健脾通络汤治疗慢性阻塞性肺疾病合并抑郁症的效果研究

  目的  观察健脾通络汤对慢性阻塞性肺疾病合并抑郁症(肺脾气虚痰瘀阻肺证)患者呼吸道症状、肺通气功能及心理状态的影响。  方法  采用随机数字表法将浙江普陀医院呼吸与危重症医学科2019年9月—2020年9月收治的84例慢性阻塞性肺疾病合并抑郁症患者分为观察组(42例)和对照组(42例)，对照组给予祛痰、解痉等常规西药治疗，观察组在对照组基础上联合健脾通络汤治疗，2组1个疗程均为4周，共治疗3个疗程。比较治疗前后2组呼吸道症状、CAT评分、BODE指数评分、HAMD评分、SDS评分及肺通气功能指标(FEV₁、FEV₁/FVC、MIP、MEP)的改善状况，并评估2组临床疗效及不良反应。  结果  观察组和对照组总有效率分别为92.86%、76.19%，观察组明显高于对照组(P＜0.05)；治疗后，观察组呼吸道症状积分、CAT评分和BODE指数评分，SDS评分和HAMD评分均明显低于对照组(均P＜0.05)，FEV₁、FEV₁/FVC、MIP、MEP水平均明显高于对照组(均P＜0.05)；2组均无明显不良反应。  结论  健脾通络汤能够改善慢性阻塞性肺疾病合并抑郁症患者肺通气功能，缓解呼吸道症状，改善患者抑郁状态。 

Effects of Jianpi Tongluo Decoction on chronic obstructive pulmonary disease complicated with depression

  Objective  To observe the effect of Jianpi Tongluo Decoction on the respiratory symptoms, pulmonary ventilation function and psychological state of patients with chronic obstructive pulmonary disease complicated with depression (Fipi Qixu Tanyu Zufei syndrome).  Methods  A total of 84 patients with chronic obstructive pulmonary disease complicated with depression treated in the Department of Respiratory and Critical Care Medicine of Putuo Hospital from September 2019 to September 2020 were randomly divided into observation group and control group, with 42 patients in each group. The control group was treated with conventional Western medicine, such as expectorant and antispasmodic, and the observation group was treated with Jianpi Tongluo Decoction on the basis of the control group. One course of treatment in both groups was 4 weeks, with a total of three courses of treatment. The respiratory symptoms, CAT, BODE index, HAMD, SDS and pulmonary ventilation function index (FEV₁, FEV₁/FVC, MIP and MEP) scores were compared. The clinical efficacy and adverse reactions of the two groups were evaluated.  Results  The total effective rates of the observation and control groups were 92.86% and 76.19%, respectively. The observation group had a significantly higher rate than the control group (P < 0.05). After treatment, the respiratory symptoms, CAT, BODE index, SDS and HAMD scores of the observation group were significantly lower than those of the control group (all P < 0.05). Meanwhile, the FEV₁, FEV₁/FVC, MEP and MIP index levels of the observation group were significantly higher than those of the control group (all P < 0.05). No obvious adverse reactions were observed in both groups.  Conclusion  The application of Jianpi Tongluo Decoction could improve pulmonary ventilation function, alleviate respiratory symptoms and improve depression in patients with chronic obstructive pulmonary disease complicated with depression.