益气温阳、活血化痰法对慢性阻塞性肺疾病稳定期患者生命质量及急性加重的影响

目的:观察益气温阳、活血化痰法对慢性阻塞性肺疾病(COPD)稳定期患者健康相关生命质量及急性加重的影响。方法:根据慢性阻塞性肺疾病诊断、处理和预防全球策略(2011年修订版),将62例中医辨证属肺肾阳(气)虚,血瘀痰阻证的COPD稳定期D组患者分为治疗组(n=30)和对照组(n=32),治疗组在夏季阳气最旺时口服益气温阳、活血化痰中药复方(7⁹个月)联合噻托溴铵粉吸入(18μg,吸入,1次/d,持续12个月),并与单纯噻托溴铵粉吸入组(18μg,吸入,1次/d,持续12个月)对照,记录患者入组时、3个月末、6个月末、12月末时慢性阻塞性肺疾病评估测试量表(CAT)评分,入组时、6个月末、12月末时肺功能,及12个月内COPD急性加重次数。结果:两组患者治疗后CAT分值较治疗前均有所下降,FEV1%pred有上升,两组间比较治疗组3个月末、6个月末时CAT分值明显好于对照组(P<0.05),FEV1%pred改善治疗组更明显(P<0.05)。12个月内急性加重次数两组均有减少,但治疗组与对照组比较差异有显著性(P<0.05)。结论:夏季口服益气温阳、活血化痰中药复方,联合噻托溴铵粉吸入,能有效提高COPD稳定期患者健康相关生命质量,改善肺功能,减少急性加重。

Effect of TCM Therapy by Principle for Nourishing Qi,Warming Yang,Activating Blood Circulation and Resolving Phlegm on Health-Related Quality of Life and Events of Acute Exacerbation During Stable Stage of Chronic Obstructive Pulmonary Disease

Objective: To observe the effect of TCM therapy for nourishing Qi,warming Yang,activating blood circulation and resolving phlegm on health- related quality of life and events of acute exacerbation during stable stage of chronic obstructive pulmonary disease( COPD). Methods: Sixty- two subjects with stable COPD in group D classified by combined COPD assessment in GOLD 2011,with Yang Qi- deficiency,blood stasis and phlegm retention syndrome were divided into a treatment group( n = 30) and a control group( n = 32). The control group was only treated with tiotropium( 18 μg,inhalation,once a day for twelve month) and the treatment group patients were treated with tiotropium( 18 μg,inhalation,once a day for twelve month) and Chinese compound recipe was prescribed based on the principle of nourishing Qi,warming Yang,activating blood circulation and resolving phlegm in summer. Health- related quality of life was measured by CAT at baseline,third month,sixth month and twelfth month. Lung function were measured at baseline,sixth month and twelfth month. The events of acute exacerbation were also recorded. Results: No significant differences existed between the groups at baseline. After 3 months,6 months and 12 months,the average im-provements( lower CAT scores and higher FEV1% pred) were significant in both treatment group and control group( P < 0. 05),and there was a greater improvement in treatment group. Conclusion: Combination treatment with tiotropium and Chinese compound recipe prescribed based on the principle of nourishing Qi,warming Yang,activating blood circulation and resolving phlegm results in greater therapeutic benefits than tiotropium inhalation alone in stable COPD patients of group D.