中西医结合治疗痰热壅肺型慢性阻塞性肺疾病急性加重期临床观察

Combination of Traditional Chinese and Western Medicine in Treating Phlegm-heat Obstructing Lung Type of Chronic Obstructive Pulmonary Disease in Acute Exacerbation

目的：评价清金化痰汤联合西药治疗痰热壅肺型慢性阻塞性肺疾病（慢阻肺）急性加重期的临床疗效与安全性。方法：72例确诊为痰热壅肺型慢阻肺急性加重期患者按随机数字表法分为两组,对照组与观察组各36例。对照组给予抗菌药物、支气管扩张剂及其他对症治疗药物,观察组在对照组治疗基础上加用清金化痰汤,所有病例均连续用药28 d,观察两组治疗前和治疗28 d后的临床疗效及痰液炎症因子白细胞介素-8（IL-8）、白细胞介素-23（IL-23）及肿瘤坏死因子α（TNF-α）的变化和不良反应情况。结果：观察组总有效率94.44%,明显高于对照组（86.11%）;观察组痰液炎症因子水平（IL-8、IL-23、TNF-α）的改善优于对照组（P〈0.05）。结论：清金化痰汤联合西药治疗痰热壅肺型慢阻肺急性加重期有较好疗效,安全性高。

Objective：To evaluate the clinical efficacy and safety of Qingjin Huatan Decoction combined with western medicine in the treatment of patients with phlegm-heat obstructing lung type of chronic obstructive pulmonary disease（COPD） in acute exacerbation. Methods：Total 72 patients with phlegm-heat obstructing lung type of COPD in acute exacerbation were divided into two groups（the control group and the observation group） according to random number table,36 patients in each group. The control group received anti-infective,bronchiectasis and expectant treatment while the observation group received Qingjin Huatan Decoction on the basis of the control group at the same time,for 28 days. The phlegm inflammation factor levels of IL-8,IL-23 and TNF-α were observed in the two groups before and 28 d after treatment. Clinical efficacy and the occurrence of adverse reactions were compared between the two groups. Results：The total efficiency of the observation group was 94.44%,better than that of the control group（86.11%）. The levels of phlegm inflammation factor（IL-8,IL-23 and TNF-α） in the observation group were improved more prominent than those in the control group（P〈 0.05）. There was no statistical significance in the incidence of adverse reactions between the observation group and the control group（P〈 0.05）. Conclusion：Qingjin Huatan Decoction combined with western medicine in the treatment of patients with phlegm-heat obstructing lung type of COPD in acute exacerbation has good efficacy and safety.