补肺汤加减配合电针对稳定期慢性阻塞性肺疾病肺脾气虚证运动耐力及血气分析指标的影响OA

Objective To investigate the effects of modified Bufei Decoction combined with electroacupuncture on exercise tolerance and blood gas analysis-related indicators in patients of chronic obstructive pulmonary disease(COPD)in stable period with lung-spleen qi deficiency pattern.Methods Patients of COPD in stable period with lung-spleen qi deficiency pattern who met the inclusion criteria were randomly divided into a control group and a study group using a random number table,with 42 cases in each group.The control group received conventional Western medical treatment,while the study group received modified Bufei Decoction combined with electroacupuncture in addition to the conventional Western medical treatment.The treatment lasted for 3 months for both groups.The time to relief of cough and wheezing,as well as the time to disappearance of lung rales,were recorded for both groups.Respiratory and exercise capacity were assessed using the Modified Medical Research Council(MMRC)Dyspnea Scale,the Barthel Index,and the 6-minute walk test(6MWT).Arterial oxygen saturation(SaO2),arterial partial pressure of oxygen(PaO2),and arterial partial pressure of carbon dioxide(PaCO2)were measured using a blood gas analyzer.Pulmonary function parameters[forced expiratory volume in one second(FEV1),forced vital capacity(FVC),and peak expiratory flow(PEF)]were measured using a spirometer.Serum levels of C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),and interleukin-6(IL-6)were measured using the enzyme-linked immunosorbent assay.TCM symptoms,including cough and asthma with weakness,shortness of breath and reluctance to speak,and aversion to wind and spontaneous sweating,were scored.Patients were followed for one year,the number of acute exacerbations and hospital readmissions rates were recorded.Quality of life was also assessed using the COPD Assessment Test(CAT).Results The total effective rate in the study group was 92.86%(39/42),which was significantly higher than the rate of 73.81%(31/42)in the control group.The time to relief of cough and wheezing,as well as the time to disappearance of lung rales in the study group were significantly shorter than those of the control group(P<0.05);Both groups showed significant reductions in MMRC scores,CRP,TNF-α,IL-6,and PaCO₂ levels,as well as TCM symptom scores of cough and asthma with weakness,shortness of breath and reluctance to speak,and aversion to wind and spontaneous sweating,compared to the baseline(P<0.05).The 6MWT,Barthel index,SaO2 and PaO2 levels,as well as the FVC,FEV1,and PEF levels,were significantly increased(P<0.05).Furthermore,the improvement in these parameters was superior in the study group compared to the control group(P<0.05).During the one-year follow-up after treatment,the study group showed significantly lower frequencies of acute exacerbations,lower readmission rates,and lower CAT scores than the control group(P<0.05).Conclusion Modified Bufei Decoction combined with electroacupuncture can not only significantly alleviate clinical symptoms such as cough and asthma,effectively promote respiratory and lung function recovery,but also improve exercise tolerance,optimize quality of life,and reduce the risk of acute exacerbation for patients of COPD in stable period with lung-spleen qi deficiency pattern.