【摘要】：目的:本研究通過觀察培土生金法(培土生金湯加減)治療間質(zhì)性肺疾病(脾氣虛證)患者,觀察患者治療前后中醫(yī)疾病臨床表現(xiàn)癥候積分、脾氣虛證臨床表現(xiàn)癥候積分、肺功能指標(biāo)TLC%預(yù)計(jì)值和DLCO%預(yù)計(jì)值、未吸氧指脈氧飽和度、影像學(xué)表現(xiàn)評(píng)分、六分鐘步行試驗(yàn)距離、臨床綜合療效方面的改善情況,從而闡明培土生金法對(duì)間質(zhì)性肺疾病的治療作用,為中醫(yī)治療該疾病提供新的臨床依據(jù)。方法:對(duì)40例符合間質(zhì)性肺疾病診斷標(biāo)準(zhǔn),且符合中醫(yī)脾氣虛證診斷標(biāo)準(zhǔn)的患者,采用隨機(jī)分組原則分為兩組,分別為試驗(yàn)組與對(duì)照組,每組各20例,試驗(yàn)組采用西醫(yī)常規(guī)治療方案聯(lián)合中藥(培土生金湯加減)治療,對(duì)照組采用西醫(yī)常規(guī)治療方案。兩組連續(xù)治療觀察3個(gè)月。分別比較兩組患者治療前后的中醫(yī)疾病臨床表現(xiàn)癥候積分、脾氣虛證臨床表現(xiàn)癥候積分、肺功能指標(biāo)TLC%預(yù)計(jì)值和DLCO%預(yù)計(jì)值、未吸氧指脈氧飽和度、影像學(xué)表現(xiàn)評(píng)分、六分鐘步行試驗(yàn)距離、臨床綜合療效,并運(yùn)用統(tǒng)計(jì)學(xué)方法評(píng)判兩組治療的臨床療效。結(jié)果:經(jīng)統(tǒng)計(jì)學(xué)檢驗(yàn),治療前后,在改善中醫(yī)疾病臨床表現(xiàn)癥狀積分、脾氣虛證癥狀積分、肺功能指標(biāo)TLC%預(yù)計(jì)值和DLCO%預(yù)計(jì)值、未吸氧指脈氧飽和度、六分鐘步行距離方面,兩組進(jìn)行組內(nèi)比較,P0.05,有顯著統(tǒng)計(jì)學(xué)差異,試驗(yàn)組與對(duì)照組的患者在上述指標(biāo)方面皆得到明顯改善;治療后兩組之間進(jìn)行上述比較,P0.05,有顯著統(tǒng)計(jì)學(xué)差異,試驗(yàn)組患者在上述指標(biāo)方面的改善程度明顯優(yōu)于對(duì)照組患者,說明培土生金湯加減聯(lián)合西醫(yī)治療組在改善上述指標(biāo)方面取得的療效明顯優(yōu)于單用西醫(yī)治療組。在改善患者影像學(xué)評(píng)分方面,治療前后兩組組內(nèi)比較,P0.05,無顯著統(tǒng)計(jì)學(xué)差異;治療后兩組之間進(jìn)行比較,P0.05,無顯著統(tǒng)計(jì)學(xué)差異,治療前后試驗(yàn)組與對(duì)照組患者在影像學(xué)評(píng)分方面皆未得到明顯改善,說明培土生金湯加減聯(lián)合西醫(yī)治療組與單用西醫(yī)治療組在改善患者影像學(xué)評(píng)分指標(biāo)方面療效皆不顯著。在臨床綜合療效方面,試驗(yàn)組顯效3人、進(jìn)步6人、穩(wěn)定8人、無效3人,總有效率85%,對(duì)照組顯效3人、進(jìn)步3人、穩(wěn)定5人、無效9人,總有效率55%,經(jīng)統(tǒng)計(jì)學(xué)檢驗(yàn),P0.05,有顯著統(tǒng)計(jì)學(xué)差異,培土生金湯加減聯(lián)合西藥組較單用西藥組取得更優(yōu)的臨床綜合療效,在安全性觀察指標(biāo)上未出現(xiàn)顯著異常,具有良好的安全性。結(jié)論:培土生金法(培土生金湯加減)聯(lián)合西醫(yī)常規(guī)方案治療間質(zhì)性肺疾病與單用西醫(yī)治療都能減輕患者的中醫(yī)疾病臨床表現(xiàn)癥狀與脾氣虛證的臨床癥狀、改善患者肺功能指標(biāo)TLC%預(yù)計(jì)值和DLCO%預(yù)計(jì)值、提高患者未吸氧指脈氧飽和度、增加患者六分鐘步行距離,但中藥聯(lián)合西藥組較單用西藥組療效改善更明顯、臨床綜合療效更優(yōu),值得在臨床上推廣使用。
[Abstract]:Objective: to observe the treatment of interstitial lung disease (spleen qi deficiency syndrome) by using the method of Peitushengjin decoction, observe the clinical symptom integral of TCM disease before and after treatment, and observe the clinical symptom integral of Qi deficiency syndrome. Pulmonary function index TLC% and DLCO% predictive value, oxygen saturation of unoxygenated finger pulse, imaging score, distance of 6-minute walking test, improvement of clinical comprehensive curative effect. The therapeutic effect of the method of cultivating native gold on interstitial pulmonary disease is expounded, which provides a new clinical basis for the treatment of this disease by traditional Chinese medicine. Methods: forty patients with interstitial lung disease and TCM syndrome of deficiency of temper were randomly divided into two groups: experimental group (n = 20) and control group (n = 20), each group was divided into two groups: control group (n = 20), control group (n = 20) and control group (n = 20). The experimental group was treated with routine western medicine combined with traditional Chinese medicine (Peitu Shengjin decoction plus or minus), while the control group was treated with western medicine routine therapy. The two groups were treated continuously for 3 months. Before and after treatment, the clinical symptom scores of TCM diseases, the clinical symptoms of