加味珍珠定喘方治疗老年慢性阻塞性肺疾病稳定期患者的临床观察  

Clinical observation on the treatment of elderly patients with stable chronic obstructive pulmonary disease with modified PearlDingchuan formula

作　　者：陆城华 吴清远 张晔敏[1] 徐向前[1] 郭晓燕[1] 陆鸿元[2] 薛鸿浩[1] Lu Chenghua;Wu Qingyuan;Zhang Yemin;Xu Xiangqian;Guo Xiaoyan;Lu Hongyuan;Xue Honghao(Department of Pulmonology,Longhua Hospital Affiliated Shanghai University of Traditional Chinese Medicine,Shanghai,200032,P.R.China;Famous TCM Studio of LuHongyuan,Shanghai University of Traditional Chinese Medicine,Shanghai,201203,P.R.China)

机构地区：[1]上海中医药大学附属龙华医院肺病科,上海200032 [2]上海中医药大学陆鸿元名中医工作室,上海201203

出　　处：《老年医学与保健》2022年第3期594-597,607,共5页Geriatrics & Health Care

基　　金：上海市卫生健康委员会科研项目(ZY-SYJS-3);上海市卫生和计划生育委员会科研计划项目(ZYKC201701105);上海市陆鸿元名中医工作室(SHGZS-2017012);“龙华医院-闵行”中医专科(专病)联盟(2021-2023年)建设项目(LM01)。

摘　　要：目的探讨加味珍珠定喘方对老年痰浊壅肺兼肺脾两虚型COPD患者稳定期的疗效。方法选择2019年1月—2019年12月于上海中医药大学附属龙华医院肺病科就诊的老年COPD稳定期痰浊壅肺兼肺脾两虚型患者120例,依据随机数字表法分为试验组和对照组,每组60例。试验组予加味珍珠定喘方,对照组予噻托溴铵吸入剂,疗程均为90d。观察并比较2组临床疗效、安全性、中医证候积分、6min步行试验检测值、FEV1%、FEV1/FVC值等情况。结果试验组和对照组治疗总有效率分别为80%和69.23%,2组疗效差异无统计学意义(P>0.05)。与同组治疗前对比,治疗后2组中医证候积分均减少(P<0.05);2组6MWT评分均增加(P<0.05);2组FEV1%和FEV1/FVC水平均增加(P<0.05)。治疗后,试验组中医证候积分减少幅度和6MWT评分增加幅度均明显大于对照组(P<0.05)、(P<0.05);2组FEV1%水平差异无统计学意义(P>0.05);试验组FEV1/FVC水平增加明显大于对照组(P<0.05)。结论加味珍珠定喘方治疗老年COPD稳定期的临床疗效满意,安全性高,可显著缓解患者的临床症状,延缓肺功能的下降。Objective To explore the curative effect of modified PearlDingchuan formula on stable stage COPD elderly patients with accumulation of phlegm in the lungs and deficiency of both lungs and spleen.Methods 120stable stage COPD elderly patients with accumulation of phlegm in the lungs and deficiency of both lungs and spleen who were treated in the Department of Pulmonology of Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January2019to December2019were selected.They were randomly divided into experimental group and control group,with60cases in each group.The experimental group was treated with modified Pearl Dingchuan formula,and the control group was treated with tiotropium bromide inhaler.The course of treatment of both groups was90days.The clinical efficacy,safety,TCM syndrome score,6-min walking score,FEV1%,FEV1/FVC and etc.were observed and compared between the two groups.Results The total effective rates of the experimental group and the control group were80%and69.23%,respectively,andthere was no significant difference between the two groups(P>0.05).Compared with before treatment in the same group,the TCM syndrome scores in both groups decreased after treatment(P<0.05);the6MWT scores in both groups increased after treatment(P<0.05);the levels of FEV1%and FEV1/FVC in both groups increased after treatment(P<0.05).After treatment,the decrease in TCM syndrome score and the increase in6MWT score in the experimental group were significantly greater than those in the control group(P<0.05);the increase of FEV1/FVC level in the experimental group was significantly greater than that in the control group(P<0.05),but there was no significant difference in the level of FEV1%between the two groups(P>0.05).Conclusion Modified Pearl Dingchuan formula has satisfactory clinical efficacy and high safety in the treatment of elderly patients with stable COPD.It can significantly relieve the clinical symptoms of patients and delay the decline of lung function.

关 键 词：老年 慢性阻塞性肺疾病 痰浊壅肺证 肺脾两虚证 珍珠定喘方 参苓白术散 疗效 肺功能 

分 类 号：R259[医药卫生—中西医结合]