补肾加拔罐治疗对COPD肺功能的影响研究

目的:观察补肾方联合拔罐治疗对慢阻肺(COPD)急性期后患者生活质量及肺功能的影响;方法:将30例患者随机分为肺康复组与补肾方加拔罐组,分别给予肺康复与补肾方加拔罐治疗2周。在实验前后测定FEV1及6分钟步行试验,进行生活质量调查。结果:经过治疗生活质量评分肺康复组与补肾方加拔罐组均明显改善,但后者优于前者,6分钟步行情况与生活质量评分类似。肺功能两组治疗前后无差异。结论:补肾方加拔罐治疗可提高COPD患者生活质量,改善患者运动耐受性。     

针刺联合康复训练改善慢性阻塞性肺病肺功能的临床研究

目的 :探讨针刺与康复训练改善慢性阻塞性肺病 (COPD)肺功能的协同作用。方法 :将稳定期COPD患者 6 6例随机分为针刺组、康复组、针刺加康复组 ,每组各 2 2例 ,在使用常规西药的基础上分别加上以上 3种治疗方法 ,共治疗 1 0 0天。于治疗前后测定肺功能并进行临床疗效评价。 结果 :治疗前各组间肺功能无明显差别 (P >0 0 5 ) ,治疗后针刺组、康复组肺功能改善 (P <0 0 5 ) ,而针刺加康复组肺功能明显改善 (P <0 0 1 ) ,并优于其它两组 (P <0 0 5 ) ,其临床疗效也优于针刺或康复组 (P <0 0 5 )。结论 :针刺、康复治疗均能改善COPD患者肺功能 ,但针刺联合康复训练表现出明显的协同作用。     

益气补肾活血汤治疗COPD稳定期肺肾两虚证37例总结

目的:观察益气补肾活血汤治疗慢性阻塞性肺疾病(COPD)稳定期肺肾两虚证的临床疗效及对患者生活质量的影响。方法:将我院收治的COPD稳定期肺肾两虚证患者73例随机分为治疗组和对照组,对照组36例采用布地奈德福莫特罗粉吸入剂治疗,治疗组37例在对照组基础上给予益气补肾活血汤治疗,比较2组的临床疗效、治疗前后肺功能和治疗后呼吸疾病问卷(SGRD)评分情况。结果:总有效率治疗组为94.59%(35/37),对照组为72.22%(26/36),2组比较,差异有统计学意义(P 0.05); 2组肺功能指标治疗前后组内比较及治疗后组间比较,差异均有统计学意义(P 0.05),治疗后治疗组SGRD评分明显低于对照组(P 0.05)。结论:益气补肾活血汤联合西医治疗COPD稳定期肺肾两虚证患者可有效缓解患者临床症状,改善其肺功能,提高其生活质量,值得临床推广。     

愈肺宁对慢性阻塞性肺疾病稳定期临床作用的研究

目的:探讨中药愈肺宁对慢性阻塞性肺疾病(COPD)稳定期患者的临床作用,为COPD稳定期的治疗提供依据.方法:38例COPD患者随机分为治疗组20例和对照组18例,治疗组予中药愈肺宁丸剂口服半年;对照组不给任何药物干预.治疗前后测定常规肺功能、血气分析,并记录中医症候计分和生活质量评分.结果:治疗组经治疗后一秒钟用力呼气容积(FEV1)、用力肺活量(FVC)有改善,与治疗前比较差异显著(P＜0.05);动脉血氧分压(PaO2)上升,动脉血二氧化碳分压(PaCO2)下降,与治疗前比较差异显著(P＜0.05).结论:愈肺宁可以改善COPD稳定期患者的肺功能,减轻临床症状,改善生活质量.     

