冬病夏治穴位敷贴配合六味补气颗粒治疗COPD稳定期疗效研究
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摘要
目的:研究外敷中药夏治咳喘宁联合内服六味补气颗粒治疗COPD稳定期患者疗效评价。方法:选取2017年3月—6月期间在我院门诊及合作医院中医门诊辨治为肺肾气虚证COPD稳定期患者60例,随机划分治疗组(30例)与对照组(30例),治疗组给予模拟缓释型茶碱口服配合夏治咳喘宁外敷穴位+六味补气颗粒口服,对照组给予缓释型茶碱口服配合模拟夏治咳喘宁外敷穴位+口服六味补气颗粒模拟剂。结果:治疗结束时,中医症状疗效治疗组优于对照组(χ~2=4.320,P<0.05);干预治疗结束时治疗组住院平均天数、急性发作次数、CAT评分均少于对照组,统计学差异存在(P<0.05),随访第3个月时治疗组较对照组而言,统计学差异不明显(P>0.05);干预治疗结束时、随访第3个月时治疗组FEV1/FVC及促炎细胞因子IL-32血清浓度水平与对照组相比,统计学差异存在(P<0.05)。治疗结束时中医症状疗效治疗组优于对照组。结论:COPD稳定期患者接受中药夏治咳喘宁敷贴+口服六味补气颗粒治疗,效果胜于单一茶碱治疗,可以减少住院天数、急性发作次数、CAT评分,降低IL-32浓度水平,患者主要症状得以改善,生活质量相应提升。
Objective:To evaluate the efficacy of external application of Xiazhi Kechuanning combined with Liuwei Buqi Granule in the treatment of COPD patients at stable stage. Methods:From March to June 2017,60 COPD patients with lung and kidney Qi deficiency syndrome were selected. Patients were randomly divided into treatment group(30 cases)and control group(30 cases). The treatment group was treated with simulated slow-release theophylline orally combined with Xiazhi Kechuanning external application of acupoint Liuwei Buqi Granule. The control group was treated with slow-release theophylline combined with simulated Xiazhi Kechuanning external application. Results:TCM symptoms at the end of treatment,the treatment group was better than the control group(χ~2=4.320,P<0.05);the average days of hospitalization,the times of acute attack and the CAT score of the treatment group were lower than those of the control group at the end of the intervention treatment group(P<0.05),at the third month of follow-up, there was no significant difference between the treatment group and the control group(P>0.05). There was significant difference in serum levels of FEV1/FVC and pro-inflammatory cytokines(IL-32)between the treatment group and the control group at the end of intervention(P<0.05). The curative effect of TCM symptom at the end of treatment was better than that of control group. Conclusion:The patients with COPD at stable stage were treated with Xiazhi Kechuanning oral application of Liuwei Buqi Granule,the effect was better than that of single theophylline therapy,which could reduce the days of hospitalization,the times of acute attack,the CAT score and the level of IL-32. The main symptoms of the patients were improved and the quality of life was improved accordingly.
Objective:To evaluate the efficacy of external application of Xiazhi Kechuanning combined with Liuwei Buqi Granule in the treatment of COPD patients at stable stage. Methods:From March to June 2017,60 COPD patients with lung and kidney Qi deficiency syndrome were selected. Patients were randomly divided into treatment group(30 cases)and control group(30 cases). The treatment group was treated with simulated slow-release theophylline orally combined with Xiazhi Kechuanning external application of acupoint Liuwei Buqi Granule. The control group was treated with slow-release theophylline combined with simulated Xiazhi Kechuanning external application. Results:TCM symptoms at the end of treatment,the treatment group was better than the control group(χ~2=4.320,P<0.05);the average days of hospitalization,the times of acute attack and the CAT score of the treatment group were lower than those of the control group at the end of the intervention treatment group(P<0.05),at the third month of follow-up, there was no significant difference between the treatment group and the control group(P>0.05). There was significant difference in serum levels of FEV1/FVC and pro-inflammatory cytokines(IL-32)between the treatment group and the control group at the end of intervention(P<0.05). The curative effect of TCM symptom at the end of treatment was better than that of control group. Conclusion:The patients with COPD at stable stage were treated with Xiazhi Kechuanning oral application of Liuwei Buqi Granule,the effect was better than that of single theophylline therapy,which could reduce the days of hospitalization,the times of acute attack,the CAT score and the level of IL-32. The main symptoms of the patients were improved and the quality of life was improved accordingly.
引文
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[11]赵娟萍,张秋樾,齐笑,等.中药穴位贴敷治疗呼吸系统疾病的研究概述[J].中华中医药学刊,2017,35(7):1780-1783.
