健脾化痰方配合温灸中脘穴对肺脾气虚型轻中度稳定期P患者的临床疗效及相关疗效影响..docVIP

健脾化痰方配合温灸中脘穴对肺脾气虚型轻中度稳定期COPD患者的临床疗效及相关疗效影响因素分析 张平1吴欢1刘泉2沈若冰1余小萍1窦丹波1 (1上海屮医药大学附属曙光医院上海201203; 2江苏省苏州市高新区人民医院江苏苏州215129) 】目的：观察健脾化痰方配合温灸屮脘的综合治疗对肺脾气虚型稳定 期轻屮度慢性阻塞性肺疾病患者的临床疗效及相关疗效影响因素。方法：本研究 为前瞻性随机对照临床试验，将符合纳入、排除标准的轻、屮度COPD稳定期患 者签署知情同意后纳入研究。按照随机数字表法，将病例随机分为治疗组(健脾 化痰方配合温灸屮脘+西医基础治疗)和对照组(西医基础治疗)，每组各70例， 治疗过程屮无病例脱落。治疗12周，随访12周，观察两组患者治疗前后临床症 状及生存质量评分变化，并通过多分类logistic回归分析，分析主要可能对疗效 产生影响的因素。结果：治疗后两组的主要临床症状较治疗前均有显著改善(P 0 01),健脾化痰方配合温灸屮脘治疗组的总临床疗效显著优于西医基础治 疗组(P0 01)。经长期随访，综合治疗组治疗后的生存质量较治疗前有显著 提高(P0 01),治疗组生存质量较对照组显著提高(P0 01),而对照组 的生存质量治疗前后无明显改善(P0 05)。多分类logistic回归分析发现， 治疗方式及病情轻重程度(分级)对临床疗效有显著影响(P0 05, P0 01)。结论：健脾化痰方配合温灸屮脘治疗肺脾气虚型轻屮度稳定期慢性阻塞性 肺疾病具有显著临床疗效，并改善Y远期生存质量及预后；治疗方式及病情轻重 程度为主要的影响临床疗效的因素，表明早期COPD的健脾化痰综合治疗可作为 慢阻肺防控工作的重点。 关键词】健脾化痰方；温灸屮脘；COPD；稳定期；肺脾气虚型；回归分 析 Analysis of factors associated with therapeutic effect and the clinical curative effect of moxibustion Zhongwan point of lung and spleen deficiency type mild to moderate COPD patients in stable phase of Jianpi Huatan Fang Zhang PingWu HuanLiu QuanShan RuobingYu XiaopingDou Danbo(lShuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai,201203;2High-tech Zone of Suzhou City People’s Hospital of Jiangsu Province,Jiangsu,Suzhou,215129) Abstract】 Objective To observe clinical effectiveness and related effects influencing factors of JianPiHuaTan therapy in patients with mild to moderate stable COPD of FeiPiQiXu syndrome differentiation. Methods This study was a prospective randomized clinical trial.All participants provided written informed consents with inclusion/exclusion criteria.We randomized all 140 subjects into two groups (70/group),group Treatment was treated by decoction of JianPiHuaTan combined with moxibustion therapy and the Control group was only treated by bronchodilators.Screening period of this study was 12 weeks and follow-up of 12ws.No cases shedding in the treatment process.Scores of clinical symptoms and quality of life questionnaire were examined in this trial.Multipl