中药穴位贴敷联合沙美特罗替卡松粉治疗慢性阻塞性肺疾病患者有效性和安全性研究

胡凤臻+李秀荣+孙红红

[摘要] 目的 评价中药穴位贴敷联合沙美特罗替卡松粉治疗慢性阻塞性肺疾病患者的有效性和安全性。 方法 选取2011年12月～2013年3月在河北省衡水市中医医院接受治疗的116例慢性阻塞性肺疾病患者作为研究对象，采用随机数字表法将所有研究对象分为实验组和对照组，每组58例。对照组患者单独使用沙美特罗替卡松粉吸入剂进行治疗，实验组患者采用中药穴位贴敷联合沙美特罗替卡松粉吸入剂治疗，比较两组患者疗效、肺功能、St.George呼吸疾病调查问卷评分和不良反应。 结果 实验组总有效率为96.55%，而对照组仅为72.41%，两组比较差异有统计学意义（P < 0.05）。治疗后，两组第1秒用力呼气量（FEV1）、用力肺活量（FVC）和呼气流速峰值（PEF）均明显上升，与治疗前比较，差异均有统计学意义（P < 0.05），同时治疗后实验组上述指标明显高于对照组，差异有统计学意义（P < 0.05）。实验组症状、活动和疾病影响评分均明显低于对照组，差异有统计学意义（P < 0.05）。实验组有1例患者出现皮肤瘙痒发红过敏现象，停止使用后自行恢复。 结论 中药穴位贴敷联合沙美特罗替卡松粉治疗慢性阻塞性肺疾病患者具有良好的效果，可显著改善患者肺功能和生存质量，值得在临床上推广应用。

[关键词] 中药穴位贴敷；慢性阻塞性肺疾病；肺功能；疗效；安全性

[中图分类号] R563.1 [文献标识码] A [文章编号] 1673-7210（2016）10（c）-0142-04

[Abstract] Objective To evaluate the efficacy and safety of acupoint application combined with Salmeterol and Fluticasone Propionate Powder in the treatment of patients with chronic obstructive pulmonary disease. Methods One hundred and sixteen cases of patients with chronic obstructive pulmonary disease treated in Hengshui Hospital of Chinese Medicine from December 2011 to March 2013 were selected as research objects， all patients were divided into the experimental group and the control group by random number table method， with 58 cases in each group. The control group was only treated with alone Salmeterol and Fluticasone Propionate Powder Inhalant， the experimental group was treated with acupoint application combined with Salmeterol and Fluticasone Propionate Powder Inhalant. The curative effect， pulmonary function， scores of St. George respiratory questionnaire and adverse reactions of the two groups were compared. Results The total effective rate of the experimental group was 96.55%， which of control group was 72.41%， the difference was statistically significant （P < 0.05）. After treatment， the first second forced expiratory volume （FEV1）， forced vital capacity （FVC） and peak expiratory flow （PEF） of the two groups were significantly improved compared with those before treatment， the differences were statistically significant （P < 0.05）， and the indexes above after treatment in the experimental group were significantly higher than those of control group， the differences were statistically significant （P < 0.05）. The scores of symptoms， activity， influence of disease in the experimental group were lower than those of control group， the differences were statistically significant （P < 0.05）. There was 1 case of skin itching and redness allergic phenomenon in the experimental group， and it restored automatically after stop using. Conclusion Acupoint application combined with Salmeterol and Fluticasone Propionate Powder in the treatment of chronic obstructive pulmonary disease has a good curative effect， which can improve pulmonary function and quality of life， it is worthy to be popularized in clinical application.

[Key words] Acupoint application； Chronic obstructive pulmonary disease； Pulmonary function； Efficacy； Safety

慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）是一种国内外均多发的呼吸系统疾病，是造成死亡排名第四的原因，研究数据显示，我国约有2500万例COPD患者，并且每年因该疾病死亡的人数高达100万例，近年来，COPD发病率和病死率进一步呈现上升趋势[1-3]。COPD属于呼吸系统慢性病的一种，以气喘、胸闷、咳嗽等为主要症状，常在春冬季节急性加重，该病反复发作会造成患者肺功能减退，严重的甚至出现呼吸衰竭等威胁患者生命的症状[4-5]。目前，西医对该病的治疗以长期氧疗、使用支气管舒张剂和康复治疗几个方式为主，虽研究较多，但均未见显著疗效[6-7]。最新研究显示，中医药在COPD的治疗中具有独有的优势，中医认为COPD为本虚标实，属肺脾肾虚，为肺长期受外邪侵袭，肺虚日久，累及脾肾所致，而《黄帝内经》中“春夏养阳”的原则为“冬病夏治”的方法提供了理论依据[8-9]。……