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[14]姚诗清,朱裕林,赵皓,等.三伏贴治疗稳定期慢性阻塞性肺疾病的疗效及对白细胞介素-8、肿瘤坏死因子-α的影响[J].中国老年学杂志,2016,36(8):1912-1914.
[15]王成阳,刘向国,彭青和,等.六味补气胶囊对COPD急性加重患者Treg及Th1、Th2、Th17型细胞的影响[J].中华中医药杂志,2014,29(6):1978-1981.
[16]赵杰,王兴建.六味补气胶囊对COPD模型大鼠JAK/STAT通路及炎性反应的影响及相关机制研究[J].临床和实验医学杂志,2016,15(16):1556-1558.
[17]张维,张福荣,胡东辉.六味补气胶囊对肺气虚型COPD稳定期患者生活质量和肺功能的影响[J].中医学报,2016,31(1):33-35.
[18]王慧,陈小菊,郑玉琼.IL-32在COPD患者诱导痰和血清中的表达及意义[J].西南国防医药,2015,25(12):1353-1355.
[19]李奕璇,朱红兰,刘代顺.IL-32在炎症相关性疾病中的研究进展[J].中国医药导报,2017,14(12):47-51.
[20]王海燕,魏成功,段晨霞,等.血清IL-32与慢性阻塞性肺疾病病情相关性研究[J].亚太传统医药,2014,10(6):6-8.
[2]魏亚东,鱼涛,谢燕华,等.“冬病夏治”治疗慢性阻塞性肺疾病稳定期患者疗效观察[J].中华中医药杂志,2011,26(2):408-410.
[3]李建生,李素云,余学庆.慢性阻塞性肺疾病中医诊疗指南(2011版)[J].中医杂志,2012,53(1):80-84.
[4]国家中医药管理局医政司.24个专业105个病种中医诊疗方案[S].北京:国家中医药管理局医政司,2011:89.
[3]李建生,李素云,余学庆.慢性阻塞性肺疾病中医诊疗指南(2011版)[J].中医杂志,2012,53(1):80-84.
[5]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:98.
[6]刘锐,何嘉,蒙定水.蒙定水论治慢性阻塞性肺疾病稳定期经验撷英[J].西部中医药,2018,31(4):59-61.
[7]李建生.正虚积损为慢性阻塞性肺疾病的主要病机[J].中华中医药杂志,2011,26(8):710-713.
[8]邵雨萌,张成博,景菲.从肺阳虚论治慢性阻塞性肺疾病[J].山东中医药大学学报,2017,41(4):304-306.
[9]金禹彤,宣丽华.冬病夏治穴位贴敷理论及临床应用[J].长春中医药大学学报,2015,31(1):90-92.
[10]陈旋,王万涛,史苗颜,等.咳喘贴敷方穴位敷贴治疗肺肾气虚型稳定期慢性阻塞性肺疾病有效性评价[J].北京中医药,2017,36(4):303-306.
[11]赵娟萍,张秋樾,齐笑,等.中药穴位贴敷治疗呼吸系统疾病的研究概述[J].中华中医药学刊,2017,35(7):1780-1783.
[12]文平凡,易良杰,陈洪,等.穴位贴敷法配合红外线照射治疗慢性阻塞性肺疾病临床研究[J].新中医,2012,44(6):129-131.
[13]刘佳,张春玲,徐德祥.“三伏贴”对慢性阻塞性肺病系统炎症的影响[J].现代生物医学进展,2014,14(21):4123-4126.
[14]姚诗清,朱裕林,赵皓,等.三伏贴治疗稳定期慢性阻塞性肺疾病的疗效及对白细胞介素-8、肿瘤坏死因子-α的影响[J].中国老年学杂志,2016,36(8):1912-1914.
[15]王成阳,刘向国,彭青和,等.六味补气胶囊对COPD急性加重患者Treg及Th1、Th2、Th17型细胞的影响[J].中华中医药杂志,2014,29(6):1978-1981.
[16]赵杰,王兴建.六味补气胶囊对COPD模型大鼠JAK/STAT通路及炎性反应的影响及相关机制研究[J].临床和实验医学杂志,2016,15(16):1556-1558.
[17]张维,张福荣,胡东辉.六味补气胶囊对肺气虚型COPD稳定期患者生活质量和肺功能的影响[J].中医学报,2016,31(1):33-35.
[18]王慧,陈小菊,郑玉琼.IL-32在COPD患者诱导痰和血清中的表达及意义[J].西南国防医药,2015,25(12):1353-1355.
[19]李奕璇,朱红兰,刘代顺.IL-32在炎症相关性疾病中的研究进展[J].中国医药导报,2017,14(12):47-51.
[20]王海燕,魏成功,段晨霞,等.血清IL-32与慢性阻塞性肺疾病病情相关性研究[J].亚太传统医药,2014,10(6):6-8.