摘要
骨骼肌功能障碍(skeletal muscle dysfunction,SMD)是慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)重要的并发症,也是导致患者运动能力下降、生活质量降低的主要原因。COPD合并SMD机制与营养不良、氧化应激、线粒体功能障碍、系统性炎症等有关。现代医学针对COPD合并SMD的治疗较少,中医治疗逐渐受到关注且取得了较大进展,主要包括中药治疗、中医康复等。目前中药治疗主要为从"肺气""肺脾"论治,以补肺益气、补肺健脾为其治疗原则。中医康复疗法包括传统功法、针灸、推拿、穴位贴敷等,临床应用广泛,效果显著。但目前中医药治疗研究尚处于起步阶段,存在若干问题:①缺乏统一的诊断依据;②缺乏规范的中医辨证及疗效评价标准;③对于中医药包括肺康复治疗SMD的作用机制缺少深入研究。基于此,拟定进一步研究方向:①加强大样本、多中心临床观察,构建COPD合并SMD的临床诊断及辨证标准;②加强临床中医药及康复疗法的疗效观察,建立规范的疗效评价标准,进一步证实其临床疗效;③基于前期建立的COPD动物模型及细胞模型,多层次地深入探讨中医药及康复技术的作用机制,为临床应用提供依据。
Skeletal muscle dysfunction(SMD)is an important complication of chronic obstructive pulmonary disease(COPD),and it is also the main reason for the decline of exercise ability and quality of life.The mechanism of COPD with SMD is related to malnutrition,oxidative stress,mitochondrial dysfunction and systemic inflammation.The treatment of COPD combined with SMD in modern medicine is less,and the treatment of Chinese medicine is gradually concerned and has made great progress,mainly including the treatment of Chinese medicine,rehabilitation of Chinese medicine,etc.At present,the treatment of Chinese medicine is mainly based on"lung qi"and"lung spleen",with the principles of invigorating lung and qi,invigorating lung and spleen as its treatment principle.Rehabilitation therapy of Chinese medicine includes traditional skill,acupuncture,massage,acupoint application and so on.It has a wide range of clinical application and many advantages.It has a significant effect in the treatment of COPD combined with SMD.But at present,the research of TCM treatment is still in the initial stage,there are several problems:①lack of unified diagnosis basis;②lack of standardized TCM syndrome differentiation and efficacy evaluation standards;③lack of in-depth research on the mechanism of TCM treatment of SMD,including pulmonary rehabilitation.Based on this,further research directions are proposed:①strengthen large sample and multi-center clinical observation,construct the clinical diagnosis and syndrome differentiation standard of COPD combined with SMD;②strengthen the observation of clinical curative effect of Chinese medicine and rehabilitation therapy,establish standard curative effect evaluation standard,further confirm its clinical curative effect;③based on the COPD animal model and cell model established in the early stage,multi-level in-depth discussion is under way.The mechanism of medicine and rehabilitation technology can provide basis for clinical application.
作者
刘帅
田燕歌
马锦地
张蓝熙
朱丽华
李建生
LIU Shuai;TIAN Yange;MA Jindi;ZHANG Lanxi;ZHU Lihua;LI Jiansheng(Collaborative Innovation Center for Respiratory Disease Diagnosis and Treatment&Chinese Medicine Development of Henan Province,Zhengzhou Henan China 450046;Henan Province Key Laboratory of TCM for Prevention and Treatment of Respiratory Disease,Zhengzhou Henan China 450046;Henan University of Chinese Medicine,Zhengzhou Henan China 450046)
出处
《中医学报》
CAS
2020年第3期579-583,共5页
Acta Chinese Medicine
基金
国家自然科学基金项目(81673942)
河南省科技攻关项目(192102310427)。
关键词
慢性阻塞性肺疾病
骨骼肌功能障碍
中药治疗
中医康复
肺康复治疗
chronic obstructive pulmonary disease
skeletal muscle disorder
Chinese medicine treatment
Chinese medicine rehabilitation
lung rehabilitation treatment
