基于玉屏风散联合酮替芬片治疗慢阻肺稳定期的中西医结合优势探讨及基层推广价值研究  

Study on the clinical advantage of integrated traditional Chinese and Western medicine based on Yupingfeng powder combined with ketotifen tablets in the treatment of stable chronic obstructive pulmonary disease and the value of grass-roots promotion

作　　者：汪辉 曾健球 石一杰 周伟斌 曾勤芳 WANG Hui;ZENG Jian-qiu;SHI Yi-jie(Zengcheng District Xiaolou Town Health Center,Guangzhou 511396,China)

机构地区：[1]广州市增城区小楼镇卫生院,511396 [2]广州市增城区中医医院,511300

出　　处：《中国实用医药》2020年第9期142-147,共6页China Practical Medicine

基　　金：广州市卫生和计划生育科技项目(项目编号:20182A010015)。

摘　　要：目的通过观察玉屏风散联合酮替芬片对慢性阻塞性肺疾病(COPD,慢阻肺)稳定期患者的临床疗效,尤其是对近期最大呼气峰流速(PEF)的影响及远期疗效的稳定性,为该技术推广及发掘中西医结合优势提供依据。方法 60例COPD稳定期患者,采用随机数字表法分为对照组和治疗组,每组30例。对照组全程采用常规治疗,疗程为6周(42 d)+1个月(30 d),治疗组在常规治疗基础上加服玉屏风散及富马酸酮替芬片治疗6周(42 d), 6周治疗结束后继续常规治疗1个月(30 d)。对比两组患者治疗前、治疗42 d后6 min步行试验(6MWT)、COPD评估测试(CAT)积分;治疗前、治疗后42 d、72 d后PEF;用药安全性及依从性。结果治疗42 d后,对照组患者6MWT(346.87±47.19)m长于治疗前的(305.13±51.44)m,治疗组患者6MWT(376.97±56.16)m长于治疗前的(294.97±50.19)m,差异具有统计学意义(P<0.05);治疗组患者治疗42 d后6MWT长于对照组,差异具有统计学意义(P<0.05)。治疗42 d后,对照组患者CAT积分(12.77±2.34)分低于治疗前的(17.40±2.54)分,治疗组患者CAT积分(11.43±2.58)分低于治疗前的(18.43±2.75)分,差异具有统计学意义(P<0.05)。治疗组患者治疗42 d后CAT积分低于对照组,差异具有统计学意义(P<0.05)。对照组患者治疗42、72 d后PEF分别为(223.17±62.81)、(224.60±61.65)L/min均高于治疗前的(217.67±58.20)L/min,但差异无统计学意义(P>0.05);治疗组患者治疗42、72 d后PEF分别为(263.87±73.51)、(265.37±74.35)L/min,均高于本组治疗前的(218.33±65.76)L/min,差异具有统计学意义(P<0.05);两组患者治疗72 d后PEF均略高于本组治疗42 d后,但差异无统计学意义(P>0.05)。治疗组患者治疗42、72 d后PEF均高于对照组,差异具有统计学意义(P<0.05)。两组患者治疗期间均未出现与用药相关的不良反应。两组患者用药依从性均控制在80%~120%,依从性良好。结论玉屏风散联合酮替芬片的中西医结合疗法可以显著�Objective To provide a basis for promotion of this technology and exploiting the strengths of the integrated traditional Chinese and Western medicine by observing the clinical efficacy of Yupingfeng powder combined with ketotifen tablets in patients with stable chronic obstructive pulmonary disease(COPD), especially exploring the impact on the recent peak expiratory flow(PEF) and the long-term efficacy stability. Methods A total of 60 patients with stable COPD were divided into control group and treatment group by random number table method, with 30 cases in each group. The control group received conventional therapy for 6 weeks(42 d) + 1 month(30 d), and the treatment group received Yupingfeng powder and ketotifen fumarate tablets for 6 weeks(42 d), then conventional therapy for 1 month(30 d). 6-minute walk test(6 MWT) and COPD assessment test(CAT) score before treatment and 42 d after of treatment, PEF before treatment, 42 d after treatment and 72 d after treatment, medication safety and compliance were compared between the two groups. Results 42 d after treatment, 6 MWT of the control group was(346.87±47.19) m, which was longer than that before treatment(305.13±51.44) m. 6 MWT of the treatment group was(376.97±56.16) m, which was longer than that before treatment(294.97± 50.19) m. The difference was statistically significant(P<0.05). 42 d after treatment, 6 MWT of the treatment group was longer than that of the control group, and the difference was statistically significant(P<0.05). 42 d after treatment, CAT score of the control group was(12.77±2.34) points, which was lower than that before treatment(17.40±2.54) points. CAT score of the treatment group was(11.43±2.58) points, which was lower than that before treatment(18.43±2.75) points. The difference was statistically significant(P<0.05). 42 d after treatment, CAT score of the treatment group was lower than that of the control group, and the difference was statistically significant(P<0.05). 42 and 72 d after treatment, PEF of the control group were(2

关 键 词：玉屏风散 酮替芬片 慢性阻塞性肺疾病稳定期 最大呼气峰流速 中西医结合优势 

分 类 号：R563.9[医药卫生—呼吸系统]