【摘要】 目的:观察真武汤合五苓散对慢性阻塞性肺疾病(chronic obstructive pulmonary disease, COPD)急性期阳虚水泛证患者血清超氧化物歧化酶(superoxide dismutase, SOD)、丙二醛(malondialdehyde, MDA)水平的影响。方法:选取2018年7月至2019年12月在重庆医科大学附属永川区中医院肺病科治疗的COPD阳虚水泛证患者40例,随机分为对照组19例和观察组21例。对照组采用常规西医治疗,观察组在对照组治疗的基础上采用真武汤合五苓散治疗,比较两组患者治疗前后生活质量评分、证候积分、炎症指标、氧化应激指标和疗效。结果:观察组有效率高于对照组,差异有统计学意义(P<0.05)。两组患者治疗后英国医学研究委员会问卷(mMRC)评分及慢阻肺评估测试表(CAT)评分较治疗前降低,差异具有统计学意义(P<0.05)。两组治疗后证候积分明显降低,与治疗前比较,差异有统计学意义(P<0.05),观察组咳痰、小便不利缓解程度优于对照组,差异有统计学意义(P<0.05)。两组患者治疗后白细胞(white blood cell, WBC)计数、中性粒细胞比率(neutrophil%,NEUT%)均降低,且观察组NEUT%下降幅度高于对照组,差异具有统计学意义(P<0.05)。治疗后观察组SOD水平较治疗前上升,差异有统计学意义(P<0.05),组间比较,差异有统计学意义(P<0.05)。两组患者治疗前后肝肾功能、尿常规、血常规、心电图等安全性指标均未出现明显异常。结论:在常规西药基础上,采用真武汤合五苓散治疗COPD阳虚水泛证可有效增强抗氧化作用,减轻血管内皮损伤,改善患者临床症状,提高生存质量。更多还原

【Abstract】 Objective: To observe the influence of True Warrior Decoction combined with Five Substances Powder with Poria on serum superoxide dismutase(SOD) and malondialdehyde(MDA) levels in patients with edema due to yang deficiency syndrome in acute stage of chronic obstructive pulmonary disease(COPD).Methods: A total of 40 patients with edema due to yang deficiency syndrome of COPD treated in the Lung Department of Yongchuan District Hospital of Traditional Chinese Medicine Affiliated to Chongqing Medical University from July 2018 to December 2019 were randomly divided into the control group with 19 cases and the observation group with 21 cases.The control group was treated with conventional Western medicine, while the observation group was treated with True Warrior Decoction combined with Five Substances Powder with Poria on the basis of the control group.The score of quality of life, syndrome score, inflammatory index, oxidative stress index and curative effect of the two groups were compared.Results: The effective rate of the observation group was higher than that of the control group, and the difference was statistically significant(P<0.05).The scores of CAT and mMRC in the two groups after treatment were lower than those before treatment, and the difference was statistically significant(P<0.05).After treatment, the syndrome scores of the two groups were significantly lower than those before treatment, and the difference was statistically significant(P<0.05).The adverse remission degree of expectoration and urination in the observation group was better than that in the control group, and the difference was statistically significant(P<0.05).After treatment, the levels of white blood cell(WBC) and neutrophil ratio(NEUT%) in the two groups decreased, and the decrease of NEUT% in the observation group was significantly higher than that in the control group, and the difference was statistically significant(P<0.05).After treatment, the level of SOD in the observation group increased compared with that before treatment, and the difference was statistically significant(P<0.05).There were no significant abnormalities in liver and kidney function, urine and stool routine, hemogram and ECG before and after treatment.Conclusion: On the basis of conventional Western medicine, True Warrior Decoction combined with Five Substances Powder with Poria in the treatment of edema due to yang deficiency syndrome of COPD can effectively enhance the antioxidant effect, accelerate the elimination of oxygen free radicals, slow down cell apoptosis, reduce vascular endothelial injury, and improve the clinical symptoms and quality of life of patients.更多还原