加减补肾纳气方对肺肾气虚型稳定期COPD纳气功能影响的临床观察  

Clinical observation on effects of Modified Bushen Naqi Formula on function of receiving qi in stable chronic obstructive pulmonary disease of lung- kidney qi deficiency type

作　　者：耿佩华 张惠勇[2] 鹿振辉[2] 徐向前[2] 鲁立文 GENG Peihua;ZHANG Huiyong;LU Zhenhui;XU Xiangqian;LU Liwen(Medical Affairs Department-Ⅰ,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Department of Pulmonary Disease,Longhua Hospital Affiliated to Shanghai University ofTraditional Chinese Medicine,Shanghai 200032,China;Department of Respiratory Medicine,Shanghai FengxianDistrict Central Hospital,Shanghai 201499,China)

机构地区：[1]上海中医药大学附属曙光医院医务一处,上海201203 [2]上海中医药大学附属龙华医院肺病科,上海200032 [3]上海市奉贤区中心医院呼吸科,上海201499

出　　处：《上海中医药杂志》2019年第9期56-59,共4页Shanghai Journal of Traditional Chinese Medicine

基　　金：上海市卫计委科研课题项目(201740103)

摘　　要：目的观察加减补肾纳气方联合西药治疗肺肾气虚型稳定期慢性阻塞性肺疾病(COPD)的临床疗效。方法将108例肺肾气虚型稳定期COPD患者随机分为治疗组与对照组,每组54例。对照组予常规西医治疗,治疗组在西医治疗基础上联用加减补肾纳气方。两组疗程均为6个月,观察比较中医证候积分、呼吸困难等级评分(mMRC)、呼吸肌肌力相关指标及肺通气功能相关指标的变化情况。结果①最终完成试验者96例,治疗组49例、对照组47例。②治疗前后组内比较,治疗组中医证候积分明显降低(P<0.05),而对照组无明显变化(P>0.05);组间治疗后比较,治疗组中医证候积分明显低于对照组(P<0.05)。③治疗前后组内比较,两组P0.1均明显降低(P<0.05),MEP均明显增高(P<0.05);治疗组MIP明显增高(P<0.05),而对照组MIP水平无明显变化(P>0.05)。组间治疗后比较,治疗组P0.1较对照组明显降低(P<0.05),治疗组MIP、MEP较对照组明显增高(P<0.05)。④治疗前后组内比较,治疗组IC明显增加,RV明显减少(P<0.05),而对照组均无明显变化(P>0.05);组间治疗后比较,治疗组较对照组IC明显增加、RV明显减少(P<0.05),FEV1%水平差异无统计学意义(P>0.05)。⑤治疗前后组内比较,治疗组mMRC评分明显降低(P<0.05),而对照组无明显变化(P>0.05);组间治疗后比较,治疗组mMRC评分明显低于对照组(P<0.05)。结论加减补肾纳气方可通过增加呼吸肌肌力,增加深吸气量,减少残气量,从而改善COPD患者"纳气"功能,缓解呼多吸少、气短喘息等肾不纳气的慢性呼吸症状,提高其生活质量。Objective To observe the clinical efficacy of Modified Bushen Naqi Formula combined with Western medicine in the treatment of stable chronic obstructive pulmonary disease(COPD) of the lung-kidney qi deficiency type. Methods 108 COPD patients of the lung-kidney qi deficiency type were randomly assigned into treatment group and control group, 54 patients in each group. The control group was given conventional Western medicine therapy, while the treatment group was treated with Modified Bushen Naqi Formula and conventional Western medicine therapy. The treatment course was 6 months in both groups. Changes in TCM syndrome score, modified Medical Research Council(mMRC) dyspnea score, related measures of respiratory muscle strength and related measures of pulmonary ventilation function were observed and compared. Results ①96 patients completed the trial finally,including 49 patients in the treatment group and 47 in the control group.(2) After treatment,the TCM syndrome score decreased significantly in the treatment group( P<0.05),but there was no significant change in the control group( P>0.05). The TCM syndrome score was significantly lower in the treatment group than in the control group after treatment( P<0.05).(3)After treatment,P0.1 decreased significantly( P<0.05) and MEP increased significantly in both groups( P<0.05);MIP increased significantly in the treatment group( P<0.05),but there was no significant change in the control group( P>0.05). P0.1 was significantly lower in the treatment group than in the control group( P<0.05),while MIP and MEP were significantly higher in the treatment group than in the control group( P<0.05) after treatment.(4)After treatment,IC increased and RV decreased significantly in the treatment group( P<0.05),but there was no significant change in the control group( P>0.05). IC increased and RV decreased significantly in the treatment group compared to those in the control group after treatment( P<0.05);there was no significant difference in the level of FEV1%( P>0.05).(5)After trea

关 键 词：慢性阻塞性肺疾病 稳定期 肺肾气虚证 加减补肾纳气方 纳气功能 

分 类 号：R563.9[医药卫生—呼吸系统]