【作者】 连重光；

【导师】 林昌松；

【作者基本信息】 广州中医药大学 ， 中医临床基础， 2012， 博士

【摘要】 研究背景：慢性阻塞性肺疾病(chronic obstructive pulmonary diseases,简称"COPD")是一种具有气流受限特征的肺部疾病,气流受限不完全可逆,呈进行性发展。由于其患病人数多,死亡率高,社会经济负担重,己成为一个重要的公共问题。COPD目前居全球死亡原因的第4位,世界银行/世界卫生组织公布,至2020年COPD将位居世界疾病经济负担的第5位。在我国,COPD同样是严重危害人民身体健康的重要慢性呼吸系统疾病。COPD病程可分为急性加重期与稳定期。目的：系统阐述总结仲景治肺理论及西医治疗,评价麦门冬汤治疗肺脾气虚型慢性阻塞性肺疾病急性加重期的临床疗效及安全性,为慢性阻塞性肺疾病急性加重期的中医药规范化治疗提供依据,从而提高中医药防治慢性阻塞性肺疾病的水平。方法：通过查阅大量文献,阐述《金匮要略》中治疗肺系疾病的理论研究；阐述西医病因、发病机理,以及临床诊治特点；并分别为之建立相关资料库以供后来者进行查阅使用。在临床研究上,将入选的41例肺脾气虚型慢性阻塞性肺疾病急性加重期患者按随机化原则分治疗组和对照组。其中对照组予西医常规治疗方案治疗；治疗组在西医常规治疗方案的基础上联用麦门冬汤治疗,观察两组患者治疗前后主要临床疗效及临床症状等改善情况。结果：1.临床疗效：经Ridit分析,P<0.05,说明治疗组与对照组疗效差异有显著性；经X2分析,P<0.05,故两组在显控率上有显著差异。治疗组总有效率为100.00%,对照组总有效率为95.24%,经X2分析,P>0.05,故两组在总有效率上无显著性差异。2.症状体征：两组治疗后各项主要症状及体征相比较,具有显著性差异(P<0.05),治疗组的治疗方案在改善患者的症状与体征方面优于对照组。3.3.肺功能方面：经过治疗,在改善用力肺活量占预计值的比例Fvc/pre%),一秒量占预计值比例(Fevl/pre%),两组治疗后组间比较,治疗组优于对照组,有显著性差异(P<0.05.)故治疗改善肺功能方面优于对照组。结论：麦门冬汤治疗肺脾气虚型慢性阻塞性肺疾病急性加重期的有明确的临床疗效,能很好的改善患者的症状及肺功能作用。提高生存质量。更多还原

【Abstract】 Background:Chronic obstructive pulmonary disease is a kind of chronic disease, which is characteristic by airflow limitation and showed a progressive development. As the number of patients, high mortality, social and economic burden, has become an important public issue. The death of COPD now ranks in the forth of the world; the World Bank/World Health Organization announced, in the2020year, the world economic burden of disease of COPD will be in the fifth. In China, COPD is also important chronic respiratory diseases that seriously endanger people’s health. COPD can be divided into acute exacerbation and stable stages.Objective:Systems summarize the Zhongjing Zhifei theory and Western medicine treatment, evaluation of the clinical efficacy and safety of Ophiopogon Decoction to hronic obstructive pulmonary disease with acute exacerbation of lung spleen deficiency.So, standardized treatment of the chronic obstructive pulmonary disease with acute exacerbations of Traditional Chinese Medicine. thereby increasing the level of prevention of chronic obstructive pulmonary disease.Methods:Through extensive literature, expounded the Theory of the Zhong jing’s "Golden Chamber" in treating lung diseases; elaborate Western etiology, pathogenesis, and clinical diagnostic and therapeutic features. Respectively. In clinical studies, Randomized controlled by a simple method,41patients were divided into control group and treatment group, Control group with conventional Western treatment; treatment group on the basis of conventional Western treatment and Ophiopogon Decoction, observed two groups of clinical efficacy and improvement in clinical symptoms before and after the treatment.Results:(1) The clinical efficacy:Trough Ridit analysis, In the two groups there was very different significant rate of efficiency. by X2analysis, so the two groups in the display and control rates were significantly different. But, there was no difference of the two groups in the total efficiency.(2) signs and symptoms:the control group is better than the treatment group of the improvement of the Symptoms.(3) Treatment groups in lung function improvement is better than the control group.Conclusion:Ophiopogon Decoction is a safe and effective method, can improve patient symptoms. Improve the quality of life.更多还原