摘要目的 探讨祛痰救肺汤联合针灸治疗慢性阻塞性肺疾病( COPD)稳定期患者的临床效果.方法 选取2017年2—12月蓬莱市中医医院肺病科收治的130例稳定期COPD患者,按照单双数分为针灸治疗组和祛痰救肺汤组,每组65 例,针灸治疗组男35 例,女30 例,年龄(57.92 ± 11.36)岁,年龄范围为36~70岁;祛痰救肺汤组男34例,女31例,年龄(58.24 ± 12.07)岁,年龄范围为35~70岁.针灸治疗组患者在常规治疗基础上应用针灸治疗,祛痰救肺汤组患者在针灸治疗组治疗基础上给予祛痰救肺汤治疗.应用中医症状积分评估患者症状改善情况,应用第1秒用力呼吸容积(FEV1)、第1秒用力呼吸容积/用力肺活量百分比( FEV1/FVC)评估患者肺功能;评估慢性阻塞性肺疾病症状评分(CAT),检测血C反应蛋白(CRP)、肿瘤坏死因子( TNF-α)、白细胞介素8 (IL-8)浓度.治疗后跟踪随访6个月,观察急性复发率.结果 治疗后,祛痰救肺汤组患者中医症状总积分[(3.22 ± 0.73)分]低于针灸治疗组[(4.38 ± 0.61)分];FEV1 和 FEV1/FVC [(1.89 ± 0.43)L、(68.46 ± 2.84)% ]均高于针灸治疗组[(1.53 ± 0.47)L、(63.80 ± 2.93)% ];CAT[(11.36 ± 1.30)分]低于针灸治疗组[(14.90 ± 1.27)分];CRP、TNF-α和IL-8[(24.37 ± 4.24)g/L、(53.20 ± 8.61)pg/ml、(7.12 ± 0.97)μg/L]均低于针灸治疗组[(31.49 ± 4.30)g/L、(71.38 ± 9.39)pg/ml、(9.68 ± 0.93)μg/L],差异均有统计学意义(P<0.05).治疗后跟踪随访6个月,祛痰救肺汤组患者急性复发率[4.6% (3/65)]低于针灸治疗组[15.4% (10/65)],差异有统计学意义(P<0.05).结论 应用祛痰救肺汤联合针灸治疗COPD能够显著改善患者症状,提高肺功能,降低炎性因子水平及急性复发率.

abstractsObjective To investigate the clinical effect of expectorant and lung saving decoction combined with acupuncture in the treatment of chronic obstructive pulmonary disease(COPD) patients with stable period. Methods A retrospective study was performed on 130 cases of COPD patients who were ad-mitted from February to December 2017.According to the odd and even numbers,they were divided into the acupuncture and moxibustion treatment group and the expectorant and lungs-relieving decoction group,with 65 patients were in each group. In the acupuncture treatment group,35 males and 30 females were aged (57.92 ± 11.36)years,ranging from 36 to 70 years. There were 34 males and 31 females in the expectorant and lung-saving decoction group,whose ages ranged from 35 to 70 years old(58.24 ± 12.07)years. Patients in the acupuncture and moxibustion treatment group were treated with acupuncture and moxibustion on the basis of conventional treatment,while patients in the expectorant and lung-saving decoction group were trea-ted with expectorant and lung-saving decoction on the basis of acupuncture and moxibustion treatment group. TCM symptom score was used to evaluate the improvement of patients′symptoms,and forced breath-ing volume(FEV1)in the first second and forced breathing volume/forced vital capacity(FEV1/FVC)in the first second were used to evaluate patients′lung function. To assess the chronic obstructive pulmonary dis-ease symptom score(CAT),blood levels of c-reactive protein( CRP),tumor necrosis factor(TNF-α),and interleukin 8 ( IL-8 ) were measured. The acute recurrence rate was observed after 6 months follow-up. Results After treatment,the total score of TCM symptoms in the expectorant and lung-saving decoction group [(3.22 ± 0.73)scores] was lower than that in the acupuncture and moxibustion group [(4.38 ± 0.61)scores].FEV1 and FEV1/FVC [(1.89 ± 0.43) L,(68.46 ± 2.84)% ] were higher than those in the acupuncture and moxibustion group [(1.53 ± 0.47) L,(63.80 ± 2.93)% ].CAT [(11.36 ± 1.30) scores] was lower than that of the acupuncture and moxibustion group [(14.90 ± 1.27) scores]. CRP, TNF-α and IL-8 [(24.37 ± 4.24) g/L,(53.20 ± 8.61) pg/ml,(7.12 ± 0.97) g/L] were lower than those of the acupuncture and moxibustion group [(31.49 ± 4.30) g/L,(71.38 ± 9.39) pg/ml,(9.68 ± 0.93)g/L],and the differences were statistically significant(P<0.05). After 6 months of follow-up,acute recurrence rate [4.6% (3/65)] was lower in the treatment group than in the acupuncture and moxibustion group [15.4% (10/65)],and the difference was statistically significant(P<0.05). Conclusion The ap-plication of Qutanjiufeitang combined with acupuncture for stable COPD improve lung function,reduce in-flammatory factor levels and acute recurrence.