苏子降气汤加味联合西药治疗急性加重期COPD疗效分析

目的探讨苏子降气汤加味联合西药治疗痰浊阻肺证急性加重期慢性阻塞性肺病（COPD）效果及安全性。方法采用前瞻性研究，急性加重期COPD患者80例，均为痰浊阻肺证，随机分为2组，各40例。对照组给予西药常规治疗，观察组在对照组基础上给予苏子降气汤加味治疗，比较两组治疗前后中医症状及体征评分、疗效，记录血气分析指标酸碱度（pH）、二氧化碳分压（PaCO2）、血氧分压（PaO2）；观察两组肝肾功能指标谷氨酸转氨酶（AST）、天冬氨酸转氨酶（ALT）、尿素（BUN）、肌酐（CREA）。结果治疗后两组咳嗽、咯痰、喘息等中医症状及体征评分均降低，观察组低于对照组；两组治疗总有效率均为100％，观察组临床控制＋显效率（75．00％）高于对照组（5000％）；治疗后两组PaC02均降低，Pa02均升高，观察组PaCO2较对照组低，PaO2较对照组高（P〈0．05）。治疗后两组肝肾功能指标均明显改善，治疗前后两组各指标比较差异无统计学意义（P〉0.05）。结论在常规治疗基础上，应用苏子降气汤加减治疗急性加重期COPD能降低炎症因子水平，改善患者临床症状，增强患者免疫机能，从而提高治疗效果；且用药安全性高，值得推广。

Objective To investigate the efficacy and safety of Suzi Jiangqi decoction combined with western medicine in treating chronic obstructive pulmonary disease （ COPD ） with phlegm-dampness-lung syndrome. Methods A prospective study was conducted in 80 hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease in our hospital. All patients were admitted with phlegm-dampness-lung syndrome. The random number table was divided into two groups. The control group received conventional western medicine. On the basis of the control group, Suzi Jiangqi decoction was given to 40 patients in observation group. The symptoms, signs and curative effect of TCM before and after treatment were compared between the two groups. PH, PaCO2 and PaO2 were recorded. The indexes of hver and kidney, aspartate aminotransferase （AST） ALT, BUN and CREA were compared. Results After treatment, the symptoms and signs of＂ cough, expectoration and wheezing in both groups were decreased, the observation group was lower than the control group. The total effective rate was 100% in both groups, and the clinical control＋ markedly effective rate （ 75.00% ） in the observation group was high than that in the control group （ 50.00% ） . PaCO2 in both groups decreased and PaO2 increased. After treatment, PaCO2 in the observation group was lower than that in the control group, PaO2 was higher than that in the control group. P〈0.05. After treatment, liver and kidney function indexes of the two groups were significantly changed. There was no significant difference between the two groups before and after treatment （P〉0.05） . Conclusion On the basis of routine treatment, the application of Suzi Jiangqi decoction in the acute exacerbation period of COPD can reduce the level of inflammatory factors, improve the clinical symptoms and enhance the immune function of the patients, thus improving the therapeutic effect, and it is highly safe and worthy of promotion.