清肺化痰健脾活血法联合低流量吸氧、头孢地嗪治疗AECOPD的临床观察

Clinical Observation of Qingfei Huatan Jianpi Huoxue Method Combined with Low Flow Oxygen Inhalation and Cefodizime in the Treatment of AECOPD

目的观察清肺化痰健脾活血法联合低流量吸氧、头孢地嗪治疗慢性阻塞性肺疾病急性加重期(AE⁃COPD)的临床效果。方法纳入79例AECOPD患者,以随机数字表法分为两组,对照组患者(40例)予低流量吸氧、头孢地嗪治疗,观察组患者(39例)予以低流量吸氧、头孢地嗪+清肺化痰健脾活血法治疗,对比分析两组效果以及治疗前后中医证候(咳嗽喘息及咯痰不爽、口渴发热、纳差、面红尿黄等)积分变化及血清炎症因子水平变化、肺功能指标、6 min步行距离及急性生理功能与慢性健康(APACHEⅡ)评分、不良反应情况。结果观察组治疗有效率为97.44%,高于对照组的82.50%(P<0.05);治疗后各组患者中医证候积分、白细胞介素-8(IL-8)、降钙素原(PCT)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、用力呼气量(FVC)、第1秒用力呼气容积(FEV1)、第1秒用力呼吸容积/用力肺活量(FEV1/FVC)、6 min步行距离、APACHEⅡ评分等指标均改善,且观察组患者各项指标改善优于对照组患者(P<0.05);观察组未见不良反应,对照组1例轻度头痛。结论清肺化痰健脾活血法联合低流量吸氧、头孢地嗪治疗AECOPD效果较好,安全可靠。

Objective:To explore the clinical effect of Qingfei Huatan Jianpi Huoxue Method combined with low flow oxygen inhalation and cefodizime in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:A total of 79 AECOPD patients were enrolled and divided into two groups by random number table method.40 patients in the control group were treated with low flow oxygen inhalation and cefodizime,while 39 patients in the observation group were treated with low flow oxygen inhalation and cefodizime plus Qingfei Huatan Jianpi Huoxue Method.The effects of the two groups were compared and analyzed,as well as the changes in the scores of TCM syndromes(cough,wheezing,phlegm,thirst and fever,poor appetite,redness and yellow urine,etc.),changes in serum inflammatory factors,lung function indexes,6 min walking distance,scores of acute physio⁃logical function and chronic health(APACHEⅡ),and adverse reactions before and after treatment.Results:The effective rate of observation group was 97.44%,higher than 82.50%of the control group(P<0.05).After treat⁃ment,the TCM syndrome score,IL-8 and PCT,CRP and TNF-α,FVC,FEV1,FEV1/FVC,6 min walking dis⁃tance,APACHEⅡscore and other indicators were improved in all groups,and the improvement of indicators in ob⁃servation group was better than that in control group(P<0.05).There were no adverse reactions in the observation group,and 1 case in the control group had mild headache.Conclusion:The treatment of AECOPD by Qingfei Huatan Jianpi Huoxue Method combined with low flow oxygen inhalation and cefodizime is safe and reliable.