| Objective:To observe the clinical effect of by the method of Yiqi Tongluo on patients with qi deficiency and blood stasis type of idiopathic pulmonary fibrosis (IPF) by taking Chinese medicine basic theories and methods.Method:According to the2000"the declaration of American thoracic society and the European respiratory society about the diagnosis and treatment of idiopathic pulmonary fibrosis" and the diagnostic criteria in the "diagnosis and treatment guidelines of idiopathic pulmonary fibrosis (interstitial)(draft)" issued by the Chinese medical association of Respiratory diseases in2002, we choose30patients with idiopathic pulmonary fibrosis in their non-acute attack period, using the method of before and after their own controls, and give the prescription what based on the Yiqi Tongluo is Qi Zhu Fei Xian Decoction for four and a half years, six months for a period of treatment, a total of nine treatments. Through the comparison of the Chinese medicine syndrome score of before and after treatment, changes of pulmonary function (DLco, VC, TLC), HRCT, analysis of arterial blood gas (PaO2, PaCO2), SGRQ score and6-minute-walking-test (6-MWT), observe the index score of before and after treatment and make a comprehensive evaluation.The results were analysised by SPSS17.0software. From October2009to October2011the specific condition of patients completed by the researchers.Results:1. Chinese medicine syndromes score:the total Chinese medicine syndrome scores of the each treatment patients obviously decrease after the treatment and the difference between the each treatment of posttreatment and before treatment is very significant (P<0.01). The main symptoms of each treatment of posttreatment, such as gasp symptom scores reduce after the treatment than before treatment and each treatment of posttreatment has a statistical meaning (P<0.05or P<0.01) comparing to before treatment and gasp symptom scores decrease with the increasment of treatment. Cough symptoms scores decrease after each treatment of posttreatment comparing to before treatment (P<0.05). Sputum symptom scores reduce after the treatment than before treatment and each treatment of posttreatment has a statistical meaning (P<0.05or P<0.01). Shortness of breath scores decrease after each treatment of posttreatment comparing to before treatment, but this is no statistically meaning (P>0.05).2. Functional index:pulmonary function, VC gradually increases after the treatment of one year and two years and the difference has statistical meaning (P<0.05) comparing to before treatment; the other course has no statistically meaning (P>0.05). Pulmonary function, VC%gradually increases after the treatment of one year and the difference has statistical meaning (P<0.05) comparing to before treatment; The other course is no statistically meaning (P>0.05).TLC, TLC%, DLco and DLco%has no significant development after the treatment and the difference has no statistical meaning comparing to before treatment; Arterial blood gas analysis index, PaO2and PaCO2are roughly equal between each treatment of posttreatment and before treatment, so the difference has no statistical meaning (P>0.05).3.HRCT:one case after a treatment of one year has improved than before treatment (4%) and one and a half years are basicly stable (69%) and7cases progress (27%), so the total effective rate are73%in26cases. Two cases after a treatment of two years has improved than before treatment (9%) and17cases are basicly stable (74%) and4cases progress (17%), so the total effective rate are83%in23cases. Two cases after a treatment of three years has improved than before treatment (11%) and13cases are basicly stable (72%) and3cases progress (17%), so the total effective rate are83%in18cases. Two cases after a treatment of three years has improved than before treatment (11%) and11cases are basicly stable (61%) and5cases progress (28%), so the total effective rate are72%in18cases.4.Quality of life(QOL):total score part of SGRQ scores, respiratory symptoms, activities section and disease effects has decreased after each treatment of posttreatment comparing to before treatment. Total score part of SGRQ scores and disease effects has statistical meaning (P<0.05) after a treatment of two and a half years ang three years. The score of respiratory symptoms has statistical meaning (P<0.05) after a treatment of two and a half years, three years and three and a half years. The score of activities section has statistical meaning (P<0.05) after a treatment of a half years, two and a half years and three years. The rest of treatment of posttreatment has no statistical meaning comparing to before treatment (P>0.05). The distance of6minutes walk has increased after treatment, comparing to before treatment and graudually increases with the increasment of treatment, and the difference between treatment after one and a half years, two years, two and a half years,three years and three and a half years and before treatment has statistical significant meaning (P<0.01).The other course has no statistical meaning(P<0.05).5. Comprehensive effect:5cases markedly improve after treatment of one years (19.23%), and17cases are effective (65.38%) and4cases are invalid (15.38%), so the total effective rate are84.61%.6cases markedly improve after treatment of two years (19.23%), and15cases are effective (65.38%) and2cases are invalid (15.38%), and3cases are dead (11.54%), so the total effective rate are80.77%.3cases markedly improve after treatment of three years (11.54%), and9cases are effective (34.62%) and11cases are invalid (42.30%), and3cases are dead (11.54%), so the total effective rate are46.16%.3cases markedly improve after treatment of three years (11.54%), and7cases are effective (26.92%) and8cases are invalid (30.78%), and4cases are dead (15.38%), and4cases are lost to follow-up(15.38%), so the total effective rate are38.46%.Conclusion:The mian effect of Yiqi Tongluo and Qi Zhu Fei Xian decoction is improve the Chinese medicine syndrome of patients, the survival quality. It’s most significant effect is to improve the gasp, the sputum and other major symptoms. It also can increase patients’VC, and to some extent, delay the decline of TLC and DLco, arterial blood gas analysis index of PaO2and PaCCO2and HRCT. So the method of Yiqi Tongluo and Qi Zhu Fei Xian decoction has clinical effect and security for the treatment of patients with IPF. |
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