文献类型：期刊文献

中文题名：麻杏石甘汤加减联合脏腑点穴治疗慢性阻塞性肺疾病急性加重合并骨质疏松症临床研究

英文题名：Clinical Study on Maxing Shigan Decoction Combined with Zang-fu Organs with Acupoints to Treat Acute Exacerbation Chronic Obstructive Pulmonary Disease with Osteoporosis

作者：沈明霞[1];李红[1];谢海彬[1]

第一作者：沈明霞

机构：[1]甘肃中医药大学附属医院

第一机构：甘肃中医药大学第二附属医院

年份：2018

卷号：25

期号：5

起止页码：13

中文期刊名：中国中医药信息杂志

外文期刊名：Chinese Journal of Information on Traditional Chinese Medicine

收录：CSTPCD;;CSCD:【CSCD_E2017_2018】；

基金：甘肃中医药大学附属医院院内青年基金项目(ZQ2013-35)

语种：中文

中文关键词：慢性阻塞性肺疾病急性加重;骨质疏松症;麻杏石甘汤;脏腑点穴

外文关键词：acute exacerbation chronic obstructive pulmonary disease;osteoporosis;Maxing Shigan Decoction;zang-fu organs with acupoints

摘要：目的观察在西医常规治疗基础上麻杏石甘汤加减联合脏腑点穴治疗慢性阻塞性肺疾病急性加重(AECOPD)合并骨质疏松症(OP)的临床疗效及骨代谢特征。方法采用随机数字表法将140例AECOPD合并OP患者随机分为治疗组和对照组各70例,最终完成129例,其中治疗组66例、对照组63例。2组均予西医常规治疗。对照组在西医常规治疗基础上予氨茶碱片+头孢呋辛酯片。治疗组在西医常规治疗基础上予麻杏石甘汤加减,每日1剂,每日2次口服;脏腑点穴天枢、中脘、气海、关元,每日1次。2组均连续治疗10 d,随访3个月。观察2组治疗前后中医症状评分、肺功能、6 min步行试验(6MWD)及MRC呼吸困难评分;观察治疗后3个月骨密度(BMD)、血清Ⅰ型前胶原氨基端前肽(PⅠNP)和Ⅰ型胶原羧基端肽β特殊序列(β-CTX)表达水平。结果与本组治疗前比较,2组治疗后咳嗽、气短、咳痰、喘息明显改善(P<0.05),治疗组治疗后咳嗽、气短、咳痰、喘息改善优于对照组(P<0.05);与本组治疗前比较,2组治疗后肺功能、6MWD及MRC呼吸困难评分明显改善(P<0.05),治疗组治疗后肺功能、6MWD及MRC呼吸困难评分优于对照组(P<0.05);与本组治疗前比较,2组治疗后3个月BMD水平及血清PⅠNP、β-CTX指数上升(P<0.05),治疗组治疗后3个月BMD、血清PⅠNP指数上升程度优于对照组(P<0.05)。结论在西医常规治疗基础上,麻杏石甘汤加减联合脏腑点穴可有效缓解AECOPD合并OP患者的临床症状,改善呼吸功能,提高BMD,其机制可能与提高血清PⅠNP、β-CTX表达水平相关。
Objective To evaluate the clinical efficacy and bone metabolism characteristics of Maxing Shigan Decoction combined with zang-fu organs with acupoints to treat acute exacerbation chronic obstructive pulmonary disease(AECOPD)with osteoporosis(OP)on the basis of Western treatment.Methods Totally 140 AECOPD patients with OP were randomly divided into treatment group and control group by using random number table method,with 70 cases in each group,and finally completed 129 cases,of which 66 cases in the treatment group and 63 cases in the control group.The two groups were given routine Western medicine treatment,and the control group was treated with aminophylline tablets and cefuroxime axetil tablets on the basis of routine treatment.The treatment group was given Maxing Shigan Decoction on a regular basis,once dosage daily and twice a day orally.Zang-fu acupoints were given to Tianshu,Zhongwan,Qihai,and Guanyuan,once a day.The two groups were treated for 10 consecutive days,followed up for 3 months.The TCM symptom scores,lung function,6MWD and MRC dyspnea score were observed before and after treatment.The bone mineral density(BMD),serum PⅠNP andβ-catenin carboxy-terminal peptide specificity sequence(β-CTX)expression level were observed after three-month treatment.Results Compared with before treatment,the symptoms of cough,shortness of breath,and phlegm and wheezing were improved after treatment in both groups(P<0.05);after treatment,the treatment group was better than the control group in symptoms of cough,shortness of breath and wheezing(P<0.05).Compared with before treatment,the lung function,6MWD and MRC score of the two groups were improved(P<0.05).After treatment,the treatment group was better than the control group in lung function,6MWD and MRC score(P<0.05).The BMD,serum PⅠNP andβ-CTX index were all higher than before the treatment after 3 months(P<0.05),and the treatment group was significantly higher than the control group(P<0.05).Conclusion Clinical symptoms of AECOPD with OP patients can be alleviated effectively by the methods of Maxing Shigan Decoction combined with zang-fu organs with acupoints,which can also improve the respiratory function of the patient,while improving the level of BMD,and the mechanism may be related with improved expression level of PⅠNP andβ-CTX in serum.