| ObjectiveTo observe the clinical efficacy of the method of’reinforcing earth to generate metal’combined with the pulmonary rehabilitation in treating patients with severe and extremely severe chronic obstructive pulmonary disease at acute aggravating stage.MethodsThe research method of randomized controlled trial was adopted in this study.112 patients with severe and extremely severe chronic obstructive pulmonary disease at acute aggravating stage were divided into four groups with 28 patients in each, including control group, traditional Chinese medicine group, rehabilitation group and comprehensive group. The control group was treated with conventional therapies, including anti-infection, anti-inflammatory, spasmolysis, asthma, relieving cough, reducing sputum, etc., the traditional Chinese medicine group was treated with the method of reinforcing earth to generate metal according to the syndrome differentiation and treatment principle on the basis of conventional therapy, the rehabilitation group was treated with the pulmonary rehabilitation on the basis of conventional therapy while the comprehensive group was treated with the method of reinforcing earth to generate metal combined with the pulmonary rehabilitation on the basis of conventional therapy. The COPD assessment test (CAT) score, mMRC dyspnea index,6 minute walk distance (6MWD), TCM score, length of stay as well as the variation of the first acute aggravation time of the four groups were observed before and after the treatment.Results1. Baseline InformationThe comparative difference of the gender, age, height, weight, occupation, course of disease, smoking history, prior drug application, CAT score, mMRC, 6MWD and TCM score in the four groups wasn’t statistically significant (P> 0.05) and has the comparability.2. CAT ScoreWithin group comparison, the CAT score after the treatment was lower than that before the treatment (P＜0.05). Comparison among the groups, the CAT score of comprehensive group after the treatment was lower than that of rehabilitation group, traditional Chinese group and control group (P＜0.001). The difference between the traditional Chinese medicine group and the rehabilitation group was not statistically significant (P＞0.05). Difference comparison among groups, before and after treatment, the CAT score difference of the comprehensive group was superior than the four groups of patients of CAT score difference, the composite group than the traditional Chinese medicine group, rehabilitation group and the control group (P＜0.05), the one of the traditional Chinese medicine group and rehabilitation group was superior than that of control group (P＜0.05). The others were not statistically significant (P＞0.05).3. mMRCWithin group comparison, after the treatment, the mMRC scales of the four groups were lower than the ones before the treatment (P＜0.05). Comparison among the groups, after the treatment the mMRC scales in the four groups were inter-compared and the differences had no statistic meaning (P＞0.05).4.6MWDWithin group comparison, after the treatment, the 6MWD of the four groups increased in comparison with the one before the treatment. Comparison among the groups, the 6MWD of the four groups after the treatment had no statistic meaning (P＞0.05). Difference comparison among groups, the 6MWD differences before and after treatment of the four groups were inter-compared and the difference had no statistic meaning (P＞0.05). 5. TCM ScoreWithin group comparison, the TCM scores of the four groups after the treatment decreased than the ones before the treatment (P＜0.05). Comparison among the groups, the TCM score of the comprehensive group was lower than that of control group, traditional Chinese medicine group and rehabilitation group (P＜0.05), the others were not statistically significant. Difference comparison among groups, the one of the comprehensive group was superior than that of traditional Chinese medicine group, rehabilitation group as well as the control group (P＜0.05). The others were not statistically significant (P＞0.05).6. Length of Stay as well as the Time of First Acute AggravationIn comparison with the length of stay as well as the time of first acute aggravation of the four groups, the difference had no statistic meaning (P＞ 0.05).ConclusionThis study evaluated the CAT score, exercise capacity, clinical symptoms of the patients with severe and extremely severe chronic obstructive pulmonary disease at acute aggravating stage on the basis of anti-infection, anti-inflammatory, spasmolysis, asthma, relieving cough, reducing sputum as well as other conventional therapies combined with the method of reinforcing earth to generate metal and the pulmonary rehabilitation, the results were as follow:1. The method of reinforcing earth to generate method combined with pulmonary rehabilitation can relieve the clinical symptoms, improve the CAT score and the difference with the conventional therapy was statistically significant.2. The method of reinforcing Earth to generate gold combined with pulmonary rehabilitation in treating severe acute exacerbation of chronic obstructive pulmonary disease and severe patients, compared with conventional treatment, mMRC,6MWD, hospital time and improvements in acute exacerbation time after discharge for the first time, the difference was not statistically significant, may be associated with pulmonary rehabilitation time is shorter and the small number of cases, and so on.3. Acute COPD exacerbation of pulmonary rehabilitation exercise is safe and feasible.4. In patients with acute exacerbation of chronic obstructive pulmonary syndrome of phlegm-heat treatment method of reinforcing Earth to generate gold as soon as possible after symptom relief may also enhance the curative effect of pulmonary rehabilitation. |
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