kidney qi in stable period shows that the method of tonifying the lung and kidney is effective in treating chronic obstructive pulmonary disease in stable period.
【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】：R259

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