The Clinical Observation Of The Effect Of Added And Subtracted Renshengejie Pulvis Combined With Pulmonary Rehabilitation To Treat The Stable Phase Of COPD With Lung-kidney Deficiency

Objective:To provide a new idea for the clinical treatment of COPD in stable stage,the clinical effect was observed through the application of added and subtracted renshengejie pulvis combined with lung rehabilitation in the treatment of patients with lung and kidney deficiency syndrome in stable stage.Methods:In this study,93 patients with lung and kidney deficiency syndrome in stable stage of COPD were included.They were randomly divided into conventional group,lung rehabilitation group,and traditional Chinese medicine combined with lung rehabilitation group,with 31 patients in each group.The conventional group received conventional western medicine treatment.The lung rehabilitation group received lung rehabilitation training on the basis of the conventional group treatment(The lung rehabilitation program: lip contraction breathing,abdominal breathing,exercise training and the three-ball resistance breathing trainer).The traditional Chinese medicine combined with lung rehabilitation group was added with added and subtracted renshengejie pulvis on the basis of the treatment of the lung rehabilitation group.The course is 90 days.Clinical efficacy,syndrome score,FEV1%pred,6MWD,m MRC,BMI,BODE index,CAT score and re-hospitalization were observed before and after treatment.Statistical analysis was conducted to draw the conclusion.Results:(1)General situations: There were 5 cases of abscission in the conventional group,and 3 cases in the pulmonary rehabilitation group and the traditional Chinese medicine plus pulmonary rehabilitation group respectively.There were no statistical differences in gender,age,course of disease,grade of airflow restriction and comprehensive evaluation of disease among the three groups(P>0.05).Before treatment,there were no statistical differences in syndrome score,FEV1%pred,6MWD,m MRC,BMI,BODE index and CAT score among the three groups(P>0.05).(2)Clinical efficacy: the effective rate of the Chinese medicine plus pulmonary rehabilitation group was 92.86%,the effective rate of the pulmonary rehabilitation group was 75%,and the effective rate of the conventional group was 57.69%.There was statistical difference among the three groups(P<0.05).(3)Syndrome score: intra-group comparison showed that the total scores of the three groups after treatment were lower than those before treatment,with statistical differences(P<0.05).Comparison in the three groups showed that after treatment,the total syndrome score of TCM plus lung rehabilitation group was lower than that of lung rehabilitation group,and that of lung rehabilitation group was lower than that of conventional group,with statistical differences(P<0.05).(4)Lung function:intra-group comparison showed that there were no significant changes in FEV1%pred between the three groups before and after treatment,with no statistical difference(P>0.05).After treatment,there was no significant difference in FEV1%pred among the three groups(P>0.05).(5)Sports endurance:intra-group comparison showed that 6MWD were increased in all three groups after treatment compared with before treatment,with statistical differences(P<0.05).After treatment,the 6MWD of the TCM plus pulmonary rehabilitation group was greater than that of the pulmonary rehabilitation group,while that of the pulmonary rehabilitation group was greater than that of the conventional group.There was a statistical difference in 6MWD among the three groups(P<0.05).(6)Dyspnea: intra-group comparison showed that there was no significant change in m MRC before and after treatment in the conventional group(P>0.05).After treatment,m MRC in the pulmonary rehabilitation group and the TCM plus pulmonary rehabilitation group decreased compared with before treatment,with statistical difference(P<0.05).After treatment,the m MRC of the TCM plus pulmonary rehabilitation group was lower than that of the pulmonary rehabilitation group,and that of the pulmonary rehabilitation group was lower than that of the conventional group,and there was a statistical difference in m MRC among the three groups(P<0.05).(7)Body mass index: intra-group comparison showed that there was no significant change in BMI between the three groups before and after treatment(P>0.05).After treatment,there was no statistically significant difference in BMI among the three groups(P>0.05).(8)Quality of daily life: intra-group comparison showed that BODE index and CAT score in the three groups decreased after treatment compared with before treatment,with statistical differences(P<0.05).After treatment,Bode index and CAT score of TCM plus lung rehabilitation group were lower than those of lung rehabilitation group,and those of lung rehabilitation group were lower than those of conventional group,with statistical differences among the three groups(P<0.05).(9)Rehospitalization: Within 3 months after treatment,there were 3 patients in the conventional group,3 patients in the pulmonary rehabilitation group,and 2 patients in the traditional Chinese medicine plus pulmonary rehabilitation group.The rehospitalization rate was 11.54% in the conventional group,10.71% in the pulmonary rehabilitation group,and7.14% in the TCM plus pulmonary rehabilitation group.There was no statistical difference in the number of rehospitalization among the three groups(P>0.05).Conclusion:The added and subtracted renshengejie pulvis combined with lung rehabilitation can effectively relieve the clinical symptoms of COPD patients with lung and kidney deficiency syndrome,improving their exercise endurance,dyspnea and quality of life,with definite efficacy.Therefore,it can be used as one of the treatment programs of integrated traditional Chinese and western medicine in the treatment of COPD patientsin stable phase.And it is worthy of promotion in clinical practice.