厚朴大黄汤联合西药治疗慢性阻塞性肺疾病急性期随机平行对照研究

Randomized Controlled Study of Houpu Dahuang Decoction(厚朴大黄汤) combined with Western Medicine in Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease

[目的]观察厚朴大黄汤联合西药治疗慢性阻塞性肺疾病急性期疗效。[方法]使用随机平行对照方法,将60例住院患者按就诊顺序编号简单随机分为两组。对照组30例头孢类、喹诺酮类抗感染,持续低流量吸氧,纠正酸碱水电解质紊乱等常规治疗,必要时予呼吸兴奋剂、支气管扩张剂等抢救措施。治疗组30例厚朴大黄汤加减（厚朴10g,大黄5-10g,炙麻黄6g,杏仁10g,生姜6g,杏仁10g,甘草15g,大枣10g;喘促气急加葶苈子15g;大量黄痰加黄芩、鱼腥草各10g;发热加金银花15g,连翘10g;双下肢水肿加茯苓25g,薏苡仁30g）,水煎400m L,200m L/次,早晚温服;西药治疗同对照组。连续治疗15d为1疗程。观测临床症状、咳嗽、痰量、肺部啰音、不良反应。连续治疗2疗程,判定疗效。[结果]治疗组显效19例,有效10例,无效1例,总有效率96.32%;对照组显效11例,有效11例,无效8例,总有效率33.25%;治疗组疗效优于对照组（P〈0.05）[结论]厚朴大黄汤联合西药治疗慢性阻塞性肺疾病急性期,疗效满意,无严重不良反应,值得推广.

[Objective] To observe the Houpu Dahuang decoction combined with western medicine in acute phase efficacy. [Methods] 60 patients were randomly divided into two groups according to the order of treatment. Control group of 30 cases of cephalosporins, quinolones anti infection, persistent low flow oxygen therapy, correcting water electrolyte and acid-base disorders routine treatment, when necessary, given respiratory stimulants, bronchodilators and other emergency measures. Treatment group, 30 eases of Houpu Dahuang decoction addition and subtraction （Cortex Magnoliae officinalis 10 g, rhubarb 5-10 g, honey fried Herba Ephedrae 6 g, almond 10 g, ginger 6 g, almond 10 g, licorice 15 g, 10 g of jujube; dyspnea and shortness of breath with Tinglizi 15 g; large yellow phlegm and baikal skullcap root, Houttuynia each 10 g; fever plus honeysuckle 15 g, 10 g of Frnctus Forsythiae; double limb edema plus Fuling 25 g, Yiyiren 30 g）, water to cook 400 mL, 200 mL / time, sooner or later, warm clothes; western medicine in the treatment of with the control group. Continuous treatment for 1 courses of 15 d. Observation of clinical symptoms, cough, sputum, pulmonary rales, adverse reactions. Continuous treatment for 2 courses of treatment, to determine efficacy. [Results] the treatment group, markedly effective in 19 cases, 10 cases were effective, 1 case ineffective, the total efficiency 96.32%; control group, 11 cases were markedly effective, 11 cases were effective, 8 cases ineffective, efficiency 33.25%; treatment group curative effect is better than that of the control group （P〈 0.05）. [Conclusion] Houpu Dahuang decoction combined with western medicine in the treatment of acute exacerbation of chronic obstructive pulmonary disease, and the results were satisfactory. No serious adverse reactions, worthy of promotion.