Clinical Efficacy Of Buzhong Yiqi Decoction Combined With Pulmonary Rehabilitation In Treating Stable-phase COPD Differentiated As Syndrome Of Qi Deficiency Of Spleen And Lung

Objective:To observe effects of Buzhong Yiqi Decoction combined with pulmonary rehabilitation on clinical efficacy,TCM syndrome,exercise endurance,quality of life,severity of dyspnea,and lung function in treating stable-phase COPD patients with syndrome of qi deficiency of spleen and lung in clinic,and to explore its clinical advantages,aiming to provide new thoughts for stable-phase COPD with syndrome of qi deficiency of spleen and lung.Methods:A total of 90 stable-phase COPD patients with syndrome of qi deficiency of spleen and lung from February 2021 to December 2021 who received follow-up treatment in outpatient department of respiratory medicine of the Affiliated People’s Hospital of Fujian University of Traditional Chinese Medicine were selected as study objects and were divided into control group(n=30),pulmonary rehabilitation group(n=30),Chinese medicinal pulmonary rehabilitation group(n=30)according to random table method.The control group received conventional treatment of western medicine,the pulmonary rehabilitation group was additionally given pulmonary rehabilitation training(oscillatory positive expiratory pressure,active cycle of breathing techniques)on the basis of the control group,while the pulmonary rehabilitation by Chinese medicinal group was added with Buzhong Yiqi Decoction on the basis of the pulmonary rehabilitation group,the total treatment course was lasted for 8 weeks.The efficacy of TCM syndromes,the changes of total score of TCM syndromes,scores of primary symptoms of TCM syndrome,scores of secondary symptoms of TCM syndrome,6-min walk distance(6MWD),COPD Assessment Test(CAT)score,modified British Medical Research Council(m MRC)and forced expiratory volume in 1 s as a percentage of the predicted value(FEV1% pred)of patients before and after treatment were observed,and the statistical analysis was conducted to obtain clinical results.Results:1.General data: before treatment,gender,age,course of disease,smoking history and grading of airflow restriction among the three groups showed no significant differences(P>0.05),and the data were comparable.2.Efficacy of TCM syndrome: after treatment,the total effective rate was 61.54% in the control group,72.00% in the pulmonary rehabilitation group and 92.31% in the Chinese medicinal pulmonary rehabilitation group.There were significant differences in total effective rate between Chinese medicinal lung rehabilitation group and control group,between Chinese medicinal pulmonary rehabilitation group and pulmonary rehabilitation group(P<0.05),while no significant difference was noted between control group and pulmonary rehabilitation group(P>0.05).3.Score of TCM syndrome: total scores of TCM syndromes,scores of primary symptoms of TCM syndrome the three groups after treatment were lower than those before treatment(P<0.05).The secondary symptom score of TCM the Chinese medicinal pulmonary rehabilitation group was lower than that before treatment(P<0.05),but no significant change was found in the control group and pulmonary rehabilitation group(P>0.05);the Chinese medicinal pulmonary rehabilitation group had lower total scores of TCM syndromes,score of primary symptoms of TCM syndrome and scores of secondary symptoms of TCM syndrome than those in the control group and pulmonary rehabilitation group(P<0.05);the pulmonary rehabilitation group had lower score of primary symptoms of TCM syndrome than the control group(P<0.05),but no significant differences in total score of TCM syndrome,score of secondary symptoms of TCM syndrome were observed between pulmonary rehabilitation group and the control group(P>0.05).4.6MWD: 6MWD of three groups were increased than treatment before(P<0.05);compared with the control group and the pulmonary rehabilitation group,6MWD of Chinese medicinal pulmonary rehabilitation group was increased,and the pulmonary rehabilitation group was better than the control group in 6MWD(P<0.05).5.CAT score: after treatment,CAT scores of three groups showed significant decreases than those of treatment before(P<0.05).The Chinese medicinal pulmonary rehabilitation group had reduced CAT score than the control group and the lung rehabilitation group,and the lung rehabilitation group had better CAT score than the control group(P<0.05).6.m MRC: after treatment,both pulmonary rehabilitation group and the Chinese medicinal pulmonary rehabilitation group had declined m MRC compared with treatment before(P<0.05),but there was no significant intra-group difference in m MRC in the control group compared with treatment before(P>0.05).Compared with the control group,the m MRC in the pulmonary rehabilitation group and the Chinese medicinal pulmonary rehabilitation group were decreased(P<0.05),but no significant difference was found between pulmonary rehabilitation group and the Chinese medicinal pulmonary rehabilitation group(P>0.05).7.FEV1%pred: after treatment,there was no significant change in FEV1%pred in three groups compared with before treatment(P>0.05).No significant between-group difference was observed in FEV1%pred in the control group,pulmonary rehabilitation group and Chinese medicinal pulmonary rehabilitation group(P>0.05).Conclusions:Buzhong Yiqi Decoction and pulmonary rehabilitation in combination is effective in treating stable-phase COPD with syndrome of qi deficiency of spleen and lung.The combined treatment can improve the clinical effective rate,alleviate the clinical symptoms of patients,strengthen exercise endurance,enhance quality of life and improve the degree of dyspnea.Besides,there are no adverse reactions,thus it provides a new safe and effective method for the treatment of COPD by traditional Chinese and western medicine.