化痰补虚法对痰浊阻肺型AECOPD的临床效果观察

摘要/Abstract

摘要： 目的观察化痰补虚法对痰浊阻肺型慢性阻塞性肺疾病急性加重期（AECOPD）患者的临床效果。方法收集2015年1月—2023年12月广州市从化区中医医院肺病科痰浊阻肺型AECOPD患者诊疗资料,根据纳排标准筛选数据。纳入数据依据是否使用化痰补虚基础方治疗分为观察组和对照组。两组采用倾向性评分匹配（PSM）,使基线均衡可比,比较两组患者治疗前后的炎症-免疫指标、通气功能（血气分析）、糖皮质激素应用情况（吸入糖皮质激素及静脉糖皮质激素）、中医临床症状（咳嗽、咯痰、痰质、痰色、喘息、发热）量化评分等,评价化痰补虚法对AECOPD患者的临床疗效。结果共收集401例患者数据,其中,观察组256例,对照组145例。利用SPSS 26.0软件进行倾向性评分匹配,成功匹配到观察组、对照组各135例。因各患者间疗效评估时间点不一致,匹配成功后利用广义估计方程（GEE）比较两组患者治疗前后中医证候评分、检验指标变化趋势,发现观察组患者中医证候评分下降的趋势比对照组更为明显,差异均有统计学意义（P<0.05）。检验指标方面升降趋势不一,但这些检验指标的变化趋势比较,差异均无统计学意义（P>0.05）。结论本研究中,化痰补虚法对痰浊阻肺型AECOPD患者的症状缓解作用显著,但对炎症指标、血气分析指标的改善不显著,这可能与样本容量有关。

关键词: 倾向性评分匹配, 慢性阻塞性肺疾病, 急性加重期, 化痰补虚法

Abstract: Objective To observe the clinical effect of eliminating phlegm and supplementing deficiency on acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Collect the diagnosis and treatment data of AECOPD patients with phlegm obstructing lung type in the Department of Pulmonary Disease, Conghua District Traditional Chinese Medicine Hospital, Guangzhou from January 1, 2015 to December 31, 2023, and screen the data according to the inclusion and exclusion criteria. The included data were divided into an observation group and a control group based on whether the basic formula for resolving phlegm and tonifying deficiency was used for treatment. Two groups were matched using propensity score matching (PSM) to achieve baseline balance and comparability. The inflammation immune indicators, ventilation function (blood gas analysis), glucocorticoid use (inhaled and intravenous glucocorticoids), and quantitative scores of traditional Chinese medicine clinical symptoms (cough, expectoration, sputum quality, sputum color, wheezing, fever) were compared between the two groups before and after treatment to evaluate the clinical efficacy of the method of resolving phlegm and supplementing deficiency in AECOPD patients. Results A total of 401 patient data were included, including 256 in the observation group and 145 in the control group. Using SPSS 26.0 for propensity score matching, 135 cases were successfully matched to the observation group and 135 cases to the control group. Due to the inconsistent timing of efficacy evaluation among different cases, after successful matching, the generalized estimation equation (GEE) was used to compare the changes in TCM syndrome scores and test indicators between the two groups of cases before and after treatment. It was found that the trend of TCM syndrome score decline in the observation group was more significant and statistically significant difference than that in the control group(P<0.05). The rising and falling trends of the inspection indicators are not consistent, but the changing trends of these inspection indicators were not statistically significant difference(P>0.05). Conclusion In this study, the method of resolving phlegm and supplementing deficiency had a significant symptom relief effect on AECOPD patients with phlegm turbidity obstructing lung type, but did not significantly improve inflammatory and blood gas analysis indicators, which may be related to sample size.

Key words: propensity score matching, chronic obstructive pulmonary disease, acute exacerbation stage, eliminating phlegm and tonifying deficiency

中图分类号:

R563.9

邵睿麟, 水敬伟, 王进忠. 化痰补虚法对痰浊阻肺型AECOPD的临床效果观察[J]. 中华养生保健, 2025, 43(6): 1-6.

SHAO Rui-lin, SHUI Jing-wei, WANG Jin-zhong. Observation of Clinical Effect of Eliminating Phlegm and Supplementing Deficiency on Phlegm-Turbidity-Obstructing Lung Type AECOPD[J]. ZHONGHUA YANGSHENG BAOJIAN, 2025, 43(6): 1-6.

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