摘要
目的观察早期介入中医肺康复对慢性阻塞性肺疾病急性加重期(AECOPD)患者的临床疗效并探讨其作用机制。方法76例患者按照随机数字表法分为早期中医药康复组(治疗组)38例,常规康复组(对照组)38例。治疗组在评估患者病情进入"AECOPD危险窗"后即进行早期中医药康复联合基础健康宣教,对照组在病情进入"AECOPD危险窗"后进行基础健康宣教,随访观察24周,观察两组临床疗效。结果两组治疗前咳嗽、咯痰、胸闷、气喘等8项评分及CAT评分总分比较,差别均不大(均P>0.05)。治疗后两组咳嗽、咯痰、胸闷、气喘等症状评分及CAT评分均较治疗前改善(均P<0.05),且治疗组咳嗽咯痰胸闷气促等改善优于对照组(P<0.05);治疗后两组外出能力评分比较,差别不大(P>0.05)。治疗后治疗组CAT评分总分低于对照组(P<0.05)。两组治疗前肺功能指标比较,差别不大(均P>0.05)。两组治疗后肺功能指标均较治疗前改善(均P<0.05);治疗组治疗后FVC、FEV1/FVC与对照组比较差别不大(均P>0.05),但治疗后治疗组FEV1%高于对照组(P<0.05)。两组在治疗前mMRC、CRP、D-Di比较,差别均不大(均P>0.05)。两组治疗后mMRC、CRP、DDi均较治疗前下降(均P<0.05)。治疗组治疗后m MRC、CRP、D-Di与对照组治疗后比较下降更为明显(均P<0.05)。结论以"AECOPD危险窗"为介入点的早期中医肺康复可促进肺功能康复,改善患者生活质量,降低炎症反应水平,改善血凝状况。
Objective:To investigate the clinical efficacy of early interventional TCM pulmonary rehabilitation in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and explore its mecha⁃nism.Methods:A total of 76 AECOPD patients were divided into the early TCM pulmonary rehabilitation group(therapy group)and routine rehabilitation group(control group)according to random number table method,38 cas⁃es in each group.After assessing the patients’condition into the“AECOPD risk window”,the therapy group re⁃ceived early TCM rehabilitation combined with basic health education.The control group received basic health ed⁃ucation after the patient’s condition entered the“AECOPD risk window”.Follow-ups for 24 weeks were conduct⁃ed to observe the clinical efficacy of the two groups.Results:There was no statistically significant difference be⁃tween the 8 item scores of coughing,sputum,chest tightness and asthma and the total score of CAT scores between the two groups before treatment(P>0.05).After treatment,the scores of cough,sputum,chest tightness and short⁃ness of breath in both groups improved(P<0.05),and the improvements in the therapy group were better than those of the control group(P<0.05).After treatment,there was little difference in the scores of the ability to go out between the two groups(P>0.05).After treatment,the total CAT score of the therapy group was lower than that of the control group(P<0.05).The comparison of lung function indices before treatment between the two groups showed little difference(P>0.05).Pulmonary function indices of the two groups were improved after treat⁃ment(P<0.05);FVC,FEV1/FVC after treatment in the therapy group were not significantly different from those in the control group(P>0.05),but FEV1pred%in the therapy group was higher after treatment than the control group(P<0.05).Before treatment,the two groups had little difference in mMRC,CRP and D-Di(P>0.05),and the lev⁃els of mMRC,CRP,and D-Di decreased after treatment in the two groups compared with before treatment(P<0.05)and the levels of mMRC,CRP,and D-Di decreased more significantly in the therapy group than in the con⁃trol group(P<0.05).Conclusion:Early TCM pulmonary rehabilitation with"AECOPD risk window"as the inter⁃vention point can promote pulmonary function rehabilitation,improve the patient's quality of life,reduce the level of inflammation,and improve blood coagulation.
作者
彭磊
夏卫明
何健忠
陈红英
Peng Lei;Xia Weiming;He jianzhong;Chen Hongying(Qidong Hospital of TCM,Jiang-su,Qidong 226200,China)
出处
《中国中医急症》
2020年第9期1583-1586,1605,共5页
Journal of Emergency in Traditional Chinese Medicine
基金
南通市市级科技计划(指导性)项目(GJZ17004)
南通市卫生和计划生育委员会科研课题专项(指导性)(WKZD2018020)。
关键词
慢性阻塞性肺疾病急性加重期
危险窗
中医
肺康复
Acute exacerbation of chronic obstructive pulmonary disease
Risk window
TCM
Pulmonary reha⁃bilitation
