Observation Of Clinical Efficacy Of Peiyuan Guben Method In The Treatment Of Stable Chronic Obstructive Pulmonary Disease

Objective:This paper is to observe the clinical efficacy of the method of Peiyuan Guben in the treatment of chronic obstructive pulmonary disease(COPD)in stable stage,and summarize and analyze the effects of the method on clinical symptoms,dyspnea,lung function,acute exacerbation times and quality of life of COPD patients in stable stage,so as to provide evidence-based basis for clinical selection of effective treatment schemes in stable stage of COPD.Methods:In this study,a prospective cohort study design was adopted,and patients with COPD in stable stage(GOLD 2-4 grade)who visited the department of respiration outpatient and ward of Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine from January 2019 to February 2021 were selected(TCM syndrome types were diagnosed as qi deficiency of lung and spleen and qi deficiency of lung and kidney).Patients were divided into exposed and non-exposed groups according to whether or not they took the method of Peiyuan Guben prescriptions as an exposure factor.The exposed group was treated with the method of Peiyuan Guben combined with conventional western medicine for 3 months;the non-exposed group was treated with conventional western medicine.The patients were evaluated with the St George’s respiratory questionnaire(SGRQ),COPD assessment test(CAT)and modified British medical research council(mMRC)before treatment,at month 3 and month 6,respectively,and pulmonary function tests were performed and the number of acute exacerbations were recorded before treatment and at month 6 to evaluate the clinical efficacy of the Peiyuan Guben Method in the treatment of COPD.Results:①Baseline data:60 cases were finally included in this study for analysis,including 29 cases in the exposed group and 31 cases in the non-exposed group.Before treatment,patients in both groups showed no differences in gender,age,season at enrollment,smoking status,GOLD classification,TCM evidence distribution,western medicine use,SGRQ score(including clinical symptoms part,mobility part,daily impact part and total score part),CAT score,mMRC score,lung function(including FVC,FEV1,FEV1%Pred,FEV1/FVC),and The differences in the number of acute exacerbations were not statistically significant(P>0.05)and were comparable.②SGRQ scores:Compared within groups,the overall total score and clinical symptom score,mobility score,and daily impact score of SGRQ were significantly lower in the exposed group at month 3 and month 6,respectively,compared with those before treatment,and the differences were all statistically significant(P<0.05);Compared with the 3rd month,the total score at month 6 decreased significantly(P<0.05),and the clinical symptom score,activity ability score and daily impact score showed a further downward trend,but the difference was not statistically significant(P>0.05).Compared with before,the total score and mobility score,daily impact score of SGRQ in the non-exposed group decreased at month 3,but the difference was not statistically significant(P>0.05),and the clinical symptom score decreased significantly(P<0.05).Compared with before treatment,the comprehensive total score and clinical symptom score decreased significantly at month 6(P<0.05).Compared with the 3rd month,the total score,clinical symptom score,activity ability score and daily impact score at month 6 showed a further downward trend,but the difference was not statistically significant(P>0.05).Compared between groups,the total score,clinical symptom score,activity ability score and daily influence score of SGRQ at month 3 and month 6 of exposure group were lower than those in the non-exposure group,and the differences were statistically significant(P<0.05).③CAT scores:Compared within groups,the CAT scorewere significantly lower in the exposed group at month 3 and month 6,respectively,compared with those before treatment,and the differences were all statistically significant(P<0.05);Compared with the 3rd month,the CAT score at month 6 was significantly lower,and the difference was statistically significant(P<0.05).Compared with before treatment,CAT scores in the non-exposed group were significantly lower at month 3 and month 6(P<0.05).Compared with the 3rd month,the CAT score at month 6 showed a further downward trend,but the difference was not statistically significant(P>0.05).Compared with the non-exposed group,the CAT scores of the exposed group at month 3 and month 6 were lower than those of the non-exposed group,with statistical significance(P<0.05).④mMRC scores:Compared within groups,the mMRC scorewere significantly lower in the exposed group at month 3 and month 6,respectively,compared with those before treatment,and the differences were all statistically significant(P<0.05);while there was no significant difference between the 6th and 3rd months(P>0.05);Compared with before treatment,mMRC score in non-exposed group showed a downward trend at month 3,but the difference was not statistically significant(P>0.05).Compared with before treatment,the mMRC score at month 6 decreased significantly(P<0.05).Compared with the 3rd month,the mMRC score at month 6 showed a downward trend,but the difference was not statistically significant(P>0.05).Compared between groups,mMRC scores of the exposed group were lower than those of the non-exposed group at month 3 and month 6,and the difference was statistically significant(P<0.05).⑤Pulmonary function:Compared within the group,the lung function FVC,FEV1,FEV1%Pred,and FEV1/FVC in the exposed group and non-exposed group showed an increasing trend at month 6,respectively,compared with those before treatment,but the difference were not statistically significant(P>0.05).Compared between groups,there was no significant difference between exposed group and non-exposed group in lung function indexes FVC,FEV1,FEV1%Pred,FEV1/FVC and difference values dFVC,dFEV1,dFEV1%Pred,dFEV1/FVC before and after treatment(P>0.05).⑥Number of acute exacerbations:Compared within groups,the acute aggravation times of exposed group and non-exposed group decreased at month 6,respectively,compared with those before treatment,and the difference was statistically significant(P<0.05).Compared between groups,the number of acute exacerbations in the exposed group(0.86±0.58)was less than that in the non-exposed group(1.19 ± 0.48)at month 6,and the difference was statistically significant(P<0.05).Conclusions:①The methos of Peiyuan Guben combined with conventional western medicine treatment is able to obviously improve the clinical symptoms(such as the duration,frequency,duration and severity of episodes of cough,coughing and shortness of breath),mobility(such as dressing,washing,indoor walking,climbing,sports,etc.),daily effects(e.g.,perception of disease impact,expectation of disease prognosis,disease impact on social life,etc.),improve the quality of life for COPD patients with lung-spleen deficiency and lung-kidney qi deficiency in stable stage and have better efficacy than conventional western medicine treatment.②The methos of Peiyuan Guben combined with conventional western medicine treatment is able to obviously improve the degree of dyspnea,and reduce the times of acute exacerbation of COPD patients with lung-spleen deficiency and lung-kidney qi deficiency in stable stage and have better efficacy than conventional western medicine treatment.③ Both the methos of Peiyuan Guben combined with conventional western medicine treatment and conventional western medicine treatment can improve the quality of life of COPD patients with deficiency of qi deficiency of lung and spleen and qi deficiency of lung and kidney in stable stage,and reduce the degree of dyspnea.However,the effective time(the third month)of the method of Peiyuan Guben combined with conventional western medicine treatment is better than that of conventional western medicine treatment(the sixth month).