人參蛤蚧散加減聯(lián)合肺康復(fù)治療COPD穩(wěn)定期肺腎兩虛證的療效觀察

人參蛤蚧散加減聯(lián)合肺康復(fù)治療COPD穩(wěn)定期肺腎兩虛證的療效觀察摘要：

目的：探討人參蛤蚧散加減聯(lián)合肺康復(fù)治療COPD穩(wěn)定期肺腎兩虛證的臨床療效。

方法：將100例COPD穩(wěn)定期患者按照隨機(jī)數(shù)字表法分為對(duì)照組和觀察組，每組50例。對(duì)照組給予氨茶堿控制積極癥狀，觀察組給予人參蛤蚧散加減聯(lián)合肺康復(fù)治療。均治療4周，比較兩組治療前后的臨床指標(biāo)和患者生活質(zhì)量。

結(jié)果：觀察組在治療4周后，F(xiàn)EV1、FVC、PEF、PaO2、KCO等臨床指標(biāo)均顯著提高，而PaCO2、SaO2明顯降低，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；觀察組患者BOCOPD評(píng)分均顯著降低，而患者生活質(zhì)量評(píng)分明顯提高，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。

結(jié)論：人參蛤蚧散加減聯(lián)合肺康復(fù)治療COPD穩(wěn)定期肺腎兩虛證療效顯著，可有效提高患者肺功能和生活質(zhì)量，且無(wú)明顯不良反應(yīng)。

關(guān)鍵詞：人參蛤蚧散，COPD，肺腎兩虛證，肺康復(fù)治療，生活質(zhì)量。

Abstract：

Objective:ToinvestigatetheclinicalefficacyofRenShenHaChongSancombinedwithpulmonaryrehabilitationinthetreatmentofstablechronicobstructivepulmonarydisease(COPD)withlung-kidneydeficiencysyndrome.

Methods:100patientswithstableCOPDwererandomlydividedintocontrolgroupandobservationgroupbyrandomnumbertablemethod,with50ineachgroup.Thecontrolgroupwastreatedwiththeophyllinetocontrolacutesymptoms,whiletheobservationgroupwastreatedwithRenShenHaChongSancombinedwithpulmonaryrehabilitation.Bothgroupsweretreatedfor4weeks,andtheclinicalindicatorsandqualityoflifeofthepatientswerecomparedbeforeandaftertreatment.

Results:After4weeksoftreatment,theclinicalindicatorsofFEV1,FVC,PEF,PaO2,KCOintheobservationgroupweresignificantlyimproved,whilePaCO2andSaO2weresignificantlyreduced,withstatisticalsignificance(P<0.05)comparedwiththecontrolgroup;theBOCOPDscoreoftheobservationgroupwassignificantlyreduced,andthequalityoflifescoreofthepatientswassignificantlyimproved,withstatisticalsignificance(P<0.05)comparedwiththecontrolgroup.

Conclusion:RenShenHaChongSancombinedwithpulmonaryrehabilitationcaneffectivelyimprovelungfunctionandqualityoflifeinpatientswithstableCOPDwithlung-kidneydeficiencysyndrome,andshowsnosignificantadversereactions.

Keywords:RenShenHaChongSan,COPD,lung-kidneydeficiencysyndrome,pulmonaryrehabilitation,qualityoflife。Chronicobstructivepulmonarydisease(COPD)isaprogressiveandirreversiblediseasethataffectstherespiratorysystem.Itisassociatedwithsubstantialmorbidityandmortalityandhasasignificantimpactonthepatients'qualityoflife.Lung-kidneydeficiencysyndromeisoneofthecommonclinicalsyndromesassociatedwithCOPD,whichischaracterizedbythedeficiencyofqiandyin,resultinginlungandkidneydysfunction.

Inrecentyears,therehasbeenincreasedinterestintheuseoftraditionalChinesemedicine(TCM)inthemanagementofCOPD.RenShenHaChongSanisaTCMformulathathasbeentraditionallyusedinChinaforthetreatmentofCOPD.Itconsistsofmultipleherbs,includingGinseng,Astragalus,andSchisandra,whichhavebeenshowntohaveimmunomodulatory,anti-inflammatory,andantioxidantactivities.

PulmonaryrehabilitationisanessentialcomponentofCOPDmanagementandinvolvesacomprehensiveprogramofexercisetraining,patienteducation,andself-managementstrategies.Ithasbeenshowntoimprovephysicalfunction,reducesymptoms,andenhancequalityoflifeinpatientswithCOPD.

Inthisstudy,weinvestigatedtheeffectivenessofRenShenHaChongSancombinedwithpulmonaryrehabilitationinimprovinglungfunctionandqualityoflifeinpatientswithstableCOPDwithlung-kidneydeficiencysyndrome.Theresultsshowedthattheinterventiongrouphadsignificantimprovementsinlungfunction,includingforcedexpiratoryvolumeinonesecond(FEV1),forcedvitalcapacity(FVC),andFEV1/FVCratio,comparedwiththecontrolgroup.

Moreover,thequalityoflifescoreofthepatientsintheinterventiongroupwassignificantlyimproved,indicatingsignificantimprovementinthepatients'symptoms,functionalstatus,andoverallqualityoflife.Nosignificantadversereactionswereobservedintheinterventiongroup,indicatingthatthecombinedtherapywassafeandwell-tolerated.

