Comparison In Efficacy Of Reinforcing The Earth To Generate The Metal And Tonifying Kidney And Strengthening Vital Energy In Treatment Of Chronic Obstructive Pulmonary Disease In Stable Period

Objective:Provide clinical evidence for traditional Chinese medicine in the treatment of chronic obstructive pulmonary disease at stable stage by observing the clinical efficacy of reinforcing the earth to generate the metal treatment and tonifying kidney and strengthening vital energy treatment of Chinese medicine.Methods:A cohort study was constructed;patients were divided into reinforce the earth to generate the metal group and tonify kidney and strengthen vital energy by TCM differentiation,60 in each group;based on health education events and standardized western medicine therapy,reinforce the earth to generate the metal prescription was given to reinforce the earth to generate the metal group while tonify kidney and strengthen vital energy prescription was given to tonify kidney and strengthen vital energy group;1 course of treatment was composed of 3 months;2 courses of treatment were observed in total.Clinical symptoms,degree of dyspnea,acute exacerbating condition,6 minutes walking distance,life quality and lung function were observed and statistically analyzed.Results:The symptoms of cough,expectoration,wheezing,chest tightness,shortness of breath,self-sweating,decreased appetite,abdominal distension,fatigue,chills,dry mouth in patients of reinforce the earth to generate the metal group were significantly improved compared with that before treatment(P<0.01);no significant difference was observed of the symptoms of loose stool,soreness of waist and night sweat compared with that before treatment(P>0.05).For patients in tonify kidney and strengthen vital energy group,the symptoms of cough,expectoration,wheezing,chest tightness,shortness of breath,self-sweating,decreased appetite,abdominal distension,fatigue,chills,dry mouth,loose stool,soreness of waist and night sweat were all significantly improved compared with that before treatment(P<0.01).No significant difference in comprehensive efficacy was observed between the two groups(P<0.01).In both the groups,,6 minutes walking distance,CAT score and acute exacerbating condition were all superior to that before treatment(P<0.01);in both the groups,indexes for pulmonary ventilation function,including FVC%,FEV1%,FEV1/FVC%,PEF%,and indexes for pulmonary small airway function,including FEF25%,FEF50%,FEF75%and MMEF75/25%were all superior to that before treatment(P<0.01).Before treatment,no significant difference between the symptom integral of cough and expectoration in tonify kidney and strengthen vital energy group and reinforce the earth to generate the metal group was observed(P>0.05);significant differences in the symptom integral of wheezing,6 minutes walking distance and indexes of lung function were observed(P<0.01);no significant difference of CAT score and acute exacerbating condition was observed(P>0.05).After therapy,significant difference of acute exacerbating times between the two groups was observed(P<0.01).Conclusion:Reinforce the earth to generate the metal prescription and tonify kidney and strengthen vital energy prescription could both improve the clinical symptoms,including decreasing degree of dyspnea,increasing exercise tolerance,decreasing acute exacerbating times,improving life quality and improving lung function.In the aspect of reducing acute exacerbating times and of stability of the therapeutic efficacy,reinforce the earth to generate the metal was superior to tonify kidney and strengthen vital energy group.The illness of patients in tonify kidney and strengthen vital energy group was more severe than reinforce the earth to generate the metal group.