杜舒婷，邢彬，张静，丁连明，郁明旭，王春霞，武娟娟，蒋延龄，苍艳，冀海峰，朱磊，刘娜静.负重呼吸操联合百令胶囊治疗稳定期慢性阻塞性肺疾病患者的疗效观察[J].中华物理医学与康复杂志,2018,40(10):758-762
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| 负重呼吸操联合百令胶囊治疗稳定期慢性阻塞性肺疾病患者的疗效观察 |
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| DOI： |
| 中文关键词: 百令胶囊 噻托溴铵 舒利迭 肺康复训练 慢性阻塞性肺疾病 |
| 英文关键词: Bailing capsules Tiotropium bromide Seretide Pulmonary rehabilitation training Chronic obstructive pulmonary disease |
| 基金项目:河北省高等学校科学技术研究青年基金项目（QN2014221） |
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| 中文摘要: |
| 目的 观察负重呼吸操联合百令胶囊以及负重呼吸操联合噻托溴铵、舒利迭治疗中重度稳定期慢性阻塞性肺疾病（COPD）患者的疗效，并对2种治疗方案疗效进行对比。 方法 采用随机数字表法将63例中重度稳定期COPD患者分为观察组及对照组。2组患者均采用负重呼吸操作为肺康复训练手段，观察组同时辅以百令胶囊口服，对照组则辅以噻托溴铵、舒利迭吸入。于治疗1 d（T1）、治疗4 W±2 d（T2）、治疗8 W±2 d（T3）时测试并记录2组患者6 min步行试验（6MWT）距离、COPD评分表问卷(CAT)评分，同时于上述时间点检测、对比2组患者血清中白细胞介素-6（IL-6）、IL-8及肿瘤坏死因子-α（TNF-α）水平。 结果 T1时期2组患者6MWT、CAT评分、IL-6、IL-8及TNF-α浓度组间差异均无统计学意义（P>0.05）。T2时期2组患者CAT评分均较治疗前显著降低（P<0.05），6MWT结果均较治疗前有改善趋势，但差异均无统计学意义（P>0.05），此时2组患者CAT评分及6MWT结果组间差异均无统计学意义（P>0.05）；观察组IL-6、IL-8及TNF-α含量均较治疗前无明显变化（P>0.05），对照组IL-8、TNF-α含量均较治疗前显著下降（P<0.05），并且该时段对照组IL-8含量亦显著低于同期观察组水平（P<0.05）。T3时期2组患者CAT评分均较治疗前显著下降（P<0.05），组间差异无统计学意义（P>0.05）；观察组6MWT结果较治疗前及同期对照组显著提高（P<0.05），对照组则提高不显著（P>0.05）。该时段对照组IL-6、IL-8及TNF-α含量均较治疗前及观察组显著下降（P<0.05），观察组IL-6、IL-8及TNF-α水平与同组治疗前差异均无统计学意义（P>0.05）。 结论 与指南推荐的负重呼吸操联合噻托溴铵、舒利迭治疗比较，负重呼吸操联合百令胶囊训练能更有效改善COPD患者呼吸困难症状，提高运动耐力，但在控制气道炎症及气道高反应性方面不及三联吸入制剂联合负重呼吸操治疗有效。 |
| 英文摘要: |
| Objective To observe and compare the effect of Cordyceps sinensis (bailing) capsules combined with weight-bearing breathing exercises, and weight-bearing breathing exercises combined with tiotropium bromide and seretide, on patients with stable but moderate-to-severe chronic obstructive pulmonary disease (COPD). Methods Sixty-three patients with moderate-to-severe COPD were randomly divided into an observation group and a control group. Both groups performed weight-bearing breathing exercises, supplemented in the observation group with the oral administration of bailing capsules. The control group instead inhaled tiotropium bromide and seretide. Six-minute walking distance, the COPD assessment test (CAT scores) and concentrations of interleukin-6 (IL-6), interleukin-8 (IL-8) and tumor necrosis factor-α (TNF-α) were observed after 1 (T1), 30 (T2) and 58 (T3) days of the treatments. Results At T1 there were no significant differences between the two groups in any of the measurements (P≤0.05). At T2, there were still no significant differences except that a significant decrease in IL-8 and TNF-α levels was observed in the control group. At T3 the average CAT scores had decreased significantly in both groups compared to before the treatment but there was no significant difference between the two groups. In the observation group, the average 6MWT distance had increased significantly compared to before the treatment and compared to the control group, where there was no significant improvement. The average IL-6, IL-8 and TNF-α readings of the control group were significantly lower than those of the observation group at T3 and compared to before the treatment. No significant changes in those indicators were observed in the observation group at T3. Conclusions Bailing capsules combined with weight-breathing exercises are more effective for relieving dyspnea symptoms and improving exercise capacity than weight-breathing exercises combined with tiotropium bromide and seretide. However, in controlling airway inflammation and airway hyper-responsiveness, the triple inhalation combined with weight-bearing breathing exercises is more effective. |
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