中药对AECOPD肺部感染控制窗等因素的影响

Effects of TCM Therapy on PIC Window of AECOPD Patients

目的观察中西医结合治疗慢性阻塞性肺疾病急性加重期(AECOPD)的临床疗效。方法将61例AECOPD痰热蕴肺型患者随机分为对照组(31例)和治疗组(30例),对照组给予西医综合治疗,治疗组在西医综合治疗的基础上加用清热化痰方,痰热证基本消失时,予健脾益肾中药,疗程为3个月。观察再感染复发时间(PIC窗)、FEV1%以及St.George问卷的改善情况等。结果与对照组比较,治疗组临床显控率90.0%,对照组为67.7%,治疗组疗效优于对照组(P<0.05)。随访3个月,治疗组复发率为33.33%,低于对照组的70.37%(P<0.05):治疗组肺部感染控制窗中化数为90d,长于对照组的65d(P<0.05);治疗组FEV1%较前提高但无显著性差异;两组St.George问卷评分均有明显改善,治疗组优于对照组(P<0.05)。结论中药清肺化痰与健脾补肾方剂序贯治疗,结合常规西医疗法可以更好地改善AECOPD患者的临床症状,延长PIC窗,提高生存质量。

Objective To evaluate the effects of integration of traditional Chinese medicine and western medicine on patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD）. Methods Sixty-one patients with AECOPD of lung phlegm-heat syndrome were randomly divided into two groups. Thirty patients in treatment group were treated with the therapy of integrated TCM and western medicine, while 31 ones in control group were treated with conventional western medicine alone. Results Compared with control group, the clinical control rate of treatment group was higher （90% VS 67.7%, P 〈 0.05）. In three-month follow-up, the recurrence rate of treatment group was significantly lower （33.33% VS 70.37%, P〈 0.05） with longer pulmonary infection control （PIC） window （median 90 days VS 65 days, P〈 0.05）.The FEVI% of treatment group increased than three months before but without a statistic significance. Both of the groups had better SGRQ scores, with the more lower scores in treatment group （42.22±14.63 VS 53.93±17.32, P〈 0.05）. Conclusion Integrated treatment of traditional Chinese medicine and western medicine may improve the clinical efficacy of AECOPD patients, prolongs the PIC window, and improves the quality of life.