益肺补肾止喘方加减联合西药治疗COPD稳定期的临床研究

目的:观察益肺补肾止喘中药联合沙美特罗替卡松粉吸入剂对COPD稳定期的临床疗效。方法:将符合标准的64例患者按入组先后顺序分为观察组和对照组。对照组32例采用沙美特罗替卡松粉吸入剂治疗,观察组32例在加用益肺补肾止喘中药治疗。观察患者中医证候积分、肺功能和生存质量变化情况。结果:两组患者治疗后中医证候积分逐渐下降。治疗2年后与本组治疗前比较,差异均有统计学意义(P<0.05);组间比较,差异有统计学意义(P<0.05)。两组患者治疗后肺功能均得以改善,以观察组改善更为明显。治疗后组间比较,FEV1差异有统计学意义(P<0.05),FVC和FEV1/预计值比值差异无统计学意义(P>0.05),生存质量积分均差异有统计学意义(P<0.05)。2年内观察组和对照组急性发作2⁵次者分别为65.63%、53.13%,急性发作>5次者分别为34.37%、46.87%,发作最长持续时间分别为9天和11天。结论:益肺补肾止喘中药联合沙美特罗替卡松粉吸入剂对COPD稳定期患者的临床疗效安全可靠,在改善临床症状和肺功能、提高生存质量、减少急性发作次数方面,优于单纯使用沙美特罗替卡松粉吸入剂。

Clinical study on effects of treating COPD in stationary phase by Yifei Bushen Zhike Formula Combined with Western Medicine

Objective ： To observe the clinical effect of traditional Chinese medicine with efficacy of tonifying kidney and relie- ving cough combined with salmeterol powder inhalant on patients in stable phase of COPD. Methods：64 patients who were con- formed to the standard according to the group order were divided into observation group and control group. 32 patients in the con- trol group took salmeterol assigned powder inhalant treatment, and 32 cases in the observation group added Chinese medicine treatment of tonifying lung and kidney. The changes of patients＇TCM syndrome score, pulmonary function and survival quality were observed. Results：The TCM syndrome integral of two groups after treatment was gradually declined. Compared with those be- fore treatment, the difference had statistical significance （ P 〈 0. 05 ）. The difference was statistically significant between two groups （ P 〈 0. 05）. Lung function was improved after treatment in both groups, and the observation group improved more obvi- ously. Between groups after treatment, FEVI difference was statistically significant （ P 〈 0. 05 ） , FVC and FEV1 expected value ratio difference reached the statistical significance （ P 〉 0. 05 ） and the quality of life score＇s difference was statistically significant （P 〈 0. 05）. The acute episodes of 2 - 5 times in 2 years was respectively 65.63% and 53.13% in observation group and con- trol group and the acute episodes more than 5 times was respectively 34.37% and 46.87%. The longest duration time was 9 and 11 days respectively. Conclusion：Yifei Bushen Zhike Formula combined with salmeterol assigned powder inhaler in patients with COPD has stabilization safe and reliable clinical curative effect on improving the clinical symptoms and pulmonary function and improving the quality of survival and reducing the number of acute episodes, and is superior to the simple use of salmeterol as- signed powder inhalant.