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Chronic obstructive pulmonary disease (COPD) has a high global morbidity and mortality and a severe disease burden, yet progress in treatment and prevention has been slow in recent decades. Early COPD has few symptoms and is severely underdiagnosed and undertreated; it is crucial to search for effective clues of early COPD and provide management interventions. By reviewing the definition, risk factors, diagnosis and management interventions, this study explores the disease evolution of early-stage COPD, which can help clinical practice to develop more effective preventive and therapeutic strategies for stopping or slowing down the natural progression of the disease, improving the long-term prognosis, and reducing the disease burden.
Assuntos
Humanos , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Prognóstico , Fatores de RiscoRESUMO
Objective To investigate the effect of rhubarb and ephedra prescription on the pulmonary function and blood pressure circadian rhythm in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods One hundred and enghty six patients with AECOPD admitted to Department of Integrated Medicine of Harrison International Peace Hospital from December 2013 to Auguest 2016 were enrolled, and they were divided into a control group 90 cases and an experimental group 96 cases by random number talbe method. The patients in control group were treated with conventional therapy, while those in the experimental group were treated with the conventional therapy and additionally rhubarb and ephedra prescription (including rhubarb 6 g, ephedra 5 g, agrimony 15 g, licorice 15 g), taken orally 2 times a day, the therapeutic course in the two groups being 2 weeks. The diference of blood gas analysis, pulmonary function indexes, dyspnea score (mMRC) and ambulatory blood pressure monitoring were compared before and after treatment in the two groups.Results Compared with before treatment, the pH value, arterial partial pressure of oxygen (PaO2), forced vital capacity (FVC), one second forced expiratory volume (FEV1), FEV1/FVC of the two groups were significantly increased after treatment, while the arterial partial pressure of carbon dioxide (PaCO2) and mMRC score were significantly lowered, and the changes in the experimental group were more significant than those in the control group [pH: 7.40±0.04 vs. 7.37±0.03, PaO2 (mmHg, 1 mmHg = 0.133 kPa): 81.09±12.54 vs. 76.27±12.20, PaCO2 (mmHg): 48.01±8.27 vs. 51.91±8.37, FVC (L): 2.37±0.39 vs. 2.13±0.45, FEV1 (L): 2.08±0.38 vs. 1.87±0.41, FEV1/FVC: (69.01±12.04)% vs. (64.02±11.81)%, mMRC: 2.02±0.76 vs. 2.40±0.87, allP 0.05),and the dSBP (mmHg) in patients with non dipper type was significantly higher than that in patients with dipper, super dipper and anti dipper types (131.55±5.08 vs. 117.78±4.47, 118.26±4.24, 113.37±3.97, allP < 0.05); the daytime diastolic blood pressure [dDBP (mmHg)] of anti dipper, non dipper type, dipper type, super dipper type increased in turn (respectively, 63.27±2.80, 70.24±3.82, 73.98±2.61, 82.96±4.52, allP < 0.05); the night SBP (nSBP) of anti dipper type was the highest (127.38±4.98) mmHg, and the nSBP of super dipper type was the lowest (89.07±3.81) mmHg; the night DBP (nDBP) of dipper type was lower than that of non dipper, anti dipper and super dipper types (mmHg: 63.57±1.37 vs. 68.86±2.12, 67.15±1.56, 67.89±2.04, allP < 0.05). After treatment, the proportion of patients with dipper type [66.7% (64/96) vs. 54.4% (49/90)], no dipper type [11.5% (11/96) vs. 8.9% (8/90)], and super dipper type [5.2% (5/96) vs. 2.2% (2/90)] in experimental group was significantly higher than that in the control group, the proportion of patients with anti dipper type [16.7% (16/96) vs. 34.4% (31/90)] in experimental group were significantly lower than those in the control group (allP< 0.05).Conclusion The Rhubarb and ephedra prescription can obviously improve the blood gas analysis indexes, pulmonary function and blood pressure rhythm in patients with AECOPD.
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Objective To investigate the protective effect of angiotensin converting enzyme inhibitor(ACEI) and angiotensin receptor antagonist(ARB) on renal function of type 2 diabetic nephropathy patients.Methods 60 patients with type 2 diabetic nephropathy and mild or midrange damages of renal function were observed.The patients all accepted routine diabetic therapy and were randomly divided into three groups,ACEI group,ARB group and combination group with ACEI and ARB.The blood pressure,blood creatinine and urine protein of 24 hours were measured before therapy and 8 weeks after therapy.Results The excretive amounts of urine protein decreased in all groups.The excretive levels of urine protein in combination group significantly decreased than in ACEI group and ARB group(P