益气活血祛痰方治疗支气管哮喘合并阻塞性睡眠呼吸暂停低通气综合征气虚痰瘀证的研究  

Efficacy of decoction for replenishing Qi,activating blood and dispelling phlegm on asthma with

作　　者：丁荣[1] 张勇[1] 吴凌华 林远茂 康善平[4] DING Rong;ZHANG Yong;WU Linghua;LIN Yuanmao;KANG Shanping(Taizhou Fourth People’s Hospital,Taizhou 225300,Jiangsu,China;Taizhou Fifth People’s Hospital,Taizhou 225300,Jiangsu,China;Guangdong Chaozhou Health Vocational College,Chaozhou 515632,Guangdong,China;Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine,Nanning 530000,Guangxi,China)

机构地区：[1]泰州市第四人民医院,江苏泰州225300 [2]泰州市第五人民医院,江苏泰州225300 [3]广东潮州卫生健康职业学院,广东潮州515632 [4]广西中医药大学附属瑞康医院,广西南宁530000

出　　处：《现代中西医结合杂志》2024年第11期1490-1495,1500,共7页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：广西中医药中医老年医学重点学科建设项目(GZXK-Z-20-36);泰州市海陵区科技发展计划项目(HLKF-2019-4);2023年广东省潮州市卫生健康局科研项目(2023076)。

摘　　要：目的评价益气活血祛痰方联合西医治疗慢性持续期支气管哮喘合并阻塞性睡眠呼吸暂停低通气综合征气虚痰瘀证患者的临床疗效。方法选择2016年1月—2021年6月于泰州市第四人民医院就诊的80例慢性持续期支气管哮喘合并阻塞性睡眠呼吸暂停低通气综合征气虚痰瘀证患者,根据随机数字表分成对照组及观察组各40例,对照组给予常规治疗及持续气道正压通气,观察组在对照组治疗基础上给予益气活血祛痰方水煎液口服,2组均持续干预3个月。观察2组患者治疗前后中医证候积分(包括气喘、咳嗽、咳痰、打鼾、憋醒、日间嗜睡、倦怠乏力)、哮喘控制测试问卷(ACT)评分、圣乔治呼吸问卷(SGRQ)评分、Epworth嗜睡量表(ESS)评分、匹兹堡睡眠指数(PSQI)评分、肺功能指标[呼气峰值流速(PEF)、第一秒用力呼气容积占预计值百分比(FEV_(1)%预计值)、第一秒用力呼气容积与用力肺活量比值(FEV_(1)/FVC)]、多导睡眠图参数[呼吸暂停低通气指数(AHI)、快速眼动睡眠期(REM)、氧减指数(ODI)、动脉血氧饱和度(SaO_(2))、最低SaO_(2)、觉醒指数]、炎症相关指标[血清C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、血管内皮生长因子(VEGF)水平和呼出气一氧化氮(FeNO)水平]变化,统计2组总体治疗效果及不良反应发生情况。结果2组治疗后中医证候积分、SGRQ评分、ESS评分、PSQI评分、AHI、ODI、觉醒指数及血清CRP、IL-6、TNF-α、VEGF水平和FeNO水平均较治疗前明显降低(P均<0.05),且观察组上述各项指标均明显低于对照组(P均<0.05);2组治疗后ACT评分、PEF、FEV_(1)%预计值、FEV_(1)/FVC、REM、SaO_(2)、最低SaO_(2)均较治疗前明显升高(P均<0.05),且观察组上述各项指标均明显高于对照组(P均<0.05)。观察组治疗3个月后的总有效率明显高于对照组[92.5%(37/40)比82.5%(33/40),P<0.05],治疗期间不良反应发生率明显低于对Objective It is to evaluate the clinical efficacy of decoction for replenishing Qi,activating blood and dispelling phlegm combined with western medicine in the treatment of patients with chronic persistent bronchial asthma and obstructive sleep apnea hypoventilation syndrome(OSAHS)of syndrome of Qi deficiency and phlegm stasis.Methods Eighty patients with chronic persistent bronchial asthma and OSAHS of syndrome of Qi deficiency and phlegm stasis treated in Taizhou Fourth People’s Hospital from January 2016 to June 2021 were selected,and were divided into control group and observation group according to the random number table,with 40 cases in each group.The control group was given conventional treatment and continuous positive pressure ventilation,and the observation group was treated with decoction for replenishing Qi,activating blood and dispelling phlegm on the basis of treatment in the control group.Both groups were continuously treated for 3 months.The syndrome scores(including asthma,cough,sputum,snoring,wakefulness,daytime sleepiness,tiredness and fatigue),scores of Asthma Control Test(ACT),St.George’s Respiratory Questionnaire(SGRQ),Epworth Sleepiness Scale(ESS),Pittsburgh Sleepiness Quotient Index(PSQI),pulmonary function indexes[peak expiratory flow(PEF),FEV_(1)%,FEV_(1)/FVC],polysomnographic parameters[apnea hypopnea index(AHI),rapid eye movement(REM),oxygen desaturation index(ODI),SaO_(2),minimum SaO_(2),arousal index],inflammation-related indexes[serum levels of C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),vascular endothelial growth factor(VEGF),and level of exhaled exhaled nitric oxide(FeNO)]of the patients before and after treatment were observed in the two groups,the overall efficacy and the occurrence of adverse reactions in the two groups were calculated.Results The syndrome scores,SGRQ scores,ESS scores,PSQI scores,AHI,ODI,arousal index and levels of CRP,IL-6,TNF-α,VEGF in serum and exhaled FeNO of the two groups were significantly lower after treatment th

关 键 词：支气管哮喘 阻塞性睡眠呼吸暂停低通气综合征 气虚痰瘀证 益气活血祛痰方 炎症反应 

分 类 号：R562.25[医药卫生—呼吸系统]