Clinical Observation On Lung Function,COR And ACTH With The Therapy Of Warming Yang And Nourishing Qi In The Treatment Of COPD Patients

Objective:Chronic obstructive pulmonary disease(COPD)is a disease with persistent airflow limitation which can be prevented and treated.The airflow limitation is progressive,and it is related to the enhancement of the chronic inflammatory response of tobacco smoke and other harmful gases or harmful particles.At present,western medicine in the treatment of stable chronic obstructive pulmonary disease mainly in bronchial relaxation agent,sugar cortical hormone,oxygen therapy and alter lung function exercise control the disease.Those methods can relieve the clinical symptoms of the patients,and delay the decline in lung function.But because of the limitations of the patients,with the development of the aging,the per capita life expectancy,more and more COPD patients perform qi and yang deficiency in lung.In clinical,patients with chronic obstructive pulmonary disease don’t receiving standardized treatment.And the excessivelate use of hormone lead to hypothalamic-pituitary-adrenal axis suppressed.Adrenal cortex in adrenocorticotropic hormone(ACTH)action can be synthesized glucocorticoids.Therefore the hypothalamic-pituitary-adrenal axis inhibition contributing to lower ACTH levels.Further lead to reduced levels of cortisol.On the other hand,old and feeble,and chronic disease,can lead to cortical function decline.Through clinical observation,we find that COPD patients with advanced symptoms were less of words,wheezing,cold,vest afraid of the wind,pale tongue,easy to catch cold,with white slip tongue,small and weak pulse,sontaneous,dlute sputumpon,which are Qi and Yang deficiency Symptoms.We found that those patients obove have low cortisol level in COR and ACTH.Therefore,qi and yang deficiency patients are correlated to low COR and ACTH level.In our hospital,in the lead of Professor Wang Peng,we have carried on a in-depth study in Qi deficiency and yang deficiency of lung disease through long-term clinical observation and laboratory research.This study was designed to investigate the application of TCM combined with western medicine warming yang qi to improve patients’ cortisol and adrenocorticotropic cortisol function,control the patient’s condition and improve the quality of life,improve lung function and other aspects of the impact evaluation warming yang qi Chinese medicine improve function in patients with cortisol,adrenocorticotropic function,improve lung function in patients with clinical efficacy.Further more,it can provide guidance and theoretical basis for the selection of clinical medicine.Method:64 patients with moderate and severe COPD were included in the stable period of 2013.5-2014.5 patients according to 2011 GOLD standard and gasp syndrome in TCM,which had lower COR and ACTH leve than normal.All patients were randomly divided into observation group and treatment group with 32 cases in each group,Control group were treated with smoking cessation,exercise lung function,oxygen,strengthen basic nutrition and other conventional therapy,and by 18 ug Tiotropium inhalation.The treatment group on the basis of the control group were exposed to be herbs by Warming Yang and Nourishing Qi prescription.Before treatment,there were no statistically significant difference in the patient’s gender,age,disease duration,disease severity,lung function,cortisol and adrenocorticotropic function(P> 0.05).Observation time of one year,all the experimental data were analyzed using statistical software SPSS19.0.All measurement data using mean(x± s)that the groups choose t test,count data using x2 test compared Ridit level data analysis,with p <0.05 indicates significant difference.Result:1.Cortisol assessment:after treatment,patients 8: 00,16: 00 cortisol levels were increased(p <0.05),treatment group raise cortisol function than the control group(p <0.05),some patients can return to normal cortisol function.2.Adrenocorticotropic functional assessment: two groups of patients after treatment 8: 00,16: 00 corticotropin levels were increased(p <0.05),treatment group adrenocorticotropic raise the level than the control group(p <0.05),part patients can return to normal adrenocorticotropic function.3.Pulmonary function assessment: the FEV1% of the lung function of the two groups after treatment,FEV1% and FEV1/FVC% were higher than those before treatment(p<0.05),the FEV1% value of the treatment group was significantly higher than the control group(p<0.05).Conclusion: The therapy of Warming Yang and Nourishing Qi in TCM combined with inhaled Tiotropium,can significantly improve lung function in patients with stable COPD,and increase FEV1% and FEV1/FVC%,and improve patient cortisol and adrenocorticotropic function,Chinese medicine treatment can compensate for the lack of Western medicine by using differential treatment,which can also importantly improve the clinical efficacy and reduce the burden on patients.