CAJ | 학술논문

目的：观察健脾化痰方配合温灸中脘治疗肺脾气虚型轻、中度稳定期慢性阻塞性肺疾病(COPD)患者的临床疗效,并分析其相关影响因素。方法采用前瞻性随机对照临床试验,将符合标准的140例轻、中度稳定期COPD患者随机分为治疗组(健脾化痰方配合温灸中脘＋西医基础治疗)和对照组(西医基础治疗),每组70例。治疗12周,随访12周。观察2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,分析可能对疗效产生影响的主要因素。结果治疗后2组主要临床症状较治疗前均显著改善(P＜0.01),治疗组显著优于对照组(P＜0.01)。治疗组治疗后生存质量较治疗前及对照组均显著提高(P＜0.01),对照组治疗后生存质量无明显改善(P＞0.05)。多分类logistic回归分析显示,治疗方式及病情程度对临床疗效有显著影响(P＜0.05,P＜0.01)。结论健脾化痰方配合温灸中脘治疗肺脾气虚型轻、中度稳定期COPD具有显著疗效,并可改善生存质量；治疗方式及病情轻重程度为影响临床疗效的主要因素。
목적：관찰건비화담방배합온구중완치료폐비기허형경、중도은정기만성조새성폐질병(COPD)환자적림상료효,병분석기상관영향인소。방법채용전첨성수궤대조림상시험,장부합표준적140례경、중도은정기COPD환자수궤분위치료조(건비화담방배합온구중완＋서의기출치료)화대조조(서의기출치료),매조70례。치료12주,수방12주。관찰2조환자치료전후림상증상급생존질량평분변화,병통과다분류logistic회귀분석,분석가능대료효산생영향적주요인소。결과치료후2조주요림상증상교치료전균현저개선(P＜0.01),치료조현저우우대조조(P＜0.01)。치료조치료후생존질량교치료전급대조조균현저제고(P＜0.01),대조조치료후생존질량무명현개선(P＞0.05)。다분류logistic회귀분석현시,치료방식급병정정도대림상료효유현저영향(P＜0.05,P＜0.01)。결론건비화담방배합온구중완치료폐비기허형경、중도은정기COPD구유현저료효,병가개선생존질량；치료방식급병정경중정도위영향림상료효적주요인소。
Objective To observe the clinical efficacy of Jianpi Huatan Decoction plus Zhongwan (RN12) moxibustion on patients of mild to moderate stable chronic obstructive pulmonary disease (COPD) with syndrome of qi deficiency of lung and spleen, and analyze the related influencing factors. Methods With prospective randomized clinical trial, 140 cases of mild to moderate stable COPD were randomized into two groups (70 cases for each group). Treatment group was treated by Jianpi Huatan Decoction plus Zhongwan moxibustion based on western medicine, and control group was only treated by western medicine. Both groups were treated for 12 weeks and followed up for 12 weeks. Scores of clinical symptoms and quality of life questionnaire were examined, and multiple logistic regression analysis was used to find possible impacting factors on the effect. Results Symptoms were significantly alleviated after treatment (P<0.01) in both groups. The clinical effects and quality of life in treatment group were significantly improved than the control group (P<0.01). There were no significant changes in life quality of control group ( P>0.05). Multiple logistic regression analysis showed that different therapies and severity of COPD were the major influencing factors of clinical effect (P<0.05, P<0.01). Conclusion Jianpi Huatan Decoction plus Zhongwan moxibustion had significant therapeutic effect on mild to moderate stable COPD patients with syndrome of qi deficiency of lung and spleen by alleviating symptoms and improving quality of life. Treatment style and severity of COPD are the main influencing factors.