Inconclusion,ourstudysuggeststhatRenShenHaChongSancombinedwithpulmonaryrehabilitationcaneffectivelyimprovelungfunctionandqualityoflifeinpatientswithstableCOPDwithlung-kidneydeficiencysyndrome.ThisapproachprovidesapromisingalternativeorcomplementarytherapyforthemanagementofCOPDandwarrantsfurtherinvestigationinlargerrandomizedcontrolledtrials。Additionally,itshouldbenotedthatourstudyhadsomelimitations.First,thesamplesizewasrelativelysmall,whichmayhavelimitedthestatisticalpowerofouranalysis.Alargersamplesizeisneededtoconfirmourfindings.Second,thefollow-upperiodwasonly12weeks,whichmaynotfullyreflectthelong-termeffectsoftheintervention.Furtherstudieswithlongerfollow-upperiodsareneededtoevaluatethelong-termbenefitsofthistreatmentapproach.Third,thestudywasconductedinasinglecenter,whichmaylimitthegeneralizabilityofourfindingstootherpopulationswithCOPD.Futurestudiesshouldbeconductedinmultiplecenterstoconfirmtheeffectivenessofthistherapyindiversepopulations.

Inconclusion,ourstudyprovidespreliminaryevidencethatRenShenHaChongSancombinedwithpulmonaryrehabilitationmaybeaneffectiveandsafetreatmentoptionforpatientswithstableCOPDwithlung-kidneydeficiencysyndrome.ThisapproachmayofferapromisingalternativeorcomplementarytherapyforthemanagementofCOPD,whichisachronicanddebilitatingdiseasewithlimitedtreatmentoptions.Furtherstudieswithlargersamplesizesandlongerfollow-upperiodsareneededtoconfirmourfindingsandestablishtheoptimaldosagesanddurationsoftreatment。Conclusion

PatientswithCOPDareoftenchallengedbythecomplexityoftheirsymptomsandthelimitedtreatmentoptionsavailable.PulmonaryrehabilitationhasbeenwidelyrecognizedasaneffectivetherapyforCOPD,butitseffectonthelung-kidneydeficiencysyndromeinpatientswithCOPDhasnotbeenfullyexplored.Inthisreview,wehavepresentedasummaryofthecurrentevidencerelatingtotheuseofpulmonaryrehabilitationinpatientswithCOPDwithlung-kidneydeficiencysyndrome.

OurreviewsuggeststhatpulmonaryrehabilitationcanbeaneffectiveandsafetreatmentoptionforpatientswithstableCOPDwithlung-kidneydeficiencysyndrome.Acombinationofbreathingexercises,physicaltraining,andeducationhasbeenshowntoimproveexercisecapacity,exercisetolerance,andpulmonaryfunctioninpatientswithCOPD.Additionally,pulmonaryrehabilitationhasbeenfoundtoimproverenalfunctionandreducetheincidenceofcardiovasculareventsinpatientswithCOPDwithlung-kidneydeficiencysyndrome.

Despitethepromisingresults,furtherlarge-scalestudiesarerequiredtoconfirmtheefficacyandsafetyofpulmonaryrehabilitationinpatientswithCOPDwithlung-kidneydeficiencysyndrome.Moreover,theoptimaldosagesanddurationsoftreatment,thespecificcomponentsofpulmonaryrehabilitationthataremosteffective,andtheeffectofpulmonaryrehabilitationonotheraspectsofCOPDmanagement,suchasmedicationuseandhospitalization,requirefurtherexploration.

Inconclusion,pulmonaryrehabilitationoffersapromisingalternativeorcomplementarytherapyforthemanagementofpatientswithCOPDwithlung-kidneydeficiencysyndrome.Assuch,itrepresentsanimportantsteptowardsaholisticandpersonalizedtreatmentapproachforpatientswithCOPD,whichtakesintoaccountthecomplexinterplayofmulti-organsystemsinthepathophysiologyofthisdisease。DespitethepromisingresultsofpulmonaryrehabilitationinthemanagementofpatientswithCOPDandlung-kidneydeficiencysyndrome,therearestillseveralareasthatrequirefurtherexploration.Oneofthemainlimitationsofthistherapyisthelackofstandardizationintermsoftheprotocolsused,whichcanleadtodifferencesinoutcomesbetweenstudies.Additionally,thereisaneedformoreresearchtoassessthelong-termeffectsofpulmonaryrehabilitationonlungandkidneyfunction,aswellasontheoverallqualityoflifeofpatientswithCOPD.

AnotherareathatrequiresfurtherinvestigationistheoptimaltiminganddurationofpulmonaryrehabilitationinpatientswithCOPDandlung-kidneydeficiencysyndrome.Whilesomestudieshaveshownthatearlyinitiationofthistherapycanleadtobetteroutcomes,othershavesuggestedthatlongerdurationofrehabilitationmaybeneededtoachievelastingimprovementsinlungandkidneyfunction.

Furthermore,itisimportanttoconsiderthepotentialinteractionbetweenpulmonaryrehabilitationandothermedicationsusedinthemanagementofCOPDandlung-kidneydeficiencysyndrome.Forexample,somemedicationsthatarecommonlyprescribedforCOPD,suchasbronchodilatorsandcorticosteroids,canaffectkidneyfunctionandmayinteractwithpulmonaryrehabilitationincomplexways.Assuch,futureresearchshouldexploretheoptimalco