Page 46 - วารสารกรมการแพทย์แผนไทยฯ ปีที่ 16 ฉบับที่ 1
P. 46

36



             °√¡°“√·æ∑¬å·ºπ‰∑¬·≈–°“√·æ∑¬å∑“߇≈◊Õ° ‡≈¢∑’Ë  À¬ÿ¥„™â¬“‡ªìπ‡«≈“ 1 ‡¥◊Õπ ¬“Õ¿—¬ “≈’ ·≈–¬“À≈Õ°

             01-2558                                     ¢π“¥ 300 ¡‘≈≈‘°√—¡ ‡μ√’¬¡‚¥¬‚√ß欓∫“≈ÕŸà∑Õß
                 ºŸâ‡¢â“√à«¡«‘®—¬                        ´÷Ë߉¥â√—∫°“√√—∫√Õß¡“μ√∞“π Good manufacturing

                 ºŸâ‡¢â“√à«¡«‘®—¬∑’ˇ¢â“√à«¡‚§√ß°“√∑—ÈßÀ¡¥ 66 √“¬  practice (GMP) μ‘¥μ“¡º≈°“√√—°…“∑—Èß ‘Èπ 5 §√—Èß
             §”π«≥‰¥â®“° Ÿμ√§”π«≥¢π“¥°≈ÿà¡μ—«Õ¬à“ß°“√    §◊Õ «—π∑’Ë 0, 30, 60, 90 ·≈– 120 ‚¥¬∫—π∑÷°
             «‘®—¬‡™‘ß∑¥≈Õß∑’Ë¡’°≈ÿà¡μ—«Õ¬à“ß 2 °≈ÿà¡ (°≈ÿà¡  ª√–«—μ‘°“√„™â¬“æàπ∫√√‡∑“Õ“°“√‡Àπ◊ËÕ¬ÀÕ∫,

             ∑¥≈Õß·≈–°≈ÿࡧ«∫§ÿ¡) √«¡°—∫®”π«πºŸâ‡¢â“√à«¡  §«“¡‡¢â¡¢âπ¢ÕßÕÕ°´‘‡®π„π‡≈◊Õ¥ (O  saturation),
                                                                                     2
             «‘®—¬∑’˧“¥«à“®–À“¬‰ª∑’ËÕ—μ√“√âÕ¬≈– 10 (R = 0.1)   ¡√√∂¿“æªÕ¥ (Lung function), √–¥—∫¿“«–

             ‚¥¬¡’‡°≥±å§—¥‡¢â“ºŸâ‡¢â“√à«¡«‘®—¬§◊Õ (1) ºŸâªÉ«¬∑’ˉ¥â  À“¬„®≈”∫“° (Modified medical research coun-
             √—∫°“√«‘π‘®©—¬‚¥¬·æ∑¬å·ºπªí®®ÿ∫—π«à“‡ªìπ‚√§  cil dyspnea score; mMRC),  ¡√√∂¿“æ√à“ß°“¬
             ªÕ¥Õÿ¥°—Èπ‡√◊ÈÕ√—ß·∫∫§ß∑’Ë √–¬–∑’Ë 1-2 ¡“√—∫°“√  ¥â«¬°“√‡¥‘π 6 π“∑’ (six minute walk test),

             μ√«®√—°…“ ≥ ·ºπ°ºŸâªÉ«¬πÕ°§≈‘π‘°‚√§∂ÿß≈¡    ·≈–§ÿ≥¿“æ™’«‘μ COPD Assessment Test (CAT)
             ªÕ¥Õÿ¥°—Èπ‡√◊ÈÕ√—ß ‚√ß欓∫“≈‡∑‘ß (2) ºŸâªÉ«¬∑—Èß‡æ»  ´÷Ë߇ªìπª√–‡¡‘πº≈°√–∑∫¢Õß‚√§∑’Ë¡’μàÕ°“√∑”
             ™“¬·≈–À≠‘ß∑’Ë¡’Õ“¬ÿ√–À«à“ß 40-80 ªï (3) ºŸâ‡¢â“√à«¡  °‘®«—μ√ª√–®”«—π·≈–§«“¡º“ ÿ¢¢ÕߺŸâªÉ«¬√à«¡°—∫