补肺益阳化痰中药方联合西医常规治疗慢性阻塞性肺疾病稳定期肺肾气虚型疗效观察

目的观察补肺益阳化痰中药方联合西医常规治疗对慢性阻塞性肺疾病(COPD)稳定期肺肾气虚型的疗效及对患者肺功能、生活质量的改善情况。方法将124例符合纳入标准的COPD稳定期肺肾气虚型患者随机分为2组。对照组62例行西医常规治疗,治疗组62例在对照组治疗基础上加补肺益阳化痰中药方,均连续治疗2个月。比较2组总有效率及治疗前后患者肺功能、生活质量改善情况。结果治疗组总有效率(98.39%)明显高于对照组(82.26%,P0.05),治疗组临床疗效优于对照组。治疗后2组患者肺功能指标用力肺活量(FVC)、第1 s用力呼气容积(FEV_1)、FEV_1/FVC及生活质量健康状况调查问卷(SF-36)生理功能、心理功能评分及总分均较本组治疗前明显升高(P0.05),且治疗组高于对照组,比较差异均有统计学意义(P0.05)。结论补肾益阳化痰中药方联合西医常规治疗COPD稳定期肺肾气虚型疗效显著,能显著改善肺功能,提高生活质量。     

补肺化瘀法对慢性阻塞性肺疾病稳定期患者生活质量及肺功能的影响

目的观察补肺化瘀法对慢性阻塞性肺疾病(COPD)稳定期患者生活质量的影响。方法将60例COPD稳定期患者随机分为对照组、治疗组各30例,对照组给予异丙托溴铵气雾剂,每次40μg(2喷),每日3次吸入;治疗组在对照组的基础上,加用补肺化瘀中药。观察2组的有效率及治疗前后圣乔治呼吸问卷评分及肺功能的变化。结果治疗3个月后,治疗组总有效率、圣乔治呼吸问卷评分改善疗效均优于对照组(P0.05);但2组肺功能改善差异无统计学意义(P0.05);治疗结束后3个月随访,治疗组圣乔治呼吸问卷评分明显低于对照组(P0.05)。结论补肺化瘀法可提高肺脾肾虚、痰瘀互结证COPD稳定期患者生活质量。     

呼吸康复治疗应用于稳定期慢性阻塞性肺疾病患者中对其生活质量的影响探讨

目的呼吸康复治疗应用于稳定期慢性阻塞性肺(COPD)疾病患者中对其生活质量的影响探讨。方法从2015年2月—2017年2月该院接收治疗的稳定期COPD患者中,随机抽取100例作为该次研究的对象,并将其平均分为两组,即A组与B组,每组50例;A组采取常规护理,B组在A组护理同时配合呼吸康复治疗,比较两组COPD患者生活治疗情况。结果治疗前,两组患者的肺功能、6 min行走以及生活能力评分对比均差异无统计学意义(P0.05),但治疗后B组均优于A组,两组比较差异有统计学意义(P0.05)。结论在常规临床护理基础上对稳定期慢性阻塞性肺患者积极配合呼吸康复治疗,能够显著提升其肺功能,改善患者的生活质量,值得积极推广与运用。     

益肺健脾汤治疗慢性阻塞性肺疾病稳定期32例分析

目的:研究益肺健脾汤对稳定期慢性阻塞性肺疾病(COPD)患者的肺功能及生命质量的影响。方法:将64例COPD患者随机等分成观察组及对照组各32例,对照组根据COPD不同分级采用一般措施及相应西药治疗,观察组在此基础上加用中药益肺健脾汤治疗,两组均用药三个月后观察两组患者肺功能、生命质量情况。结果:治疗后观察组中医证候控显率(71.88%)、总有效率(93.75%)优于对照组(P0.05);肺功能改善程度优于对照组(P0.01));生活质量评分降低程度及6min步行距离改善程度均优于对照组(P0.05)。两组治疗期间均无不良反应发生。结论:针对稳定期COPD患者,益肺健脾汤在改善中医证候疗效、肺功能及生活质量等方面效果满意。     

