老年COPD合并肌少症的中西医结合诊疗研究进展

Research Progress on the Integrated Traditional Chinese and Western Medicine Diagnosis and Treatment of Chronic Obstructive Pulmonary Disease Combined with Sarcopenia in the Elderly

摘要: 目的：老年患者多病共存现象普遍，慢性阻塞性肺疾病与肌少症作为常见的老年共病，因相似的慢性炎症等病理机制相互影响，严重损害患者的生活质量与临床预后。本文旨在系统梳理该共病领域的研究现状，为提升临床诊疗水平提供参考。方法：本文系统回顾了近年来国内外关于COPD合并肌少症的病理生理机制、诊断评估工具及干预策略的相关研究，重点分析了中西医在认识与处理该共病方面的理论与实践进展。结果：慢性阻塞性肺疾病与肌少症在炎症激活、氧化应激、能量代谢障碍等方面存在共同通路。西医侧重于肺康复、营养支持及药物治疗，而中医则从“肺脾肾虚、痰瘀互结”等病机出发，采用益气、健脾、化痰、活血等治法。中西医结合干预在改善患者运动耐力、肌肉质量及生活质量方面显示出潜在优势。结论：老年患者慢性阻塞性肺疾病合并肌少症的诊治需要多学科综合管理。未来研究应致力于建立规范的共病诊断流程，并深入探索中西医结合的一体化、个性化治疗策略，以优化患者远期预后。

Abstract: Objective: Multimorbidity is prevalent among elderly patients. Chronic obstructive pulmonary disease (COPD) and sarcopenia, as common geriatric comorbidities, interact through shared pathological mechanisms such as chronic inflammation, severely compromising patients’ quality of life and clinical prognosis. This review aims to systematically summarize the current research landscape in this field to provide a reference for enhancing clinical diagnosis and treatment. Methods: This article systematically reviews recent domestic and international studies concerning the pathophysiological mechanisms, diagnostic assessment tools, and intervention strategies for COPD combined with sarcopenia. It focuses on analyzing the theoretical and practical advancements in both traditional Chinese medicine (TCM) and Western medicine regarding the understanding and management of this comorbidity. Results: The analysis indicates that COPD and sarcopenia share common pathways involving inflammatory activation, oxidative stress, and energy metabolism dysfunction. Western medicine primarily focuses on pulmonary rehabilitation, nutritional support, and pharmacological treatment. In contrast, TCM approaches the condition based on pathogenesis theories such as “deficiency of the lung, spleen, and kidney” and “phlegm-blood stasis interaction”, employing therapeutic methods like replenishing qi, strengthening the spleen, resolving phlegm, and activating blood circulation. Integrated interventions combining TCM and Western medicine have demonstrated potential advantages in improving patients’ exercise tolerance, muscle mass, and quality of life. Conclusion: The diagnosis and treatment of COPD combined with sarcopenia require multidisciplinary comprehensive management. Future research should focus on establishing standardized diagnostic procedures for this comorbidity and further exploring integrated, personalized treatment strategies that combine TCM and Western medicine to optimize long-term patient outcomes.