麻辛附芪汤联合西药治疗肺肾气虚兼阳虚证慢性阻塞性肺疾病稳定期临床研究  

Clinical Study on Maxin Fuqi Tang Combined with Western Medicine for Chronic Obstructive Pulmonary Disease in Stable Stage with Lung-Kidney Qi and Yang Deficiencies Syndrome

作　　者：常胜[1] 俞俊薏[1] 李慧娇[1] 祝炳军 CHANG Sheng;YU Junyi;LI Hui jiao;ZHU Bingjun

机构地区：[1]绍兴市中医院,浙江绍兴312000 [2]绍兴文理学院附属医院,浙江绍兴312000

出　　处：《新中医》2020年第17期64-67,共4页New Chinese Medicine

摘　　要：目的:观察麻辛附芪汤联合西药治疗肺肾气虚兼阳虚证慢性阻塞性肺疾病(COPD)稳定期的临床疗效及对患者生活质量、免疫功能的影响。方法:选取98例肺肾气虚兼阳虚证COPD稳定期患者,按随机数字表法分为对照组和观察组各49例。对照组给予西药治疗,观察组在对照组基础上加用麻辛附芪汤治疗,2组均连续治疗8周。比较2组临床疗效,观察患者中医症状、肺功能、血气分析及免疫功能指标的改善情况,采用6 min步行试验(6-MWT)和COPD评估测试(CAT)问卷评价2组治疗前后的运动能力和生活质量。结果:治疗后,愈显率观察组为87.76%,对照组为69.39%;总有效率观察组为95.92%,对照组为81.63%,观察组愈显率及总有效率均高于对照组(P<0.05)。治疗后,2组中医症状积分和CAT评分均较治疗前降低(P<0.05),6-MWT距离均较治疗前增加(P<0.05);观察组中医症状积分、CAT评分均低于对照组(P<0.05),6-MWT距离长于对照组(P<0.05)。治疗后,2组呼气流速峰值(PEFR)、第1秒用力呼气量(FEV1)、FEV1/用力肺活量(FEV1/FVC)及动脉血氧分压(PaO2)水平均较治疗前升高(P<0.05),动脉二氧化碳分压(PaCO2)水平均较治疗前降低(P<0.05);观察组PEFR、FEV1、FEV1/FVC及PaO2水平均高于对照组(P<0.05),PaCO2水平低于对照组(P<0.05)。治疗后,2组CD3+、CD4+、CD4+/CD8+及免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)水平均较治疗前升高(P<0.05),观察组上述指标水平均高于对照组(P<0.05)。结论:麻辛附芪汤联合西药治疗肺肾气虚兼阳虚证COPD稳定期可以提高临床疗效,改善患者的肺功能,提升其运动能力和免疫功能,提高生活质量。Objective: To observe the clinical effect of Maxin Fuqi tang combined with western medicine for chronic obstructive pulmonary disease(COPD) in stable stage with lung-kidney qi and yang deficiencies syndrome and its effect on the quality of life and immune function of patients. Methods:A total of 98 cases of COPD patients in stable stage with lungkidney qi and yang deficiencies syndrome were selected and divided into the control group and the observation group according to the random number table method, 49 cases in each group. The control group was treated with western medicine,and the observation group was additionally treated with Maxin Fuqi tang based on the treatment of the control group. Both groups were treated for eight weeks. The clinical effect in the two groups was compared;the improvement of the indexes of Chinese medicine symptoms, lung function, blood gas analysis and immune function in patients was observed. The sports ability and quality of life before and after treatment in the two groups were evaluated by the questionnaires of 6-min walking test(6-MWT) and COPD Assessment Test(CAT). Results:After treatment,the cured and markedly effective rate was 87.76% in the observation group and 69.39% in the control group;the total effective rate was 95.92% in the observation group and 81.63% in the control group;both of the above rates in the observation group were higher than those in the control group(P<0.05). After treatment,the scores of Chinese medicine symptoms and CAT in the two groups were decreased when compared with those before treatment(P<0.05), and the distances of 6-MWT were increased(P<0.05);the scores of Chinese medicine symptoms and CAT in the observation group were lower than those in the control group(P<0.05),and the distance of 6-MWT was longer(P<0.05). After treatment,the levels of peak expiratory flow rate(PEFR), forced expiratory volume in the first second(FEV1), FEV1/forced vital capacity(FEV1/FVC) and arterial partial pressure of oxygen(PaO2) in the two groups were increased when co

关 键 词：慢性阻塞性肺疾病 稳定期 肺肾气虚证 肺肾阳虚证 麻辛附芪汤 生活质量 免疫功能 

分 类 号：R563.9[医药卫生—呼吸系统]