| 引用本文:赵晔1，温世春2.不同冬病夏治方案预防肺气虚证患者呼吸道感染效果的回顾性队列研究[J].世界中医药,2023,(13):. |
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| 不同冬病夏治方案预防肺气虚证患者呼吸道感染效果的回顾性队列研究 |
| Different Schemes of Treating Winter Diseases in Summer Prevent and Treat Respiratory Tract Infections in Patients with Syndrome of Lung Qi Deficiency：A Retrospective Cohort Study |
| 投稿时间：2023-05-17 |
| DOI：10.3969/j.issn.1673-7202.2023.13.019 |
| 中文关键词: 肺气虚证 慢性阻塞性肺疾病稳定期 支气管哮喘 冬病夏治 三伏贴 四君子汤合玉屏风散 玉屏风胶囊 芪参补气胶囊 回顾性队列研究 |
| English Keywords:Syndrome of lung qi deficiency Stable chronic obstructive pulmonary disease Bronchial asthma Treating winter diseases in summer Sanfu medicinal patch Sijunzi Decoction plus Yupingfeng Powder Yupingfeng Capsules Qishen Buqi Capsules Retrospective cohort study |
| 基金项目:中国人口福利基金会慢病防治项目科研支撑计划项目（MBKY2023A002） |
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| 中文摘要: |
| 目的：探索三伏贴联合口服不同中药的冬病夏治方案对预防肺气虚证患者呼吸道感染的效果差异。方法：选取2022年7月16日至2022年8月25日在国药同煤总医院中医科就诊的肺气虚证患者1 584例作为研究对象，进行回顾性分析。其中526例未接受冬病夏治疗法，设为D组。1 058例接受了冬病夏治疗法，其中546例接受三伏贴+四君子汤合玉屏风散加减汤剂治疗，设为A组；261例接受三伏贴+玉屏风胶囊治疗，设为B组；251例接受三伏贴+芪参补气胶囊治疗，设为C组。通过面对面问卷和（或）电话微信沟通，搜集其基本人口学资料，西医诊断，冬病夏治前西医疾病严重程度指标，所接受的冬病夏治方案，冬病夏治前后免疫炎症指标，在2022年10月9日至2023年3月27日期间是否发生呼吸道感染、是否住院、是否死亡，以评估接受不同的冬病夏治方案是否能显著减少呼吸道感染的发生风险、住院风险、死亡风险。结果：共收集到慢性阻塞性肺疾病1 315例，其中肺功能Ⅰ级384例、肺功能Ⅱ级505例、肺功能Ⅲ级426例；支气管哮喘269例。与D组比较，A、B、C 3组冬季呼吸道感染风险均显著降低，风险降低分别为：A组17.1%（RR=0.175，95%CI为0.110~0.279，P=0.000）、B组3.8%（RR=0.523，95%CI为0.284~0.963，P=0.035）、C组22.1%（RR=0.134，95%CI为0.081~0.221，P=0.000）。其中A组与C组的感染风险降低相当（P>0.05），并分别显著优于B组（均P<0.05）。A、B、C 3组的住院率和免疫炎症指标改善情况均显著优于D组（均P<0.05），其中A组的免疫炎症指标改善情况与C组比较，差异无统计学意义（P>0.05），A组、C组又显著优于B组（均P<0.05）。共3例患者出现与三伏贴相关的不良反应，发生率为0.3%；没有患者发生与口服汤剂或中成药相关的不良反应。结论:采用三伏贴与口服中药联合进行冬病夏治疗法，特别是联合汤药四君子汤合玉屏风散加减，或芪参补气胶囊，可显著降低呼吸道感染风险，减少住院风险，值得临床推广使用。 |
| English Summary: |
| To compare the performance of different schemes of treating winter diseases in summer in the prevention and treatment of respiratory tract infections in patients with the syndrome of lung qi deficiency.Methods:A retrospective study was conducted，involving 1 584 patients with the syndrome of lung qi deficiency treated in the Department of Traditional Chinese Medicine，Sinopharm Tongmei General Hospital from July 16 to August 25 in 2022.The patients were assigned into groups A(546 patients，Sanfu medicinal patch+modified Sijunzi Decoction plus Yupingfeng Powder)，B(261 patients，Sanfu medicinal patch+Yupingfeng Capsules)，C(251 patients，Sanfu medicinal patch+Qishen Buqi Capsules)，and D(526 patients，did not receive the scheme of treating winter diseases in summer).Face-to-face questionnaire interview and/or WeChat communication were employed to collect the demographic data of patients，Western medicine diagnosis conclusions，Western medicine disease indicators before the treatment of winter diseases in summer，the accepted scheme of treating winter diseases in summer，and laboratory indicators related to immune function before and after treatment of winter diseases in summer.Moreover，the respiratory infection，hospitalization，and death conditions from October 9，2022 to March 27，2023 were surveyed to evaluate whether different schemes of treating winter diseases in summer can reduce the risks of respiratory infections，hospitalization，and death.Results:The patients enrolled in this study included 269 patients with bronchial asthma and 1 315 patients with chronic obstructive pulmonary disease(384 patients of grade Ⅰ，505 patients of grade Ⅱ，and 426 patients of grade Ⅲ).Compared with group D，groups A，B，and C showed reduced risks of respiratory infections in winter.Specifically，the risk reduction was 17.1%(RR=0.175，95%CI 0.110 to 0.279，P=0.000) in group A，3.8%(RR=0.523，95%CI 0.284 to 0.963，P=0.035) in group B，and 22.1%(RR=0.134，95%CI 0.081 to 0.221，P=0.000) in group C.Groups A and C showed similar performance in risk reduction(P>0.05) and outperformed group B(P<0.05).Groups A，B，and C were superior to group D in terms of the hospitalization rate and inflammation indicators(P<0.05)，and groups A and C were superior to group B in terms of the inflammation indicators(P<0.05).Three patients experienced adverse reactions related to the Sanfu medicinal patch，with an incidence rate of 0.3%，and no patient presented the adverse reactions associated with the oral administration of decoctions or Chinese patient medicines.Conclusion:The combination of Sanfu medicinal patch and oral administration of Chinese medicines(especially modified Sijunzi Decoction plus Yupingfeng Powder，or Qishen Buqi Capsules) for treating winter diseases in summer can significantly reduce the risks of respiratory tract infections and hospitalization in patients with the syndrome of lung qi deficiency，being worthy of promotion in clinical practice. |
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