茯苓甘草合剂治疗肺脾气虚型慢性阻塞性肺疾病合并肌肉衰减临床观察  

Clinical efficacy of Fuling Gancao Mixture for chronic obstructive pulmonary disease with muscle attenuation

作　　者：张巍巍 于海霞 刘霞 张积友 ZHANG Weiwei;YU Haixia;LIU Xia;ZHANG Jiyou(Department of Pulmonary Disease,Shandong Qingdao Hospital of Integrated Traditional and Western Medicine,Qingdao,Shandong 266002;First-aid Station,Shandong Qingdao Hospital of Integrated Traditional and Western Medicine,Qingdao,Shandong 266002;Department of Nephrology,Shandong Qingdao Hospital of Integrated Traditional and Western Medicine,Qingdao,Shandong 266002)

机构地区：[1]山东青岛中西医结合医院肺病科,山东青岛266002 [2]山东青岛中西医结合医院急救站,山东青岛266002 [3]山东青岛中西医结合医院肾病科,山东青岛266002

出　　处：《河北中医》2024年第9期1436-1440,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：山东省中医药科技项目(编号:M-2022015)。

摘　　要：目的观察茯苓甘草合剂治疗肺脾气虚型慢性阻塞性肺疾病(COPD)合并肌肉衰减的临床疗效。方法将100例肺脾气虚型COPD合并肌肉衰减患者按照随机数字表法分为2组,对照组50例予常规西药治疗,治疗组50例予茯苓甘草合剂联合常规西药治疗,2组均连续治疗3个月。比较2组治疗前后中医证候评分变化;比较2组治疗前后肺功能指标第1 s用力呼气容积(FEV_(1))、FEV_(1)占预计值百分比(FEV_(1)%_(pred))、FEV_(1)/用力肺活量(FEV_(1)/FVC)变化;比较2组治疗前后肌肉衰减指标[握力、四肢肌肉质量(RASM)、步行速度]、氧化应激因子[超氧化物歧化酶(SOD)、过氧化氢酶(CAT)、活性氧(ROS)]、炎症因子[白细胞介素1(IL-1)、IL-8、肿瘤坏死因子α(TNF-α)]变化;比较2组治疗前后COPD评估测试(CAT)评分、营养风险筛查2002(NRS 2002)评分、日常生活活动能力量表(ADL)评分变化;比较2组不良反应。结果2组治疗后咳嗽气短、声低气怯、步履缓慢、乏力、肌肉萎缩评分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后FEV_(1)/FVC、FEV_(1)%_(pred)、FEV_(1)均较本组治疗前升高(P<0.05),且治疗组升高更明显(P<0.05)。2组治疗后握力、步行速度、RASM均较本组治疗前升高(P<0.05),且治疗组升高更明显(P<0.05)。2组治疗后SOD、CAT水平均较本组治疗前升高(P<0.05),ROS水平较本组治疗前降低(P<0.05);治疗后治疗组SOD、CAT水平均高于对照组(P<0.05),ROS水平低于对照组(P<0.05)。2组治疗后血清IL-1、IL-8、TNF-α水平均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后CAT评分、NRS 2002评分均较本组治疗前降低(P<0.05),ADL评分均较本组治疗前升高(P<0.05);治疗后治疗组CAT评分、NRS 2002评分均低于对照组(P<0.05),ADL评分高于对照组(P<0.05)。治疗组无不良反应;对照组恶心1例,头晕2例。结论茯苓甘草合剂治疗肺脾气虚型COPD合并肌肉�Objective To investigate the clinical ef ficacy of Fuling Gancao Mixture for chronic obstructive pulmonary disease(COPD)with muscle attenuation.Methods One hundred COPD patients with muscle attenuation were randomly assigned into treatment group(n=50)and control group(n=50).All patients were managed by conventional Western medicine,and those in treatment group were additionally treated with Fuling Gancao Mixture.A 3-month treatment was performed,the aim was to compare traditional Chinese medicine(TCM)syndrome score,pulmonary function indexes(forced expiratory volume in one second[FEV_(1)],FEV_(1)percentage of predictive value[FEV_(1)%_(pred)],FEV_(1)to forced vital capacity ratio[FEV_(1)/FVC]),muscle attenuation indexes(holding power,relative skeletal muscle mass index[RASM],walking speed),oxidative stress factors(superoxide dismutase[SOD],catalase[CAT],reactive oxygen species[ROS]),inflammatory factors(interleukin-1[IL-1],IL-8,tumor necrosis factor-alpha[TNF-α]),COPD Assessment Test(CAT),Nutritional Risk Screening 2002(NRS 2002),Activities of Daily Living Scale(ADL),adverse reactions.Results After treatment,TCM symptom(cough and shortness of breath,low voice,slow walking,fatigue,and muscle atrophy)scores in the both groups were significantly decreased(P<0.05),which decreased notably in the treatment group compared with the control group(P<0.05).FEV_(1)/FVC,FEV_(1)%_(pred)and FEV_(1)in the both groups were significantly increased(P<0.05),which were significantly higher in the treatment group than in the control group(P<0.05).The holding power,walking speed,RASM in the both groups were significantly increased(P<0.05),the increaseS in the treatment group were more prevalent compared with the control group(P<0.05).After treatment,the levels of SOD and CAT int the both groups significantly increased(P<0.05),but level of ROS significantly decreased(P<0.05),and the different was significant in the levels of SOD,CAT,and ROS between groups(P<0.05).The levels of IL-1,IL-8 and TNF-αin the both groups were significantly d

关 键 词：肺疾病 阻塞性 中药疗法 

分 类 号：R563[医药卫生—呼吸系统] R289.6[医药卫生—内科学]