Clinical Efficacy Of Buqi Jianpi Huatan Decoction On Asthma-chronic Obstructive Pulmonary Disease Overlap With Syndrome Of Lung-spleen Qi Asthenia And Phlegmatic Dampness Retention In Lung In Stable Stage

Objective:To observe the changes of clinic indices before and after treatment on asthma-chronic obstructive pulmonary overlap?ACO?patients with syndrome of lung-spleen qi asthenia and phlegmatic dampness retention in lung in stable stage,objectively evaluate the clinical efficacy of Professor Hong Minli's experience prescription Buqi Jianpi Huatan Decoction,in order to provide new ideas for the study of TCM treatment of ACO and lay a foundation for the development of new TCM.Methods:A randomized,controlled study was conducted.Seventy patients who met the inclusion criteria were selected and divided into therapeutic group?35 cases?and control group?35 cases?respectively according to the principle of random allocation in clinical experimental study.During the treatment,the therapeutic group and the control group were fallen off two cases respectively,33 cases in the therapeutic group and 33 cases in the control group were actually completed.The control group was treated with routine western medicine,while the therapeutic group was treated with Buqi Jianpi Huatan Decoction on the basis of routine western medicine,one dose a day,decocted in water for 3 months.The changes of clinical efficacy,TCM symptom score,pulmonary function,CAT and 6-minute walking distance?6MWD?before and after treatment were observed,and drug adverse reactions were also observed.Result:1.There was no significant difference in age,sex,course of disease,smoking index and severity of pulmonary function between the two groups before treatment?P>0.05?.The baseline of general data of the two groups before treatment were consistent and comparable.2.Comparison of the overall efficacy:33 cases in the therapeutic group,2 cases were markedly effective,23 cases were effective,8 cases were ineffective,and the total effective rate was 75.76%.33 cases in the control group,0 cases were markedly effective,17 cases were effective and 16 cases were ineffective.The total effective rate was 51.52%.Statistical analysis showed that there was significant difference between the two groups?P<0.05?.The efficacy in the therapeutic group was better than that of the control group.In the aspect of traditional Chinese medicine?TCM?syndrome scores,the total scores of TCM syndrome after treatment were significantly lower than those of base line in the two groups.?P<0.05?.But it decreased significantly in the therapeutic group than that in the control group 3months later?P<0.01?.3.Comparison of pulmonary function:There was no significant difference in each index of pulmonary function between the two groups before treatment?P>0.05?,which was comparable.After treatment in the therapeutic group,FEF 25%,FEF 50%were better than those of before treatment?P<0.01?,FEV_1,FEV₁%,FEF 75%were also better than those of before treatment?P<0.05?.The pulmonary function in the control group did not improve significantly after treatment?P>0.05?.The improvement of FEF 25%and FEF 50%in the therapeutic group were better than those of the control group after treatment?P<0.05?.4.Comparison of CAT scores:After treatment,the total scores of CAT in the therapeutic group decreased significantly?from 16.09±5.11 to 12.39±4.46?compared with that before treatment,and the difference was statistically significant?P<0.01?.Compared with the control group,the total scores of CAT in the therapeutic group decreased more significantly?12.39±4.46 vs 14.88±4.79?,with statistical significance?P<0.05?.There were significant differences in TCM syndrome scores of cough,expectoration,chest tightness,asthma and energy before and after treatment in the therapeutic group?P<0.01?.Home activities also improved?P<0.05?.After treatment,the improvement of cough and expectoration in the therapeutic groups were better than those in the control group?P<0.01?,and the improvement of energy in the the therapeutic group was also better than that in the control group?P<0.05?.TCM syndrome scores of expectoration and the asthma increased significantly compared with base line in the control group?P<0.01?.The total scores and other TCM syndrome scores did not decreased significantly in the control group?P>0.05?.5.Comparison of 6MWD scores:6 MWD in the therapeutic group increased from 369.56±102.89?m?to 389.94±90.24?m?after treatment,with significant difference?P<0.05?,while there was no significant difference in the control group before and after treatment?P>0.05?.Conclusion:1.Buqi Jianpi Huatan Decoction combined with routine western medicine treatment could improve the clinical symptoms of ACO patients with syndrome of lung-spleen qi asthenia and phlegmatic dampness retention in lung in stable stage,and the curative effect was better than that of conventional western medicine only.2.Buqi Jianpi Huatan Decoction combined with routine western medicine treatment could significantly improve the pulmonary function of ACO patients with syndrome of lung-spleen qi asthenia and phlegmatic dampness retention in lung in stable stage.3.Buqi Jianpi Huatan Decoction combined with routine western medicine treatment could reduce the CAT scores of ACO patients with syndrome of lung-spleen qi asthenia and phlegmatic dampness retention in lung in stable stage,and improve the quality of life.4.Buqi Jianpi Huatan Decoction combined with routine western medicine treatment could improve the 6MWD and exercise endurance of ACO patients.