玉屏风散加味结合西医常规疗法治疗慢性支气管炎急性发作临床研究

Yupingfeng powder combined with conventional western medicine therapy for patients with chronic bronchitis acute clinical studies

目的 评价玉屏风散加味结合西医常规疗法治疗慢性支气管炎急性发作的疗效.方法 将符合入选标准的慢性支气管炎急性发作患者80例,采用随机数字表法分为2组,每组40例.对照组采用西医常规疗法治疗,治疗组在对照组基础上结合玉屏风散加味治疗.2组均治疗2周.采用肺功能检测仪检测用力肺活量（forced vital capacity,FVC）、深吸气量（total lung capacity,TLC）、肺活量（vital capacity,VC）、最大通气量（maximal voluntary ventilation,MVV）;采用全自动免疫发光分析仪和血液分析仪检测hs-CRP、WBC和中性粒细胞百分比;分别于治疗前后进行中医证候积分评估,评价临床疗效.结果 观察组总有效率为92.5%（37/40）、对照组为72.5%（29/40）,2组比较差异有统计学意义（χ2=5.541,P=0.037）.治疗后,观察组中医证候积分[（4.58±1.16）分比（7.74±2.35）分,t=3.256]低于对照组（P〈0.05）;FVC[（2.58±0.35）L比（2.15±0.32）L,t=5.664]、TLC[（2.68±0.49）L比（2.41±0.37）L,t=3.523]、VC[（2.43±0.38）L比（1.52±0.35）L,t=11.152]、MVV[（72.5±14.54）L比（51.2±12.47）L,t=7.305]高于对照组（P〈0.01）;血清hs-CRP[（12.55±4.55）mg/L比（24.72±5.70）mg/L,t=3.543]、WBC[（5.03±1.10）×10^9/L比（7.52±1.41）×10^9/L,t=2.347]、中性粒细胞[（60.32±4.49）%比（71.13±4.14）%,t=3.651]水平低于对照组（P〈0.01）.结论 玉屏风散加味结合西医常规疗法可改善慢性支气管炎急性发作患者的肺功能,降低炎性细胞因子水平,提高临床疗效.

Objective To evaluate the effect of Yupingfeng powder for the patients with chronic bronchitis acute episodes. Method A total of 80 patients with chronic bronchitis acute phase were divided into two groups, 40 in each group, using the random number table method. The control group were treated with conventional western medicine therapy, and the treatment group were treated with Yupingfeng powder on the intervention of control group.Two groups were treated 2 weeks. The pulmonary function before and after treatment, the changes in inflammatory cytokines, and TCM syndrome scores, and clinical effect rates were detected and compared. Results The observation group total effective rate was 92.5% （37/40）, and the control group was 72.5% （29/40）. The difference was statistically significant （χ2=5.541, P=5.541）. After treatment, the TCM syndrome scores（4.58 ± 1.16 vs.7.74 ± 2.35,t=3.256）in the observation group was significantly lower than that in the control group（P〈0.05）.The FVC（2.58 ± 0.35 L vs.2.15 ± 0.32 L,t=5.664）,TLC（2.68 ± 0.49 L vs.2.41 ± 0.37 L,t=3.523）,VC（2.43 ± 0.38 L vs.1.52 ± 0.35 L,t=11.152）,MVV（72.5 ± 14.54 L vs.51.2 ± 12.47 L, t=7.305） in the observation group were significantly higher than those in the control group （Ps〈0.01）. The hs-CRP serum（12.55 ±4.55 mg/L vs.24.72 ± 5.70 mg/L,t=3.543）,the WBC[（5.03 ± 1.10）×10^9/L vs.（7.52 ± 1.41）×10^9/L,t=2.347）],percentage of neutrophils（60.32% ± 4.49 % vs.71.13% ± 4.14%,t=3.651）levels in the observation group were significantly lower than those in the control group （P〈0.01）. Conclusions The Yupingfeng powder combined with conventional western medicine therapy can improve lung function in patients with chronic bronchitis acute, lower the levels of inflammatory cytokines, and improve the clinical effect.