| Objective:1.Study 1:Delphi method was used to study the standardization of pulmonary obstruct in miao medicine and to determine the quantitative criteria for diagnosis of pulmonary obstruct in Miao medicine.2.Study 2:To investigate the clinical efficacy of herbal solution qi Jujujube decocting for miao medicine on patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:1.Study 1:Check miao medical literature,books,selected entry terms related to the description,establish Excle document database,choose a 1%or greater frequency and "lung","gas" indicates disease were related to the entries to determine the item pool,constructed in the first round of expert consultation questionnaire,after consultation,through statistical processing computing expert positive coefficient,the entry word mean,hierarchy and coefficient of variation coefficient,authority,filtered through the evaluation criteria and complement,initial relative unified expert opinion,expert questionnaires completed the first round.The second round of expert questionnaire continues to unify the expert opinions on the basis of the first round of questionnaire,and adds the judgment of items and words in the second round,and finally preliminarily establishes the quantitative criteria for the diagnosis of pulmonary scaffolding gas disease in Miao yi.2.Study 2:A total of 60 hospitalized patients in the department of Respiratory Medicine of the Second Affiliated Hospital of Guizhou University of Chinese Medicine,who met the diagnostic criteria of western medicine AECOPD and Miao medicine for pulmonary obstruction through heat and gas,were selected and divided into two groups by random occult distribution method:Control group(30 cases),miao medicine group(30 cases)and control group with AECOPD conventional western medicine treatment,miao medicine group treated with conventional western medicine treatment combined miao medicine experience side "gas indicates Juan poison decoction",by comparing the two groups of patients before and after treatment the blood routine,PCT,CRP,blood gas analysis and lung function,CAT scores,hot bullishness indicates disease symptom integral and related indicators,to observe the change of the two groups before and after treatment.Results:1.Study 1:In the first round of the expert consultation questionnaire,20 questionnaires were issued and 20 were recovered.A total of 44 items were included in the survey.In the second round of expert consultation questionnaire,20 questionnaires were issued and 20 were recovered.A total of 26 terms were included in the survey.3 terms were deleted,0 were merged and 0 were added,and 23 terms were determined.The final index of the importance of items(i.e.the mean)ranges from 3.05 to 3.95,and the degree of authority ranges from 0.72 to 0.79.According to the evaluation criteria,the quantitative criteria for the diagnosis of lung obstruct gas in miao medicine are preliminarily determined as follows:(1)Lung obstruct heat flow through gas:the main symptoms are:MOE(cough),dry MOE(cough),right(wheeze)according to Arrow,Kaiji huishe(fever),and phlegm with yellow and sticky color.Secondary symptoms:Menggang Gu(cough chest pain),chest pain without definite place,chest distension,dyspnea,pressing urgent(urgent breath),nasal agitation,restlessness,thirst;Essential condition:pulse fast or pulse big,tongue red,tongue coat yellow.(2)Cold passage gas obstruct of lung frame:Main symptoms are as follows:moths(cough),dried moths(cough phlegm),right side(wheezing)according to Arrow,body tired and crouching;Secondary symptoms:Mengganggu(chest pain when coughing),chest pain without definite location,chest distension,dyspnea malaise,headache,dry lam(sputum);Necessary conditions:tight or large pulse,white tongue coat.It can be diagnosed by meeting any four of the main symptoms,any two of the secondary symptoms and necessary conditions.2.Study 2:(1)Comparison of white blood cell count and percentage of neutrophils between the two groups:Compared before and after treatment,the white blood cell count and percentage of neutrophils in the two groups were improved compared with that before treatment(P<0.05);After treatment,the improvement of the vaccine group was better than that of the control group(P<0.05).(2)Comparison of PCT and CRP between the two groups before and after treatment:compared with that before and after treatment,PCT and CRP of the two groups were improved after treatment(P<0.05).After treatment,the PCT and CRP decrease in the vaccine group were better than those in the control group(P<0.05).(3)Comparison of PaO2 and PaCO2 in arterial blood gas analysis between the two groups:Comparison before and after treatment showed that PaO2 increased and PaCO2 decreased after treatment in both groups,and both groups improved after treatment compared with before treatment(P<0.05).After treatment,the improvement of the vaccine group was better than that of the control group(P<0.05).(4)Comparison of lung function FEV1%pred and FEV1/FVC between the two groups:Before and after treatment,FEV1%pred and FEV1/FVC of the two groups were improved compared with that before treatment(P<0.05).After treatment,the improvement of the vaccine group was better than that of the control group(P<0.05).(5)Compared with the treatment group,the overall improvement was significant in the vaccine group(P<0.05).(6)No hepatic or renal injury or serious adverse events occurred in the two groups.Conclusion:1.Study 1:The preliminary quantification of the diagnosis of pga with miao medicine through Delphi method has good feasibility,accuracy and clinical value.This study provides effective theoretical support for clinical application of Miao medicine theory to guide miao medicine in the treatment of disease.2.Study 2:Compared with western medicine routine treatment of conventional western medicine treatment of joint miao medicine experience side gas indicates Juan poison frying,which can effectively improve AECOPD(lung hot bullishness indicates disease)in patients with inflammatory indexes(white blood cell count,neutrophil percentage,PCT and CRP),can reduce patients' symptoms score,can improve oxygen supply and reduce carbon dioxide retention,and would be helpful to improve the pulmonary function,safe and reliable. |
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