tantal-deficiency syndrome, the TLC% and DLCO% predictors of pulmonary function, the oxygen saturation of the unoxygenated finger, and the imaging scores were compared between the two groups. Six-minute walking test distance, clinical comprehensive efficacy, and statistical methods were used to evaluate the clinical efficacy of the two groups. Results: before and after treatment, we improved the scores of clinical symptoms of TCM diseases, the score of syndrome of deficiency of temper, the predicted value of TLC% and DLCO% of pulmonary function index, the oxygen saturation of unoxygenated finger pulse, the distance of walking for six minutes. There was a significant difference between the two groups (P0.05). The patients in the test group and the control group were significantly improved in the above indexes. There was significant statistical difference between the two groups after treatment (P0.05). The improvement of the above indexes in the trial group was significantly better than that in the control group. The results showed that the therapeutic effect of Peitushengjin decoction combined with western medicine in improving the above indexes was obviously better than that in the single western medicine treatment group. In improving the imaging score of the patients, there was no significant difference between the two groups before and after treatment (P0.05). There was no significant difference between the two groups after treatment (P0.05). The imaging scores of the patients in the experimental group and the control group were not significantly improved before and after treatment. The results showed that the therapeutic effect of Peitushengjin decoction combined with western medicine treatment group and single western medicine treatment group was not significant in improving the imaging scoring index of the patients. In the clinical comprehensive curative effect, the experimental group showed remarkable effect 3, improvement 6, stable 8, ineffective 3, total effective rate 85, control group 3 remarkable, improvement 3, stable 5, ineffective 9, total effective rate 5555. P0.05, there was significant difference between the two groups. Peitushengjin decoction plus or minus western medicine group obtained better clinical comprehensive curative effect than the western medicine group, and there was no significant abnormality in safety observation index, which had good safety. Conclusion: the treatment of interstitial lung diseases with traditional western medicine combined with Peitusheng Gold decoction and western medicine alone can alleviate the clinical symptoms of TCM diseases and spleen Qi deficiency syndrome. The TLC% and DLCO% predictive values of lung function indexes were improved, the oxygen saturation of finger pulse without oxygen was increased, and the walking distance of six minutes was increased. However, the curative effect of traditional Chinese medicine combined with western medicine group was better than that of western medicine group alone. Clinical comprehensive curative effect is better, it is worth popularizing in clinical use.
【學(xué)位授予單位】：山東中醫(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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