纳气通络方联合西药治疗肺肾气虚型慢性阻塞性肺疾病稳定期临床研究

目的观察纳气通络方联合西药治疗肺肾气虚型慢性阻塞性肺疾病（COP／））稳定期的临床疗效。方法将93例患者随机分为治疗组（45例）和对照组（48例），对照组予西药常规治疗及中药安慰剂，治疗组在西药常规治疗基础上加用中药纳气通络方。两组疗程均为3个月，治疗结束后随访9个月，评价中医证候疗效并观察肺功能（FEV1、FEV1／FVC、FEV，％）指标、SGRQ评分、1年内感冒次数及COPD急性加重次数等的变化情况。结果①共有86例患者完成临床观察，治疗组44例，对照组42例。②治疗组、对照组总有效率分别为88．64％、71．43％；组间中医证候疗效比较，治疗组优于对照组，差异有统计学意义（P〈0．05）。③治疗前后组内比较，两组第1秒用力呼吸容积（FEV1）、FEV1与用力肺活量（FVC）的比值（FEV1／FVC）及FEV。占预计值百分比（FEV1％）水平差异有统计学意义（P〈0．05）；组间治疗后比较，各肺功能指标水平差异有统计学意义（P〈0．05）。④治疗前后组内比较，两组圣乔治呼吸量表（SGRQ）各项评分（症状评分、活动评分、影响评分、总计评分）差异均有统计学意义（P〈0．05）；组问治疗后比较，各项评分治疗组均较对照组明显下降（P〈0．05）。⑤治疗后9个月内治疗组的感冒次数与COPD急性发作次数均明显少于对照组（P〈0．05）。结论纳气通络方联合西药治疗稳定期COPD，可显著减轻患者临床症状、改善肺功能、提高生活质量、增强体质。

Combination of ＂Naqi Tongluo Decoction＂ and western medicine for the treatment of chronic obstructive pulmonary disease at stable phase of lung qi and kidney qi deficiency type

Objective To verify the clinical efficacy of ＂Naqi Tongluo Decoction＂ and western medicine in treating chronic obstructive pulmonary disease （COPD） at stable phase of lung qi and kidney qi deficiency type. Methods Ninety-three cases with COPD were randomized into two groups ： control group in which 48 cases were treated by routine western medicine and Chinese medical placebo, and treatment group in which 45 cases were treated by routine western medicine and ＂Naqi Tongluo Decoction＂, with the course of 3 months. The patients were follow up after treatment for 9 months. The indicators of lung function （ FEV1 , FEV1 / FVC, FEV1% ）, SGRQ score, times of catching cold in 1 year and acute aggravation times were evaluated before or after treatment. Results （1） Eighty-six cases were observed, 44 in treatment group and 42 in control group. （1） The overall effective rate was 88.64% in the treatment group and 71.43% in the control group, with a difference between the two groups （P 〈0.05）. （3） In each group, there were significant differences in FEV1 , FEVI/FVC and FEV1% between before and after treatment （ P 〈 0.05 ） ; after treatment, significant differences were found in the indicators of lung function between the two groups （ P 〈 0.05 ）. （4） In each of the group, significant difference was found in SGRQ scores between the two groups （ P 〈 0.05 ） ; after treatment, all the scores in treatment group were reduced markedly, with significant difference between treatment group and control group （P 〈 0.05 ）. （5） Nine months after treatment, the times of catching a cold and acute attack in treatment group were less than that of the controls （ P 〈 0.05 ）. Conclusion Combined ＂Naqi Tongluo Decoction＂ and western medicine can alleviate the clinical symptoms, improve the lung function, improve the life quality and enhance the physical fitness in COPD at stable phase.