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中国中医科学院 西苑医院,北京 100091
Received:26 May 2024,
Accepted:12 August 2024,
Published Online:09 September 2024,
Published:20 March 2025
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何沂,李紫雨,张文江等.固本祛瘀解毒方治疗慢性阻塞性肺疾病合并阻塞性睡眠呼吸暂停低通气综合征夜间低氧血症的临床观察[J].中国实验方剂学杂志,2025,31(06):146-153.
HE Yi,LI Ziyu,ZHANG Wenjiang,et al.Clinical Observation of Guben Quyu Jiedu Prescription in Treating Nocturnal Hypoxemia of COPD Combined with OSAHS[J].Chinese Journal of Experimental Traditional Medical Formulae,2025,31(06):146-153.
何沂,李紫雨,张文江等.固本祛瘀解毒方治疗慢性阻塞性肺疾病合并阻塞性睡眠呼吸暂停低通气综合征夜间低氧血症的临床观察[J].中国实验方剂学杂志,2025,31(06):146-153. DOI: 10.13422/j.cnki.syfjx.20242023.
HE Yi,LI Ziyu,ZHANG Wenjiang,et al.Clinical Observation of Guben Quyu Jiedu Prescription in Treating Nocturnal Hypoxemia of COPD Combined with OSAHS[J].Chinese Journal of Experimental Traditional Medical Formulae,2025,31(06):146-153. DOI: 10.13422/j.cnki.syfjx.20242023.
目的
2
观察固本祛瘀解毒方治疗慢性阻塞性肺疾病(COPD)合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)夜间低氧血症(肺脾肾虚、瘀毒交阻证)的临床疗效及安全性。
方法
2
采用前瞻性、随机双盲、安慰剂对照的设计方法,选择符合COPD合并OSAHS的西医诊断标准且中医辨证为肺脾肾虚、瘀毒交阻证患者96例,随机分为观察组和对照组,各48例。两组均在西医常规治疗基础上,观察组加用固本祛瘀解毒方,对照组加用中药安慰剂治疗,疗程均为90 d。比较治疗前后两组患者夜间最低血氧饱和度(SpO
2
)、呼吸暂停指数(AHI)、OSAHS疗效判定、中医证候疗效评定、中医症状积分的变化。
结果
2
观察组脱落5例、对照组脱落8例,实际完成观察组43例,对照组40例。与治疗前比较,观察组夜间最低SpO
2
、AHI均显著改善(
P
<
0.01),且显著优于对照组(
P
<
0.01);OSAHS疗效观察组优于对照组(
χ
2
=7.085,
P
<
0.05);中医证候疗效,观察组总有效率81.40%(35/43),对照组总有效率15.00%(6/40),观察组明显高于对照组(
χ
2
=36.78,
P
<
0.01);中医症状积分二组均较治疗前改善,在打鼾、憋醒、嗜睡、咳嗽4项主证上疗效相当,但在头昏头痛、胸闷胸痛、喘息、口干口渴等10项细节上观察组优于
对照组(
P
<
0.05)。
结论
2
固本祛瘀解毒方联合常规西医治疗COPD合并OSAHS夜间低氧血症(肺脾肾虚、瘀毒交阻证),可改善患者最低SPO
2
、提升OSAHS控制水平、提高生活质量、改善临床症状。
Objective
2
To observe the clinical efficacy and safety of Guben Quyu Jiedu prescription in treating nocturnal hypoxemia of chronic obstructive pulmonary disease (COPD) combined with Obstructive sleep apnea hypopnea syndrome ( OSAHS ) (deficiency of lung, spleen and kidney with blood stasis and toxicity).
Methods
2
The paper used a forward-looking, random double-blind, placebo-controlled design method to select 96 patients with COPD combined with OSAHS, and their traditional Chinese medicines (TCM) syndrome differentiation was deficiency of lung, spleen and kidney with blood stasis and toxicity. These patients were randomly divided into the observation group and the control group, with 48 cases in each group. Based on conventional Western medicine treatment, the observation group was treated with Guben Quyu Jiedu prescription and the control group was treated with traditional Chinese medicine placebo. Both courses of treatment were 90 days. Then the paper compared the changes in minimum pulse oxygen saturation (SpO
2
) during the night, apnea index (AHI), OSAHS efficacy evaluation, TCM syndrome efficacy evaluation, and TCM symptom score before and after treatment between the two groups.
Results
2
There were 5 withdrawals in the observation group and 8 withdrawals in the control group, so 43 cases in the observation group and 40 cases in the control group completed the trial. Compared with the condition before treatment, the minimum SpO
2
during the night and AHI in the observation group were significantly improved at night (
P
<
0.01) and were better than those in the control group (
P
<
0.01). OSAHS efficacy in the observation group was better than
in the control group (
χ
2
=7.085,
P
<
0.05). In terms of TCM syndrome efficacy, the total effective rate was 81.40% (35/43) in the observation group, significantly higher than that in the control group, which was 15.00% (6/40) (
χ
2
=36.78,
P
<
0.01). The TCM symptom scores of the two groups were improved compared with the condition before treatment, and the effect of the two groups was similar in the four main symptoms of snoring, choking, lethargy, and cough. However, the observation group was better than the control group in 10 details such as dizziness, headache, chest tightness, chest pain, wheezing, dry mouth, and thirst (
P
<
0.05).
Conclusion
2
Using Guben Quyu Jiedu prescription combined with conventional Western medicine can treat COPD combined with OSAHS hypoxemia at night (deficiency of lung, spleen and kidney with blood stasis and toxicity). In this way, the minimum pulse oxygen saturation (SpO
2
) of patients, the level of disease control, and the quality of life of patients can be improved, and the clinical symptoms can be relieved.
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