康复运动对稳定期COPD49例肺功能的影响

目的:观察康复运动处方对稳定期慢性阻塞性肺疾病(COPD)患者肺功能及运动能力的影响。方法:选取98例稳定期COPD患者为研究对象,将其随机分为观察组与对照组,每组49例。对照组给予基础治疗与常规康复训练;观察组在对照组治疗基础上应用康复运动处方,观察两组患者治疗前后肺功能指标与运动能力变化。结果:两组患者治疗前肺功能指标无统计学差异(P0.05),治疗后均有改善,观察组患者治疗后FVC及FEV1均明显高于对照组,差异有统计学意义(P0.05);两组患者治疗前运动能力无统计学差异(P0.05),治疗后观察组6min步行距离明显较对照组远,差异有统计学意义(P0.05)。结论:康复运动处方的应用,可有效改善稳定期COPD患者肺功能状况,增强运动能力,提高生活质量,值得推广。     

健脾补肾方治疗慢性阻塞性肺疾病稳定期脾肾气虚兼痰瘀证临床研究

目的观察健脾补肾方治疗慢性阻塞性肺疾病(COPD)稳定期脾肾气虚兼痰瘀证的临床疗效。方法将91例COPD稳定期脾肾气虚兼痰瘀证患者随机分为2组,对照组45例给予沙美特罗替卡松粉吸入剂治疗,治疗组46例在对照组基础上加中药健脾补肾方治疗,2组疗程均为3个月。比较2组临床疗效及治疗前后临床症状、体征积分,肺功能、6 min步行试验(6MWT)距离及生活质量变化。结果治疗组总有效率97.83%,对照组84.44%,2组总有效率比较差异有统计学意义(P0.05),治疗组临床疗效优于对照组。2组治疗后咳嗽、咯痰、喘息、哮鸣音症状、体征积分及圣·乔治医院呼吸问题调查问卷(SGRQ)评分中临床症状、活动能力、心理影响评分及总分均较本组治疗前下降(P0.01,P0.05),且治疗组积分低于对照组,比较差异均有统计学意义(P0.05)。2组治疗后肺功能检测第1 s用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC及6MWT距离均较本组治疗前增加(P0.05),且治疗组高于对照组,比较差异均有统计学意义(P0.05)。结论健脾补肾方可有效改善COPD稳定期脾肾气虚兼痰瘀证患者的临床症状及肺功能,提高其生活质量,疗效确切,具有临床应用价值。     

慢性阻塞性肺疾病及并发月市动脉高压之中医述要

慢性阻塞性肺疾病是一种呼吸系统常见病和多发病。肺动脉高压属于肺循环疾病,可由多种心、肺或肺血管本身的疾病引起,以肺血管阻力进行性升高为主要特征,可导致右心负荷增大,右心功能不全,肺血流减少,而引起一系列,陆床表现。近些年,中医药在防治慢性阻塞性肺疾病方面积累了许多宝贵的经验,在治疗慢性阻塞性肺疾病并发肺动脉高压方面也取得了许多进展。     

苏木乙酸乙酯提取物对野百合碱诱导肺动脉高压大鼠肺动脉压、血浆BNP及肺小动脉的影响

目旳 研究苏木乙酸乙酯提取物对野百合碱诱导肺动脉高压大鼠肺动脉压、血浆脑钠肽(BNP)及肺小动脉的影响.方法 采用完全随机化的分组方法将50只健康雄性SD大鼠随机分为空白组、模型组、苏木乙酸乙酯高剂量组、苏木乙酸乙酯低剂量组、阿魏酸钠组,每组10只.除空白组外,其余组大鼠采用腹腔注射野百合碱方法制备肺动脉高压模型.实验...     

