| 引用本文: |
易可兰, 廖若夷, 邓贵玉, 罗珂.基于五行学说经络呼吸排痰法对慢性阻塞性肺疾病患者的临床观察[J].湖南中医药大学学报,2024,44(7):1219-1225[点击复制] |
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| 基于五行学说经络呼吸排痰法对慢性阻塞性肺疾病患者的临床观察 |
| 易可兰,廖若夷,邓贵玉,罗珂 |
| (湖南中医药大学第一附属医院, 湖南 长沙 410007) |
| 摘要: |
| 目的 探讨基于五行学说经络呼吸排痰法护理干预对慢性阻塞性肺疾病（chronic obstructive pulmonary disease, COPD）患者的临床疗效，并探索其对COPD患者免疫功能、生活质量、心理状态的影响。方法 按随机数字表法将湖南中医药大学第一附属医院中医经典病房2022年8月至2023年12月收治的96例COPD稳定期患者分为两组，对照组患者给予临床常规治疗方案，观察组患者在对照组基础上给予基于五行学说经络呼吸排痰法护理干预。分别比较两组患者在干预前后的肺功能[第1秒用力呼气容积（forced expiratory volume in one second, FEV1）、用力肺活量（forced vital capacity, FVC）、最大自主通气量（maximalvoluntaryventilation, MVV）、呼吸困难评分]、中医症候积分、6分钟步行实验（6-minute walk test, 6MWT）、COPD评估测试（COPD assessment test, COPT CAT）评分、生活质量综合评定问卷-74（generic quality of life inventory-74, GQOLI-74）、免疫功能指标（CD4+、CD4+/CD8+）、心理状态指标[抑郁自评量表（self-rating depression scale, SDS）评分、焦虑自评量表（self-rating anxiety scale, SAS）评分]、炎性因子指标[超敏C反应蛋白（hypersensitive C-reactive protein, hs-CRP）、白细胞介素（interleukin, IL）-1β、IL-6]、临床疗效及安全性。结果 干预后，观察组患者的总有效率及GQOLI-74评分优于对照组（P＜0.05）。干预后，两组患者FEV1、FVC、MVV、6MWT、免疫功能指标较干预前均明显升高（P＜0.05），且观察组上述指标均高于对照组（P＜0.05）。干预后，两组患者呼吸困难评分、SDS评分、SAS评分、COPD CAT评分、炎性因子指标均低于干预前（P＜0.05），且观察组上述指标均低于对照组（P＜0.05）。两组患者均未发生不良反应。结论 基于五行学说经络呼吸排痰法护理干预可改善COPD患者的肺功能、临床症状及抑郁焦虑状态，有效提升患者免疫功能及生活质量，降低炎性水平。 |
| 关键词: 慢性阻塞性肺疾病 经络呼吸排痰法 五行学说 免疫功能 生活质量 炎性水平 心理状态 |
| DOI：10.3969/j.issn.1674-070X.2024.07.010 |
| 投稿时间：2024-02-19 |
| 基金项目:湖南省中医护理门诊规范化建设体系的构建研究项目（D2023007）；湖南省中医药管理局委托课题项目（2023）；2024年湖南省中医药管理局中医药科研计划项目（B2024072）；湖南省中医药大学学科“揭榜挂帅”项目（2023）；湖南省第一批中医药学科带头人培养项目；国家中医优势专科建设项目（湖南中医药大学第一附属医院重症医学科）。 |
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| Clinical efficacy of meridian press-respiration sputum excretion method based on the five elements theory in patients with chronic obstructive pulmonary disease |
| YI Kelan, LIAO Ruoyi, DENG Guiyu, LUO Ke |
| (The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China) |
| Abstract: |
| Objective To investigate the clinical efficacy of nursing intervention using meridian pressing-respiration sputum excretion method based on the five elements theory in patients with chronic obstructive pulmonary disease (COPD), and to explore its impacts on immune function, quality of life, and psychological state. Methods A total of 96 stable COPD patients admitted to the Chinese Medicine Classic Ward of The First Hospital of Hunan University of Chinese Medicine from August 2022 to December 2023 were divided into two groups by random number table method. The control group was given conventional therapy, while the observation group was dealt with nursing intervention using meridian pressing-respiration sputum excretion method based on the five elements theory, in addition to the conventional therapy. The lung function parameters [forced expiratory volume in one second (FEV1), forced vital capacity (FVC), maximal voluntary ventilation (MVV), and dyspnea scores], TCM pattern scores, 6-minute walk test (6MWT), COPD assessment test (COPT CAT) scores, generic quality of life inventory-74 (GQOLI-74), immune function indicators (CD4+, CD4+/CD8+), psychological state indexes [self-rating depression scale (SDS) scores, self-rating anxiety scale (SAS) scores], inflammatory factor indexes [hypersensitive C-reactive protein (hs-CRP), interleukin-1β (IL-1β), and IL-6], clinical efficacy and safety between the two groups before and after the intervention were compared. Results After intervention, compared with those of the control group, the total effective rate and GQOLI-74 scores of the observation group were superior (P<0.05). After intervention, FEV1, FVC, MVV, 6MWT and immune function indexes in both groups were significantly higher than those before intervention (P<0.05), with the observation group outperforming the control group (P<0.05). Meanwhile, dyspnea scores, SDS scores, SAS scores, COPD CAT scores, and inflammatory factor indexes in both groups were lower than those before intervention (P<0.05), and the above indexes in the observation group were lower than those in the control group (P<0.05). No adverse reactions occurred in either group. Conclusion Nursing intervention using meridian pressing-respiration sputum excretion method based on the five elements theory can effectively improve lung function, clinical symptoms, and depression and anxiety state of patients with COPD, significantly enhance their immune function and quality of life, and reduce inflammatory levels. |
| Key words: chronic obstructive pulmonary disease meridian pressing-respiration sputum excretion method the five elements theory immune function quality of life inflammatory levels psychological state |
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