清肺补肾化瘀法治疗急性加重期慢性阻塞性肺疾病临床疗效及对血气指标与肺功能影响

Clinical Efficacy of Qingfei Bushen Huayu Theropy on Blood Gas Index and Pulmonary Function in Treating Acute Exacerbation of COPD

目的观察清肺补肾化瘀法治疗急性加重期慢性阻塞性肺疾病(COPD)的临床疗效以及对血气指标与肺功能的影响。方法将88例气急性加重期慢性阻塞性肺疾病患者随机分为观察组以及对照组(各44例)。其中对照组给予西医常规疗法,观察组在对照组基础上给予清肺补肾化瘀法。比较两组患者临床疗效以及不良反应发生情况,治疗前后的血气指标、肺功能、血清炎症因子水平、临床症状与体征积分比较。结果观察组临床治疗效果明显高于对照组(95.45%vs 77.27%,P<0.05);治疗前,两组血气指标、肺功能比较无明显差异(P>0.05),治疗后,两组血二氧化碳分压(PaCO2)指标低于同组内治疗前,PaO2、FEV1、FEV1/FVC指标均高于同组内治疗前(P<0.05),观察组PaCO2明显低于对照组,PaO2、最大呼气第一秒呼出的气量的容积(FEV1)、第一秒用力呼气量占所有呼气量的比例(FEV1/FVC)指标均明显高于对照组(P<0.05);治疗前,两组血清炎症因子水平比较无明显差异(P>0.05),治疗后,两组血清炎症因子水平均低于同组内治疗前(P<0.05),且观察组白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)水平均明显低于对照组(P<0.05)。治疗前,两组临床症状与体征积分比较无明显差异(P>0.05),治疗后,两组患者咳嗽、气喘、咳痰积分均低于同组内治疗前(P<0.05),且观察组明显低于对照组(P<0.05)。两组患者不良反应发生率比较无明显差异(P>0.05)。结论采用清肺补肾化瘀法治疗急性加重期慢性阻塞性肺疾病患者的临床疗效较好,提高患者肺功能,能够明显改善患者临床症状与体征,且对于调节血气指标、降低患者机体血清炎症因子水平均十分有效。

Objective To investigate clinical efficacy of Qingfei Bushen Huayu theropy on blood gas index and pulmonary function in treating acute exacerbation of COPD(AECOPD).Methods 88 cases of AECOPD were randomly divided into two groups,each with 44 cases.The control group was given conventional Western medicine therapy,and based on this,the observation group was given Qingfei Bushen Huayu Decoction.Then the clinical efficacy,adverse reactions,blood gas index,pulmonary function,serum inflammatory factors and scores of clinical symptoms and signs were compared between the two groups before and after treatment.Results The clinical effect of the observation group was significantly higher than that of the control group(95.45%vs 77.27%,P<0.05).The blood gas index and pulmonary function had no significant difference between the two groups(P>0.05).After treatment,the PaCO2 levels were decreased in both groups,and were lower in the observation group than in the control group(P<0.05),meanwhile the levels of PaO2,FEV1 and FEV1/FVC were increased,and were higher in the observation group than in the control group(P<0.05).The IL-1,IL-6 and TNF-αlevels had no significant difference between the two groups before treatment(P>0.05),were decreased in both groups after treatment,and were lower in the observation group than in the control group(P<0.05).Before treatment,there was no significant difference in the scores of clinical symptoms and signs between the two groups(P>0.05).After treatment,the scores of cough,asthma and expectoration in the two groups were lower than those before treatment in the same group(P<0.05),and that in the observation group was significantly lower than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The application of Qingfei Bushen Huayu theropy is an effective way to ameliorate the blood gas index and pulmonary function,and significantly improve the clinical symptoms and signs of patients as well as reduce the serum levels of inflammatory factors in AECOPD patients.