加味桑皮汤联合西药治疗慢性阻塞性肺疾病急性加重期痰热郁肺证临床观察

Clinical Observation of Modified Sangpi Tang Combined with Western Medicine for AECOPD with the Syndrome of Phlegm-Heat Obstructing Lung

目的:观察加味桑皮汤联合西药治疗慢性阻塞性肺疾病急性加重期(AECOPD)痰热郁肺证的临床疗效。方法:将符合纳入标准的66例AECOPD痰热郁肺证患者随机分为治疗组和对照组各33例,对照组给予西医常规治疗,治疗组在西医常规治疗的基础上加服中药加味桑皮汤。14天后统计分析2组患者的中医证候积分、证候疗效、肺功能、血常规、抗菌药物使用时间。结果:治疗后,治疗组证候疗效优于对照组,差异有统计学意义(P<0.05)。2组咳嗽、痰量、痰液性状、呼吸困难、哮鸣音、发热积分与总积分均较治疗前下降(P<0.01);除发热外,治疗组其余各项症状积分和总积分均较对照组减少,差异均有统计学意义(P<0.05)。2组第1秒用力呼气容积(FEV1)、第1秒用力呼气容积占预计值百分比(FEV1%)、第1秒用力呼气量与用力肺活量之比(FEV1/FVC)均较治疗前提高,差异均有统计学意义(P<0.01);2组各指标比较,差异均无统计学意义(P>0.05)。2组白细胞计数、中性粒细胞均较治疗前降低,差异均有统计学意义(P<0.01);治疗组2项指标均低于对照组,差异均有统计学意义(P<0.01)。治疗组抗菌药物使用时间较对照组缩短(P<0.05)。结论:加味桑皮汤联合西医常规治疗AECOPD痰热郁肺证患者较单纯西医治疗效果更显著,能够迅速缓解患者的全身症状,改善肺功能,有效缓解炎症,缩短抗菌药物使用时间。

Objective：To observe the clinical effect of modified Sanpi tang combined with western medicine for AECOPD with the syndrome of phlegm-heat obstructing lung.Methods：Selected 66 patients with AECOPD due to phlegm-heat obstructing lung,and divided them into the treatment group and the control group with 33 cases in each.The control group was given routine western medicine,and the treatment group was given modified Sangpi tang based on the treatment of the control group.After 14 days of treatment,analysis the main Chinese medicine symptom score,therapeutic effect of syndrome,pulmonary function,blood routine and time of antibiotics usage in the two groups.Results：After treatment,therapeutic effect of syndrome of the treatment group was better than that of the control group（P〈0.05）.Scores of cough,phlegm quantity,sputum character,dyspnea,asthma wong,fever and the total scores of the two groups were all lower than those before treatment（P〈0.01）.Expect fever,scores of every single index and total scores of the treatment group were lower than those of the control group（P〈0.05）.Forced expiratory volume in one second（FEV1）,the percentage of FEV1 in predicted value,the ratio of forced expiratory volume in one second（FEV1） to forced vital capacity（FEV1/FVC） of both groups were all higher than those before treatment（P〈0.01）;compared every index of the two groups respectively,there was no significant difference（P〈0.05）.White blood cell and neutrophil of the two groups were both lower than those before treatment（P〈0.01）;the two indexes of the treatment group were lower than those of the control group（P〈0.01）.The time of using antibiotics in the treatment group was shorter than that in the control group（P〈0.05）.Conclusion：Effect of modified Sangpi tang combined with western medicine for AECOPD with the syndrome of phlegm-heat obstructing lung is better than use western medicine only,which can relieve general symptom quickly,improve pulmonary function and shorten the time of using antibiotics.