槲皮素对肺动脉高压大鼠肺动脉平滑肌细胞增殖和重构的影响

目的:研究槲皮素对野百合碱(MCT)诱导的肺动脉高压大鼠肺动脉平滑肌细胞增殖和肺动脉结构重建的调节作用。方法:成年雄性SD大鼠40只随机分为4组:正常对照组(对照组)、MCT诱导的肺动脉高压组(MCT组)、槲皮素预防组(预防组)和槲皮素治疗组(治疗组),每组10只。测量各组大鼠干预后平均肺动脉压力(mPAP);测定肺小动脉管壁厚度(WT)占动脉外径(ED)的百分比(WT%)及管壁面积(WA)占血管总面积的百分比(WA%);采用免疫组化和Western blot检测肺小动脉平滑肌细胞增殖细胞核抗原(PCNA)和平滑肌细胞抗体(α-SMA)的表达。结果:野百合碱组50mg/kg,再以生理盐水2ml/d每日灌胃一次,共20天,与对照组(生理盐水,再以生理盐水2ml/d每日灌胃一次,共20天)、预防组(MCT 50mg/kg,同时给予槲皮素100mg/kg每日灌胃一次,共20天)和治疗组(MCT 50mg/kg饲养20天后,以槲皮素100mg/kg每日灌胃一次,共20天)相比,mPAP、WT%、WA%、PCNA阳性率显著升高及PCNA、α-SMA的表达显著增多。结论:槲皮素对野百合碱诱导的大鼠肺动脉高压有预防和治疗作用,其机理可能是通过抑制肺血管中小动脉平滑肌细胞增殖,改善肺血管重构。     

肺力咳胶囊联合沙丁胺醇治疗慢性阻塞性肺疾病疗效及对患者肺功能的影响

目的:探讨肺力咳胶囊联合沙丁胺醇治疗慢性阻塞性肺疾病(COPD)疗效及对患者肺功能影响。方法:选取80例COPD患者为研究对象,根据不同治疗方法分为研究组和对照组,每组患者40例。对照组患者采取沙丁胺醇治疗,研究组患者采取肺力咳胶囊联合沙丁胺醇治疗。比较两组患者临床疗效和肺功能。结果:研究组患者的治疗总有效率高于对照组(P<0.05)。两组患者治疗后TNF-α、hs-CRP、IL-4、FEV₁、FVC、PEF均改善,且研究组患者各炎性指标均低于对照组,各肺功能指标均高于对照组,两组比较差异均具有统计学意义(P<0.05)。研究组和对照组不良反应发生率分别为7.5%和10%,两组比较差异无统计学意义(P>0.05)。结论:肺力咳胶囊联合沙丁胺醇治疗COPD疗效较好,可改善患者临床症状,减少气道炎性反应,改善肺功能。     

Effect of cold-dryness on pulmonary and immunologic function in chronic obstructive pulmonary disease model rats

OBJECTIVE： To study the effects of cold-dryness on pulmonary and immunologic function of peripheral T-lymphocytes in chronic obstructive pulmonary disease （COPD） model rats, and to provide references for the prevention and treatment of cold-dryness COPD in the Xinjiang region. METHODS： The COPD model was established with an elastase drip into the trachea combined with smoking. The cold-dryness COPD model was developed by stressing with a cold-dry environment. Success of the model was determined by observation of pathologic lung sections. Rats were sacrificed by exsanguination from the femoral artery and changes of peripheral blood CD4＋, CD8＋, and CD4＋/CD8＋ were detected by flow cytometryo Data were analyzed with SAS 11.5 statistical software. RESULTS： On the ninetieth day after ending the ex- periment, Peak expiratory flow in the cold-dryness COPD group was lower than that in the COPD and normal control groups （P〈0.01）. The time of inspiration in the cold-dryness COPD group was higher than that in the COPD and normal groups （P〈0.05）. Time of expiration （Te） in the cold-dryness COPD group was higher than that in the COPD and normal groups （P〈0.01）. 50% tidal volume expiratory flow （EFS0） in the cold-dryness COPD group was lower than that in the COPD and normal groups （P〈 0.01）, and EFS0 in the COPD group was lower than that in the normal group （P〈0.05）. CD4＋ content of peripheral blood in the cold-dryness COPD group was lower than that in the COPD and the normal groups （P〈0.05）. CD8＋ content in the cold-dryness COPD and COPD groups was higher than that in the normal control group （P〈0.01）, and CD8＋ content in the cold-dryness COPD group was higher than that in the COPD group （P〈0.01）. CD4＋/CD8＋ in the cold-dryness COPD group and the COPD group was lower than that in the normal control group （P〈0.01）, and CD4＋/CD8＋ in the cold-dryness COPD group was lower than that in the COPD group （P〈0.05）. CONCLUSION： In the cold-dryness COPD model, CD8＋ increased and CD4＋/CD8＋ decreased. Moreover, cold-dryness may aggravate this state. The effects of cold-dryness on pulmonary function main- ly manifested as prolongation of Te and decrease of EF50, which could be one of causes of cold-dryness environment in the northwest of China leading to COPD with region characteristics.     

