| 1.Research backgroundChronic obstructive pulmonary disease (COPD) is a disease of having serious harm to human health and affecting the quality of life of the patients. Its morbidity and mortality rate is higher. It brings a heavy economic burden to the patients and the community. COPD is a systemic chronic inflammatory response, not only involving the lungs, and causing adverse pulmonary reactions. COPD has multiple complications, such as depression and/or anxiety, cardiovascular disease, and osteoporosis, but depression and/or anxiety is one of the pulmonary complications that can not be ignored in COPD. Repetitive aggravation of the illness and the increase in medical costs, resulting in decrease in the quality of life of patients, led to feelings of depression and anxiety in patients. And this depression and/or anxiety, in turn, lead to further decline in the patient’s quality of life. Now western medicine treats the symptoms of depression and/or anxiety of the patients with COPD by using antidepressant and/or anti-anxiety medication.But this kind of drug is short of specificity, and it also affects the quality of life of patients. Traditional Chinese medicine has its advantages in the treatment of COPD combined with depression and/or anxiety, but there is little research on it. The study treat the patients with COPD complicated with depression and/or anxiety by using guben yangxin decoction, to relieving the symptoms of depression and/or anxiety and improving the patient’s quality of life.2. Clinical studyObjectiveThe study is to evaluating the effect of guben yangxin decoction to the degree of depression and/or anxiety improved, and the patient’s quality of life.MethodThis study had selected 96 patients coming from clinic in Xiyuan Hospital from 2015,8 to 2015,12. These patients of COPD with depression and/or anxiety symptoms is in a period of stability. They belong to TCM syndromes types of xinshen shiyang and feishen liangxu. Patients were randomly divided into treatment and control groups in ratio of 1:1. The treatment group included 48 patients,3 patients falling off; the control group included 48 patients,1 patient falling off. The treatment group was given the guben yangxin decoction on the basis of routine western medicine, the control group received routine therapy. Before entering the group, the patients need to complete some questionnaires, such as Self-rating anxiety scale(SAS), Self-rating depression scale(SDS), Chronic obstructive pulmonary disease assessment test(CAT), Medicine research council scale, St George’s questionnaire(SGRQ). The same time the patients need to complete determination of pulmonary function and a 6-minute walk test. After 45 days of treatment, the patients also need to complete these checks. During the treatment, we need to record whether there is any adverse reactions.Result(1) Anxiety and depression:The scores of SAS and SDS of treatment group after treatment were significantly reduced(P<0.05). The score of SAS of control group after treatment were reduced(P<0.05). The score of SDS of control group before and after treatment has no significant difference(P>0.05). After treatment, the scores of SAS and SDS between the two groups has statistically significant differences (P<0.05).(2) Quality of life:The scores of SGRQ and CAT of treatment group after treatment were significantly reduced, and 6MWD was significantly prolonged (P<0.05). After treatment, the scores of SGRQ and CAT and 6MWD between the two groups has statistically significant differences (P<0.05).(3) TCM symptom:The curative effect of the main symptoms of Chinese medicine (such as depression, restless mood, cough weakness) in the treatment group is better than that of the control group (P<0.05). The curative effect of the secondary symptoms of Chinese medicine (such as wufeng, sweating, yaoxi suanruan, wuxin fanre, beiyou xiku, irritability) in the treatment group is better than that of the control group (P<0.05).(4) Clinical curative effect:The total effective rate in the treatment group is 71.1%, and the control group is 21.3%. There is significant difference in the curative effect after treatment between the two groups (P<0.05).(5) Pulmonary function:FEV1/FVC% and FEV1 percentage of predicted value in the treatment group and the control group before and after treatment has no significant difference. (P>0.05).ConclusionGuben yangxin decoction can relieve the symptoms of depression and/or anxiety in patients with chronic obstructive pulmonary disease, and has some influence on improvement in the patient’s quality of life. |
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