健脾化痰方配合温灸中脘穴对肺脾气虚型轻中度稳定糍COPD患者的临床疗效及相关疗效影响因素分析  

Analysis of factors associated with therapeutic effect and the clinical curative effect of moxibustion Zhongwan point of lung and spleen deficiency type mild to moderate COPD patients in stable phase of Jianpi Huatan Fang

作　　者：张平[1] 吴欢[1] 刘泉 沈若冰[1] 余小萍[1] 窦丹波[1] 

机构地区：[1]上海中医药大学附属曙光医院,上海201203 [2]江苏省苏州市高新区人民医院,江苏苏州215129

出　　处：《河南中医》2013年第B04期175-176,179,共3页Henan Traditional Chinese Medicine

摘　　要：目的：观察健脾化痰方配合温灸中脘的综合治疗对肺脾气虚型稳定期轻中度慢性阻塞性肺疾病患者的临床疗效及相关疗效影响因素。方法：本研究为前瞻性随机对照临床试验，将符合纳入、排除标准的轻、中度COPD稳定期患者签署知情同意后纳入研究。按照随机数字表法，将病例随机分为治疗组（健脾化痰方配合温灸中脘＋西医基础治疗）和对照组（西医基础治疗），每组各70例，治疗过程中无病例脱落。治疗12周，随访12周，观察两组患者治疗前后，临床症状及生存质量评分变化，并通过多分类logistic回归分析，分析主要可能对疗效产生影响的因素。结果：治疗后两组的主要临床症状较治疗前均有显著改善（P〈0．01），健脾化痰方配合温灸中脘治疗组的总临床疗效显著优于西医基础治疗组（P〈0.01）。经长期随访，综合治疗组治疗后的生存质量较治疗前有显著提高（P〈0．01），治疗组生存质量较对照组显著提高（P〈0．01），而对照组的生存质量治疗前后无明显改善（P〉0．05）。多分类logistic回归分析发现，治疗方式及病情轻重程度（分级）对临床疗效有显著影响（P〈0．05，P〈0．01）。结论：健脾化痰方配合温灸中脘治疗肺脾气虚型轻中度稳定期慢性阻塞性肺疾病具有显著临床疗效，并改善了远期生存质量及预后；治疗方式及病情轻重程度为主要的影响临床疗效的因素，表明早期COPD的健脾化痰综合治疗可作为慢阻肺防控工作的重点。Objective To observe clinical effectiveness and related effects influencing factors of JianPiHuaTan therapy in patients with mild to moderate stable COPD of FeiPiQiXu syndrome differentiation. Methods This study was a prospective randomized clinical trial. All participants provided written in formed consents with inclusion/exclusion criteria. We randomized all 140 subjects into two groups （70/group） ,group Treatment was treated by decoction of JianPiHuaTan combined with moxibustion therapy and the Control group was only treated by bronchodilators. Screening period of this study was 12 weeks and follow--up of 12ws. No cases shedding in the treatment process. Scores of clinical symptoms and quality of life questionnaire were examined in this trial. Multiple logistic regression analysis was used to find possible effects impacting factors. Results Symptoms were significantly alleviated after treatment（P〈0. 01）in both group. The clinical effects and life qualities after treatment of comprehensive therapy （Treatment group）were significantly im-proved than the control（P〈0.01）, but there were no changes of life qualities in the control group（P〉0.05）. Multiple logistic regression analysis found that different therapies and severity of COPD were the major influencing factors of clinical effects（P〈0.05 ,P〈0.01）. Conclusion JianPiHuaTan decoction with moxibustion treatment had got a very significant efficacy in mild to moderate stable COPD patients of FeiPiQiXu syndrome differentiation by allevia-ting symptoms and improving life qualities and prognosis for a long time. Comprehensive treatment and mild COPD were easier to get better clinical effects, so treatment style and severity of COPD are the governing effects impacting factors.

关 键 词：健脾化痰方 温灸中脘 COPD 稳定期 肺脾气虚型 回归分析 

分 类 号：R856.2[医药卫生—航空、航天与航海医学]