| Objective:To observe the correlation between the modified sangpi tang combined with conventional western medicine therapy on chronic obstructive pulmonary disease acute exacerbation in patients with phlegm heat obstructing lung syndrome (AECOPD) pulmonary function, main symptoms, the curative effect of TCM syndrome, chronic obstructive pulmonary disease assessment test (CAT) score and the Nottingham Health table (NHP) and other indicators, and to explore the homemade AECOPD TCM symptom quantified score table for relia bility and validity of the improved after AECOPD TCM symptom quantified score table, cat scores, NHP and evaluation test with asquare of AECOPD effect and quality of life influence, rich of TCM in the prevention and treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) syste ms of theory and practice.Methods:The December 2014 to January 2016 period in Yunnan Provinci al Hospital of traditional Chinese medicine geriatrics Hospital of 66 cases of patients with AECOPD of phlegm heat obstructing lung syndrome after the inclu sioncriteria and exclusion criteria selected by random number table method we rerandomly divided into two groups, namely treatment (modified sangpi tang combined with conventional therapy of Western medicine group)33 cases and 33 patients in the control group (conventional therapy of Western medicine), obse rvation is removed in 6 cases, remaining in the treatment group and control group with 30 cases in each. The control group were treated by antiinfection, e liminating phlegm, bronchial relaxation, oxygen and other conventional treatment of Western medicine. The treatment group added modified sangpi tang of Chinese medicine treatment on the basis of the control group, the daily dose. The two groups of patients were 14 days of treatment. Statistical analysis of two groups of patients with lung function, symptom score, TCM symptoms efficacy, CAT score, NHP, high sensitive Creactive protein (hs-CRP), white blood cell (WBC) and other indicators of changes.Results:(1) The reliability and validity of the quantitative score table of the self-made AECOPD Chinese medicine symptom:TCM symptoms of TCMs ymptoms of AECOPD of TCM symptoms of AECOPD by reliability and validi tyanalysis, homemade quantization scale Cronbach’s alpha coefficient is 0.624, reliability, validity is not good, "if the item has been deleted is metric (a)", delete "thirsty and like cold drink" after the highest belief is 0.725, with good r eliability. The validity analysis, delete "thirst hi cold" after the quantization scale in the two main components of cumulative variance contribution rate of 67. 61%, in the rotating component matrix, delete "thirsty and like cold drink" after AECOPD quantified score table of each individual in a principal component of the load is greater than 0.6, has good reliability and validity; (2) Improved AECOPD of TCM symptoms quantitative score table, between cat scores, NHP correlation:The improved AECOPD TCM symptom quantization scale and cat score is highly significant is correlation (P and a higher level, P< 0.05); impr oved AECOPD TCM symptom quantified score table between the NHP and which have the significant is correlation (P= 0.475, P< 0.05); between cat scores and NHP has significant positive correlation (P=0.376, P< 0.05); (3) The main indexes of lung function:the main indexes of lung function after treatment in two groups (FEV1, FEV1/FVC, FEV1%pred) were significantly improved compared with before treatment, there was significant difference (P< 0.05), but the two groups of patients after treatment of the main indexes of lung funct ion between the two groups, there was nosignificant difference (P> 0.05); (4) Symptom score:Cough after treatment, the patients in the two groups, sputum volume, character of sputum, wheezing, drystool, fever six scores were comp ared with those before treatment significantly reduced, the difference is signific ant (P<0.05) and treatment group after treatment the symptom scores except fever were lower than those in the control group decreased significantly, the di fference is significant (P< 0.05); total score of symptoms after treatment, the patients in the two group than before treatment was significantly reduced, the difference is significant (P< 0.05) and after treatment, the treatment group tota1 score of symptoms compared with the control group decreased more. The difference was significant (P< 0.05); (5) Syndrome curative effect:the treatment group total effective rate and significant efficiency were 96.7% and 86.7%, the total efficiency of the control group and the effective rate were 90% and 63. 3%, efficacy data of two groups of patients after statistical treatment, there wer esignificant differences (P< 0.05). The syndrome curative effect is better than that of treatment group in the control group; (6) CAT score:the CAT score of the two groups of individual scores were significantly lower than that before treatment, there were significant differences (P< 0.05), and the treatment group after treatment CAT score of each individual score were compared with the control group decreased more significantly, there are differences significant (P <0.05); the two groups of patients after treatment CAT score total score was significantly reduced, there were significant differences (P< 0.05), and the pati ents in the treatment group after treatment CAT score total score decreased significantly compared with the control group, there was significant difference (P <05); (7) NHP:two groups of patients after treatment of eachitem of the NHP integral was significantly reduced, there were significant differences (P 0.05), and the treatment group after treatment, energy levels, sleep, social isolat ion, emotional reactions of four points were compared with the control group decreased more obviously, the difference there was significant (P< 0.05); the two groups of patients after treatment NHP total score was significantly reduced, there were significant differences (P< 0.05), and the patients in the treatment group after treatment NHP total score decreased more than the control group, there was significant difference (P< 0.05); (8) Antibacterial drug use time:patients in the treatment group were shorter than those in the control groupusing time of antibacterial drugs, after statistical treatment, there were significant differences (P< 0.05); (9) The main indicators of inflammation (hs-CRP, WBC): the main indicators of inflammation after treatment in two groups (hs-CRP, W BC) were cured Before treatment significantly decreased, the difference was significant (P< 0.05), and the treatment group after treatment, the main indicators of inflammation (WBC, hs-CRP) decreased more significantly than the control group, the difference was significant (P< 0.05).Conclusion:1. The homemade AECOPD Chinese medicine symptom quantization score table after improvement, has good reliability and validity, can better reflect the condition of AECOPD patients change, can be used as the index of curative effect judgment.2. Compared with the conventional western medicine treatment alone, modified sangpitang combined with conventional therapy of Western medicine can be more significant improvement in the symptoms in patients with AECOPD (cough, sputum volume, character of sputum, wheezing, dry stool, fever) score, total score, cat score of each individual score and the total score to and and NHP energy levels, sleep, social isolation, emotional reaction of four individual score and the total score, improve the patient’s quality of life, improve the totalef ficiency and significant efficiency, improve the therapeutic effect of syndrome.3. Compared with the conventional western medicine treatment alone, modified sangpitang combined with conventional western medicine therapy can more significantly reduce AECOPD patients with inflammatory index (hs CRP and WB C), shorten time of antibioticuse, reduce the patient’s pain and the economic burden.4. The improved AECOPD Chinese medicine symptom quantification score, CAT score and NHP can beused as the treatment of traditional Chinese medicine AECOPD efficacy evaluation and quality of life evaluation of the perfect seale system. |
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