清金化痰汤治疗AECOPD痰热壅肺证患者的临床观察

Clinical Observation of Qingjin Huatan Decoction for Patients with AECOPD Phlegm-heat Obstructing Lung

目的:观察清金化痰汤治疗慢性阻塞性肺疾病急性加重期(AECOPD)痰热壅肺证患者的临床疗效及安全性。方法:选取AECOPD痰热壅肺证患者120例,按照随机数字表法分为观察组和对照组,各60例。对照组患者采用低流量氧疗、抗感染、扩张支气管、祛痰等常规治疗;观察组患者在对照组基础上加用清金化痰汤(用400 ml纯净水煎制),tid。观察两组患者治疗前和治疗7 d后痰液白细胞介素(IL)-8、IL-17、IL-23及肿瘤坏死因子α(TNF-α)水平,并比较临床疗效及不良反应发生情况。结果:观察组患者均顺利完成研究,对照组患者有3例脱落。治疗前,两组患者IL-8、IL-17、IL-23、TNF-α水平比较,差异均无统计学意义(P>0.05)。治疗7 d后,观察组患者IL-8、IL-17、IL-23、TNF-α水平明显降低,且显著低于对照组,差异均有统计学意义(P<0.05);对照组患者IL-17、IL-23、TNF-α水平较治疗前明显降低,差异均有统计学意义(P<0.05),但IL-8水平较治疗前无明显变化,差异无统计学意义(P>0.05)。观察组患者优良率为95.00%,明显高于对照组的78.95%,差异有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:清金化痰汤治疗AECOPD痰热壅肺证患者疗效显著,能明显改善其炎症因子水平,且安全性较好。

OBJECTIVE：To observe the clinical efficacy and safety of Qingjin huatan decoction for patients with AECOPD phlegm-heat obstructing lung. METHODS：120 patients with AECOPD phlegm-heat obstructing lung were divided into observation group and control group according to random number table,with 60 cases in each group. Control group received routine therapy as low-flow oxygen therapy,anti-infective,bronchiectasis,expectorant,etc.;observation group additionally received Qingjin huatan decoction（decocted by 400 ml pure water）,tid,on the basis of control group. The levels of IL-8,IL-17,IL-23 and TNF-α were observed in 2 groups before and 7 d after treatment. Clinical efficacies and the occurrence of ADR were compared between 2 groups. RESULTS：Before treatment,there was no statistical significance in the levels of IL-8,IL-17,IL-23 and TNF-α between 2 groups （P〉0.05）. After treatment,the levels of IL-8,IL-17,IL-23 and TNF-α in observation group were significantly decreased and lower than in control group,with statistical significance （P〈0.05）. The levels of IL-17,IL-23 and TNF-α in control group were decreased significantly compared to before treatment,with statistical significance（P〈0.05）;the level of IL-8 had no signifi-cant change compared to before treatment,without statistical significance （P〉0.05）. Excellent rate of observation group was 95.00%,which was significantly higher than 78.95% of control group,with statistical significance（P〈0.05）. There was no statis-tical significance in the incidence of ADR between 2 groups（P〉0.05）. CONCLUSIONS：Qingjin huatan decoction shows signifi-cant therapeutic efficacy in the treatment of AECOPD phlegm-heat obstructing lung,and can improve inflammatory factors with good safety.