补中益气汤治疗慢性阻塞性肺疾病临床疗效分析

目的探讨补中益气汤加减联合西医常规疗法治疗稳定期慢性阻塞性肺疾病(COPD)患者的临床疗效及其对患者呼吸肌和肺功能的影响。方法纳入2015年8月至2016年8月在本院治疗的120例稳定期COPD患者,根据治疗方法不同分为补中益气组(补中益气汤加减+舒利迭)和常规组(舒利迭)各60例,连续用药8周。采用第1秒用力呼气容积占预计值的百分比(FEV1%预计值)、第1秒用力呼气容积/用力肺活量(FEV1/FVC)评价各组患者治疗前后的肺功能指标。采用辅助呼吸肌动用评分、医学研究委员会呼吸困难刻度尺(MRC)评分对患者的呼吸肌力进行评估。采用SPSS 16.0对数据进行统计分析。结果治疗后,补中益气组患者的咳嗽、咳痰、喘息、自汗、易感冒、气短、哮鸣音等评分均低于常规组(P0.05);补中益气组的第1秒用力呼气容积占预计值的百分比(FEV1%预计值)和第1秒用力呼气容积/用力肺活量(FEV1/FVC)均高于常规组[FEV1%:(57.92±6.09)(52.84±6.64);FEV1/FVC:(67.34±7.11)vs(63.01±6.95);P0.05],且均较治疗前显著增高(P0.05);补中益气组的呼吸肌动用评分和MRC评分均低于常规组[(1.41±0.41)(1.79±0.50);(1.38±0.39)(1.61±0.49);P0.05],且均较治疗前显著下降(P0.05);补中益气组的治疗总有效率高于常规组(95.00%vs 81.67%;P0.05)。结论补中益气汤加减联合西医常规疗法治疗稳定期COPD患者能改善肺功能、缓解呼吸肌疲劳症状,提高临床疗效。

Clinical efficacy of Buzhong Yiqi Decoction in treatment of chronic obstructive pulmonary disease

Objective To investigate the clinical efficacy of modified Buzhong Yiqi Decoction combined with conventional drug therapy in the treatment of stable chronic obstructive pulmonary disease (COPD), and determine the effect on respiratory muscle and lung function in the patients. Methods A total of 120 patients with stable COPD admitted in our hospital from August 2015 to August 2016 were prospectively enrolled in this study. They were equally and randomly divided into the treatment group (Buzhong Yiqi Decoction+Seretide Evohale) and control group (Seretide Evohale). After the treatment of 8 weeks, the predicted percentage of forced expiratory volume in one second (FEV1%), ratio of FEV1 to forced vital capacity (FEV1/FVC)) were used to evaluate the pulmonary function parameters of each group before and after treatment, and the score of the activity of accessory respiratory muscles and the Medical Research Council dyspnea scale (MRC) were employed to assess the respiratory muscle strength of the patients. Statistical analysis was performed using SPSS 16.0. Results After the treatment, when compared with the control group, Buzhong Yiqi Decoction group had obviously lower scores in cough, expectoration, gasp, spontaneous sweating, colds, shortness of breath and wheezing (P<0.05), significantly higher predicted FEV1% [(57.92±6.09) vs (52.84±6.64), P<0.05] and ratio of FEV1/FVC [(67.34±7.11) vs (63.01±6.95), P<0.05], and notably lower MRC [ (1.38±0.39) vs (1.61±0.49), P<0.05] and accessory respiratory muscle activity score[ (1.41±0.41) vs (1.79±0.50), P<0.05]. The total efficiency was higher in Buzhong Yiqi Decoction group than the control group (95.00% vs 81.67%, P<0.05). Conclusion Modified Buzhong Yiqi Decoction combined with conventional drug therapy can improve lung function, relieve respiratory muscle fatigue, and thus promote the clinical efficacy in the stable COPD patients.