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目的:探讨影响慢性阻塞性肺疾病(COPD)患者生活质量及预后的因素。方法:选取133例COPD稳定期病例,对所有病例进行为期2年的电话随访,并予健康宣教,如对疾病的认识、建议长期氧疗、戒烟教育、预防感冒、注意营养、辨证食疗、坚持合理用药、呼吸操教育、八段锦及太极拳教育、心理疏导。从中医学角度,对影响患者预后及生存质量的因素进行前瞻性临床研究。结果:在生活质量评分(圣乔治呼吸问卷,SGRQ)方面,气阴两虚组、肺脾肾虚组、肺脾气虚组3组间比较,差异有显著性意义(P<0.05),气阴两虚组>肺脾肾虚组>肺脾气虚组。在预后方面,3组证型间病死率比较,差异无显著性意义(P>0.05);血常规中中性粒细胞值及血气分析中碳酸氢根值死亡组均高于存活组,差异均有显著性意义(P<0.05)。结论:患者生活质量存在差异,肺脾气虚组高于肺脾肾虚组,肺脾肾虚组高于气阴两虚组。证型的不同,患者病死率存在差异;血中性粒细胞及碳酸氢根与患者预后相关。
Objective: To explore the factors affecting the quality of life and prognosis of patients with chronic obstructive pulmonary disease (COPD). Methods: A total of 133 cases with stable COPD were enrolled in this study. All patients were followed up for 2 years by phone and were educated for health education. For example, the patients should know long-term oxygen therapy, quit smoking education, prevent colds, pay attention to nutrition, Rational use of medicine, breathing exercises education, Ba Duan Jin and Tai Chi education, psychological counseling. From the perspective of traditional Chinese medicine, we prospectively studied the factors affecting the prognosis and quality of life of patients. Results: There was significant difference in quality of life score (SGRQ) between the three groups of Qi and Yin Deficiency, Lung Spleen and Kidney Deficiency and Lung Spleen Deficiency (P <0.05) Deficiency group> Lung spleen and kidney group> Lung spleen deficiency group. In terms of prognosis, there was no significant difference between the three groups in the case fatality rate (P> 0.05). The neutrophil count in blood and the death rate of bicarbonate in blood gas analysis were higher than those in survival group There was significant (P <0.05). Conclusion: There are differences in the quality of life of patients with lung spleen qi deficiency group than in lung spleen deficiency group, lung spleen and kidney deficiency than qi yin deficiency group. Different types of patients, there are differences in patient mortality; blood neutrophils and bicarbonate and the prognosis of patients.