中药加镜下灌洗治疗支气管扩张疗效观察

"Zhikuo Ganran Decoction" Combined with Bronchoalveolar Lavage in Treating Bronchiectasis

目的观察支扩感染方加支气管灌洗治疗支气管扩张急性加重期的近期及远期疗效。方法将37例支扩急性加重期患者,随机分为灌洗加中药组(12例)、灌洗组(10例)及无灌洗组(15例)。灌洗加中药组给予支扩感染方加减合并灌洗、抗生素治疗及其他常规治疗;灌洗组予支气管灌洗及常规抗感染等治疗;无灌洗组予中药支扩感染方加减口服,并结合常规抗感染等治疗。各组均治疗两周。观察临床疗效、抗生素用药时间、血清CRP、痰TNF-α水平及远期疗效。结果灌洗加中药组治疗疗程比无灌洗组抗生素用药时间明显缩短[(12±2.65)dVS(17.3±6.1)d,P<0.05],血清CRP及痰TNF-α值明显降低(P<0.05)。与灌洗组比较,灌洗加中药组有提高临床疗效、减少远期发作的倾向。结论支扩感染方结合支气管灌洗,能缩短抗生素疗程,减轻炎症反应,且安全性良好。

Objective To evaluate the near-term and long-term effects of ＂Zhikuo Ganran Decoction＂ combined with bronchoalveolar lavage on bronchiectasis with infection. Methods 37 patients with exacerbation of bronchiectasis were randomly divided into three groups： group A by ＂Zhikuo Ganran Decoction＂ combined with bronchoalveolar,group B by single bronchoalveolar lavage group and group C by no bronchoalveolar lavage. The clinical effects,duration of antibiotic administration,serum CRP,sputum TNF-α before and after treatment and long-term effect were observed. Results The duration of antibiotic administration[（12± 2.65）days VS （17.3±6.1） days,P〈 0.05],the level of serum CRP and sputum TNF-α in group A were significantly reduced, compared with group C （P〈 0.05）.There was a tendency of increasing near-term and long-term clinical effects after treatment by ＂Zhikuo Ganran Decoction＂ combined with bronchoalveolar lavage. Conclusion ＂Zhikuo Ganran Decoction＂ combined with local bronchoalveolar lavage can safely improve the symptoms rapidly and shorten the duration of antibiotic administration, and relieve the local irritation of patients with exacerbation of bronchiectasis.