平咳化痰汤治疗脾虚痰湿型COPD患者的临床观察

Clinical Observation of Pingke Huatan Decoction in Treating Patients of Chronic Obstructive Pulmonary Disease with the Type of Spleen-deficiency and Phlegm-damp

目的:观察平咳化痰汤联合西医常规疗法治疗脾虚痰湿型慢性阻塞性肺疾病(COPD)稳定期患者的临床疗效。方法:将62例脾虚痰湿型COPD稳定期患者随机分为治疗组和对照组,每组31例。治疗组予中药平咳化痰汤联合西医常规治疗,对照组予西医常规治疗,两组均治疗3个月。观察两组临床疗效,观察治疗前后中医证候、肺功能、生活质量、血清IL-8、TNF-α水平。结果:1治疗组总有效率87.10%,显著高于对照组64.52%,组间比较差异有统计学意义(P<0.05)。2治疗组临床主要症状咳、痰、喘、胸脘痞满的有效率均高于对照组(P<0.05,P<0.01)。3治疗前后组内比较,治疗组肺功能FEV1%提高(P<0.01),FVC、VC%提高(P<0.05),对照组FEV1、FVC、VC%无显著性差异(P>0.05)。治疗后组间比较,治疗组VC%、FEV1较对照组升高(P<0.05)。4治疗前后组内比较,两组生活质量均提高(P<0.01);组间比较,治疗组的生活质量改善优于对照组(P<0.05)。5治疗前后组内比较,治疗组血清IL-8、TNF-α水平降低(P<0.05);组间比较,IL-8、TNF-α水平低于对照组,差异有统计学意义(P<0.05)。结论:平咳化痰汤联合西医常规疗法治疗COPD稳定期(脾虚痰湿型)患者,可改善患者肺功能指标(FEV1、FVC、VC%),提高生活质量,降低血清IL-8和TNF-α水平,临床疗效确切。

Objective：To observe the clinical efficacy of Pingke Huatan Decoction,combined with routine western therapy,in treating patients of Chronic Obstructive Pulmonary Disease （COPD） patients with type of Spleen-deficiency and Phlegm-damp Syndrome in stable phase. Methods：62 patients,who are in COPD stable phase,were randomized into two groups：treatment group and control group. Each has 31 patients. The control group was treated by routine western therapy. The treatment group was treated by Pingke Huatan Decoction in addition to the same therapy as control group. The treatments in each groups take 3 months. The clinical efficacy of TCM syndrome score,lung function,life quality,IL-8 and TNF-α are observed. Result：①The clin-ical effectiveness of treatment group is 87.10%,higher than 64.52%（P〈0.05） in control group. The differ-ence is of statistical significance. ②The improvement of main syndromes （coughing,phlegm,wheezing,chest cavity or fullness） in treatment group are higher than that in control group （P〈0.05 or P〈0.01）. ③Com-paring the before-treatment and after-treatment,lung function FEV1 in treatment group increased（P〈0.01）. FVC,VC% increased（P〈0.05）. While in control group,FEV1,FVC and VC% are with no significant changes （P〉0.05）. Comparing after-treatment of two groups,VC%,FEV1% in treatment group are higher than that in control group（P〈0.05）. ④Comparing the before-treatment and after-treatment,life qualities in both groups improved（P〈0.01）. The improvement in treatment group is better than that in control group（P〈0.05）. ⑤Comparing the before-treatment and after-treatment,IL-8,TNF-α in treatment group are lowered（P〈0.05）. Comparing with control group,IL-8,TNF-α in treatment group is lower than that in control group. The differ-ence is significant in statistics（P〈0.05）. Conclu-sion：Pingke Huatan Decoction combined with routine western therapy,applied to patients in COPD stable phase （with type of Spleen Damp-ness）,can increase lung function indices （VC,＆amp;nbsp;FVC,FEV1）,improve life quality,reduce IL-8 and TNF-α. The effect is definite and with good safety.