Effect of cold-dryness on pulmonary and immunologic function in chronic obstructive pulmonary disease model rats

Objective

To study the effects of cold-dryness on pulmonary and immunologic function of peripheral T-lymphocytes in chronic obstructive pulmonary disease (COPD) model rats, and to provide references for the prevention and treatment of cold-dryness COPD in the Xinjiang region.

Methods

The COPD model was established with an elastase drip into the trachea combined with smoking. The cold-dryness COPD model was developed by stressing with a cold-dry environment. Success of the model was determined by observation of pathologic lung sections. Rats were sacrificed by exsanguination from the femoral artery and changes of peripheral blood CD4+, CD8+, and CD4+/CD8+ were detected by flow cytometry. Data were analyzed with SAS 11.5 statistical software.

Results

On the ninetieth day after ending the experiment, Peak expiratory flow in the cold-dryness COPD group was lower than that in the COPD and normal control groups (P<0.01). The time of inspiration in the cold-dryness COPD group was higher than that in the COPD and normal groups (P<0.05). Time of expiration (Te) in the cold-dryness COPD group was higher than that in the COPD and normal groups (P<0.01). 50% tidal volume expiratory flow (EF50) in the cold-dryness COPD group was lower than that in the COPD and normal groups (P<0.01), and EF50 in the COPD group was lower than that in the normal group (P<0.05). CD4+ content of peripheral blood in the cold-dryness COPD group was lower than that in the COPD and the normal groups (P<0.05). CD8+ content in the cold-dryness COPD and COPD groups was higher than that in the normal control group (P<0.01), and CD8+ content in the cold-dryness COPD group was higher than that in the COPD group (P<0.01). CD4+/CD8+ in the cold-dryness COPD group and the COPD group was lower than that in the normal control group (P<0.01), and CD4+/CD8+ in the cold-dryness COPD group was lower than that in the COPD group (P<0.05).

Conclusion

In the cold-dryness COPD model, CD8+ increased and CD4+/CD8+ decreased. Moreover, cold-dryness may aggravate this state. The effects of cold-dryness on pulmonary function mainly manifested as prolongation of Te and decrease of EF50, which could be one of causes of cold-dryness environment in the northwest of China leading to COPD with region characteristics.     

慢性阻塞性肺疾病肺性脑病合并低渗性脑病的临床分析

目的：探讨慢性阻塞性肺疾病肺性脑病合并低渗性脑病的临床表现及治疗措施。方法：对慢性阻塞性肺疾病肺性脑病及肺性脑病合并低渗性脑病临床特征及治疗进行回顾性分析。结果：在30例慢性阻塞性肺疾病肺性脑病中肺性脑病合并低渗性脑病16例，经补钠治疗后临床症状明显好转。结论：慢性阻塞性肺疾病肺性脑病合并低渗性脑病病因复杂，预防并及早治疗低钠血症有重要的临床意义。     

肺表面活性物质的研究进展及应用

 目的对肺表面活性物质剂型的研究进展及应用作一简要综述。方法总结了肺表面活性物质组成功能和作用机制,总结分析了近年来国内外关于天然及人工肺表面活性物质的研究进展及应用的相关文献。结果与结论肺表面活性物质不仅自身可以作为治疗药物,也可以作为肺部给药的药物载体,具有较大的发展前景。对于肺表面活性物质的各种给药剂型、剂量、方式的选择需要进一步探索。     

脑钠肽和肺高压

脑钠肽（BNP）是1988年首先从猪脑中分离纯化的一种利尿钠多肽。近年来，BNP在心血管疾病的诊治中广泛应用，成为心力衰竭从筛查、诊断、分级、鉴别到治疗的敏感指标或药物。随着研究的不断深入拓展，BNP在其他领域中的应用逐渐被认识，笔者对BNP在肺高压（PH）疾患中的诊治进展做一综述。