补肺汤合参蛤散辨治联合伏九贴敷对稳定期COPD肺肾气虚证患者的防治

姚诗清; 周兰; 孙涛; 柳雯; 汪超; 王苗苗

doi:10.13422/j.cnki.syfjx.20192331

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补肺汤合参蛤散辨治联合伏九贴敷对稳定期COPD肺肾气虚证患者的防治

临床 | 更新时间：2021-02-09

- 补肺汤合参蛤散辨治联合伏九贴敷对稳定期COPD肺肾气虚证患者的防治
- Effect of Dialectical Therapy of Bufeitang Combined with Shengesan and Fujiu Application on COPD at Stable Period and Lung-kidney Qi Deficiency Syndrome
- 中国实验方剂学杂志 2020年26卷第7期页码：92-97
- 作者机构：
  
  蚌埠医学院　第一附属医院，安徽蚌埠　 233004
- 作者简介：
  
  [第一作者]　姚诗清，硕士，副主任中医师，从事中西医结合内科学的临床、科研及教学工作，E-mail：ysqdww@163.com
  *周兰，主任中医师，从事中医内科学的临床、科研及教学工作，E-mail：zhoulan3092845@163.com
- 基金信息：
  
  2016年安徽省卫生和计划生育委员会科研计划项目（全科医学临床科研课题）(2016QK072)
- DOI：10.13422/j.cnki.syfjx.20192331
  中图分类号： R25; R56; R256; R256.1
- 收稿日期：2019-08-12，
  
  网络出版日期：2019-09-25，
  
  纸质出版日期：2020-04-05
- 稿件说明：
移动端阅览
姚诗清, 周兰, 孙涛, 等. 补肺汤合参蛤散辨治联合伏九贴敷对稳定期COPD肺肾气虚证患者的防治[J]. 中国实验方剂学杂志, 2020,26(7):92-97.

Shi-qing YAO, Lan ZHOU, Tao SUN, et al. Effect of Dialectical Therapy of Bufeitang Combined with Shengesan and Fujiu Application on COPD at Stable Period and Lung-kidney Qi Deficiency Syndrome[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(7): 92-97.
姚诗清, 周兰, 孙涛, 等. 补肺汤合参蛤散辨治联合伏九贴敷对稳定期COPD肺肾气虚证患者的防治[J]. 中国实验方剂学杂志, 2020,26(7):92-97. DOI： 10.13422/j.cnki.syfjx.20192331.

Shi-qing YAO, Lan ZHOU, Tao SUN, et al. Effect of Dialectical Therapy of Bufeitang Combined with Shengesan and Fujiu Application on COPD at Stable Period and Lung-kidney Qi Deficiency Syndrome[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(7): 92-97. DOI： 10.13422/j.cnki.syfjx.20192331.

摘要

目的：

观察补肺汤合参蛤散辨治联合伏九贴敷对稳定期慢阻肺(COPD)肺肾气虚证的防治效果及对炎症损伤和气道重塑的影响。

方法：

选取134例患者作为研究对象，随机按数字表法分为对照组66例和观察组68例。对照组采用噻托溴铵粉吸入剂，每次采用药粉吸入器吸入1粒胶囊，1次/d，并视情况加用沙美特罗替卡松粉吸入剂，喷雾吸入，每次1吸，1～2次/d，连续治疗12个月；观察组西医治疗同对照组，并给予伏九贴敷，在三伏的每一伏的第1天和三九的每一九的第1天，将药饼贴敷于双侧肺俞、脾俞、肾俞，共计6次，并于三伏第1天和三九第1天分别开始给予补肺汤合参蛤散辨治，分别连续服用2个月，共服用4个月。两组疗程均为连续治疗12个月。进行治疗前后慢阻肺患者自我评估测试问卷(CAT)FEV

占预计值百分比(FEV

%)，6 min步行距离(6 MWD)，圣乔治呼吸问卷(SGRQ)，呼吸困难严重程度(mMRC)和BODE指数评价；检测治疗前后肿瘤坏死因子-

(TNF-

)，白细胞介素-6(IL-6)，基质金属蛋白酶-9(MMP-9)和基质金属蛋白酶抑制因子1(TIMP-1)。

结果：

治疗后观察组患者CAT评分低于对照组(

0.01)，FEV

%较对照组升高(

0.01)；观察组患者SGRQ总分及各个维度评分均低于对照组(

0.01)；观察组患者6 min步行距离多于对照组(

0.01)，急性加重次数少于对照组(

0.01)，BODE指数评分低于对照组(

0.01)；观察组患者呼吸困难严重程度轻于对照组(

＝2.047，

0.05)；观察组MMP-9，TNF-

和IL-6水平均低于对照组(

0.01)，TIMP-1水平高于对照组(

0.01)，MMP-9/TIMP-1低于对照组(

0.01)。

结论：

补肺汤合参蛤散辨治联合伏九贴敷干预稳定期慢阻肺(肺肾气虚证)患者，可减轻当前呼吸困难症状，改善了运动耐量和生活质量，提高了肺功能，减少了急性加重次数，减轻了炎症损伤和气道的重塑，临床综合效果优于西医常规治疗。

Abstract

Objective:

To observe the clinical efficacy of dialectical therapy of Bufeitang combined with Shengesan and Fujiu application on chronic obstructive pulmonary disease (COPD) and lung-kidney Qi deficiency syndrome

and its effect on inflammatory damage and airway remodeling.

Method:

One hundred and thirty-four patients were randomly divided into control group (66 cases) and observation group (68 cases) by random number table. Patients in control group got spiriva by powder inhaler

1 grain/time

1 time/day

and salmeterol xinafoate and fluticasone propionate powder for inhalation for spray as appropriate

1 suction/time

1-2 times/days

for a continued 12 months. In addition to the therapy of control group

patients in observation group were also given Fujiu application at two-tailed acupoints of Feiyu

Piyu and Shenyu for the first day of the every San Fu and San Jiu

and dialectical therapy of Bufeitang combined with Shengesan were given at the first day of San Fu and San Jiu for 2 months. The course of treatment was 12 months. Before and after treatment

FEV

% of self-assessment questionnaire of patients with COPD (CAT)

6-min walking distance

St George's respiratory questionnaire (SGRQ)

severity of dyspnea (mMRC) and index of BODE were assessed. And levels of tumor necrosis factor-alpha (TNF-alpha)

interleukin-6 (IL-6)

matrix metalloproteinase-9 (MMP-9) and matrix metalloproteinase inhibitor-1 (TIMP-1) were detected.

Result:

After treatment

scores of CAT

the total score of SGRQ

scoring of each dimension and index of BODE in observation group were all lower than that in control group (

0.01)

while FEV

% was higher than that in control group (

0.01). And 6-min walking distance was more than that in control group (

0.01)

and the numbers of acute exacerbations were less than that in control group (

0.01). The severity of dyspnea was lighter than that in control group (

=2.047

0.05). And levels of MMP-9

TNF-

IL-6 and ratio of MMP-9/TIMP-1 were lower than those in control group (

0.01)

whereas the level of TIMP-1 was higher than that in control group (

0.01).

Conclusion:

Dialectical therapy of Bufei decoction combined with Shenge powder and Fujiu application can alleviate the current symptoms of dyspnea

improve exercise tolerance

quality of life and pulmonary function

reduce the number of acute exacerbations

relieve inflammation damage and airway remodeling. The comprehensive clinical efficacy is better than that of conventional western medicine.

关键词

Keywords

references

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