             «‘®—¬À≠‘ß«—¬‡®√‘≠æ—π∏å∑ÿ°√“¬μâÕß¡’°“√§ÿ¡°”‡π‘¥∑’Ë  °“√μ√«®‡≈◊Õ¥∑“ßÀâÕߪؑ∫—μ‘°“√ 2 §√—Èß §◊Õ «—π∑’Ë 0
             ‡™◊ËÕ∂◊Õ‰¥âÕ¬à“ßπâÕ¬ 2  —ª¥“Àå∑—Èß°àÕπ·≈–À≈—߇¢â“  ·≈– 90 ¥—ß·ºπ¿“æ∑’Ë 1
             √à«¡‚§√ß°“√ ·≈– (4) μâÕ߉¡à‡ªìπ‚√§‡∫“À«“π·≈–    °“√«‘‡§√“–Àå¢âÕ¡Ÿ≈

             ¡’πÈ”μ“≈πâÕ¬°«à“À√◊Õ‡∑à“°—∫ 126 mg/dl           «‘‡§√“–Àåº≈‚¥¬„™â ∂‘쑇™‘ßæ√√≥π“ ‰¥â·°à §à“
                                                         §«“¡∂’Ë §à“√âÕ¬≈– §à“‡©≈’ˬ (Mean)  à«π‡∫’ˬ߇∫π
             2. «‘∏’°“√»÷°…“
                                                         ¡“μ√∞“𠇪ìπμâπ ·≈– ∂‘쑇™‘ßÕπÿ¡“π ‰¥â·°à °“√
                 ß“π«‘®—¬§√—Èßπ’È ‡ªìπ°“√»÷°…“‡™‘ß∑¥≈Õß (ex-  «‘‡§√“–Àå¢âÕ¡Ÿ≈¥â«¬ Independent t-test, Chi-
             perimental study) ·∫∫ ÿà¡ ª°ªî¥ºŸâ‡¢â“√à«¡  square ·≈– Repeated one-way ANOVA

             ‚§√ß°“√·≈–ºŸâª√–‡¡‘πº≈≈—æ∏å (double-blind ran-  °”Àπ¥§à“§«“¡‡™◊ËÕ¡—Ëπ∑’Ë√âÕ¬≈– 95 ·≈–°√≥’ºŸâ‡¢â“
             domized controlled trial) ·∫àß°≈ÿࡺŸâ‡¢â“√à«¡  √à«¡«‘®—¬ÕÕ°®“°°“√»÷°…“°àÕπ§√∫°”Àπ¥®–

             «‘®—¬∑’ˇ¢â“√à«¡°“√«‘®—¬ 66 √“¬ÕÕ°‡ªìπ 2 °≈ÿࡥ⫬  «‘‡§√“–Àåº≈‚¥¬„™âÀ≈—° intention to treat
             °“√®—∫©≈“° °≈ÿà¡≈– 33 √“¬ °≈ÿà¡·√°‡ªìπ°≈ÿà¡
                                                                      º≈°“√»÷°…“
             ∑¥≈Õ߉¥â√—∫¬“Õ¿—¬ “≈’ ·≈–°≈ÿà¡∑’Ë 2 °≈ÿࡧ«∫§ÿ¡

             ‰¥â√—∫¬“À≈Õ° ‚¥¬ºŸâ‡¢â“√à«¡«‘®—¬∑—Èß 2 °≈ÿࡉ¥â√—∫  ¢âÕ¡Ÿ≈∑—Ë«‰ª
             °“√√—°…“‚√§ªÕ¥Õÿ¥°—Èπ‡√◊ÈÕ√—ßμ“¡¡“μ√∞“π°“√      ß“π«‘®—¬§√—Èßπ’È¡’ºŸâ‡¢â“√à«¡«‘®—¬‡¢â“√à«¡‚§√ß°“√∑—Èß
             ·æ∑¬å·ºπªí®®ÿ∫—π ∑—Èß 2 °≈ÿà¡®–‰¥â√—∫¬“§√—Èß≈– 900   ‘Èπ 66 √“¬  ÿà¡Õ‘ √–‚¥¬°“√®—∫©≈“°·∫à߇ªìπ Õß

             ¡‘≈≈‘°√—¡ (3 ·§ª´Ÿ≈) °àÕπÕ“À“√ «—π≈– 3 §√—Èß (‡™â“  °≈ÿࡧ◊Õ °≈ÿà¡∑’Ë 1 °≈ÿà¡∑¥≈Õ߉¥â√—∫¬“Õ¿—¬ “≈’®”π«π
             °≈“ß«—𠇬Áπ) μ‘¥μàÕ°—π‡ªìπ‡«≈“ 3 ‡¥◊Õπ®“°π—Èπ  33 √“¬ ·≈–°≈ÿà¡∑’Ë 2 °≈ÿࡧ«∫§ÿ¡‰¥â√—∫¬“À≈Õ°
   41   42   43   44   45   46   47   48   49   50   51