温针灸联合沙美特罗替卡松粉吸入剂治疗慢性阻塞性肺疾病稳定期临床研究  

Clinical Study on Warming-Needle Moxibustion Combined with Salmeterol Xinafoate and Fluticasone Propionate Powder for Inhalation for COPD in Stable Stage

作　　者：史兆雯 倪婷婷[1] 王雄彪[1] SHI Zhaowen;NI Tingting;WANG Xiongbiao

机构地区：[1]上海中医药大学附属普陀医院呼吸内科,上海普陀200062

出　　处：《新中医》2021年第14期150-153,共4页New Chinese Medicine

基　　金：上海中医药大学附属普陀医院院级科研项目(2019323);上海市普陀区卫生健康系统临床特色专科建设计划呼吸与危重症医学科专项建设项目(2020tszk02)。

摘　　要：目的:观察温针灸联合沙美特罗替卡松粉吸入剂治疗对慢性阻塞性肺疾病(COPD)稳定期患者心肺功能、生活质量的临床疗效。方法:将97例COPD稳定期患者随机分为观察组(49例)及对照组(48例)。对照组给予沙美特罗替卡松粉吸入剂治疗,观察组在对照组的基础上加用温针灸治疗。2组疗程均为8周,比较2组临床疗效、心脏功能[左心室舒张末期内径(LVEDD)、左室射血分数(LVEF)、六分钟步行试验(6MWT)]、肺功能[第1秒用力呼气容积(FEV_(1))、第1秒用力呼气容积/用力肺活量(FEV_(1)/FVC)、第1秒用力呼气容积占预计值百分比(FEV_(1)%)]、生活质量[COPD评估测试(CAT)问卷评分]及中医证候积分情况,并观察治疗期间的不良反应发生情况。结果:观察组总有效率为93.88%,对照组为79.17%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组咳嗽、咳痰、纳呆、腹胀、气短、胸闷、喘息、自汗评分均较治疗前下降(P<0.05),且观察组各项评分均低于对照组(P<0.05)。治疗后,2组LVEDD较治疗前降低(P<0.05),LVEF、6MWT、FEV_(1)、FEV_(1)/FVC、FEV_(1)%均较治疗前升高(P<0.05),且观察组各项指标改善较对照组更显著(P<0.05)。治疗后,2组CAT评分均较治疗前降低(P<0.05),且观察组评分低于对照组(P<0.05)。治疗期间,2组均无发生局部血肿、烫伤、感染等不良事件。结论:温针灸联合沙美特罗替卡松粉吸入剂治疗COPD稳定期患者疗效显著,可有效缓解患者临床症状,改善心肺功能,提高生活质量,且安全性较高。Objective:To observe the clinical effect of warming-needle moxibustion combined with salmeterol xinafoate and fluticasone propionate powder for inhalation for patients with chronic obstructive pulmonary disease(COPD)in stable stage,and its effect on quality of life as well as the heart function and the lung function.Methods:A total of 97 cases of patients with COPD in stable stage were randomly divided into the observation group and the control group,49 and 48 cases in each group respectively.The control group was given salmeterol xinafoate and fluticasone propionate powder for inhalation,and the observation group was additionally given warming-needle moxibustion based on the treatment of the control group.Both groups were treated for eight weeks.The clinical effect,the heart function[left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),6-minute walking test(6MWT)],the lung function[forced expiratory volume in the first second(FEV_(1)),the ratio of FEV_(1)to forced vital capacity(FEV_(1)/FVC),the percentage of predicated value of FEV_(1)(FEV_(1)%)],quality of life[the score of COPD Assessment Test(CAT)],and Chinese medicine syndrome score were compared between the two groups.The incidence of adverse reactions during treatment was observed.Results:The total effective rate was 93.88%in the observation group,and 79.17%in the control group,the difference being significant(P<0.05).After treatment,the scores of cough,expectoration,torpid intake,abdominal distension,shortness of breath,oppression in the chest,gasping,and spontaneous sweating in the two groups were decreased when compared with those before treatment(P<0.05),and each syndrome score in the observation group was lower than that in the control group(P<0.05).After treatment,LVEDD in the two groups were decreased when compared with those before treatment(P<0.05),and LVEE,6MWT,FEV_(1),FEV_(1)/FVC,and FEV_(1)%were increased(P<0.05),and the improvement in the study group was more significant than that in the control group(P<0.05

关 键 词：慢性阻塞性肺疾病稳定期 沙美特罗替卡松粉吸入剂 温针灸 心功能 肺功能 生活质量 

分 类 号：R563[医药卫生—呼吸系统]