清肺止咳化痰汤联合盐酸氨溴索雾化吸入治疗老年慢性支气管炎急性发作疗效观察

Clinical Observation of Efficacy of Decoction for Clearing Lung Heat and Stopping Cough and Resolving Phlegm Combined with Atomization Inhalation of Ambroxol Hydrochloride on Acute Exacerbation of Chronic Bronchitis in the Elderly

目的:观察清肺止咳化痰汤联合盐酸氨溴索雾化吸入治疗老年慢性支气管炎(chronic bronchitis,CB)急性发作的临床疗效及对肺功能、肿瘤坏死因子-α(Tumor necrosis factor alpha,TNF-α)、白介素-6(Interleukin-6,IL-6)、白介素-4(Interleukin-4,IL-4)水平的影响。方法:选取本院收治的急性发作期老年CB患者116例作为研究对象,按照随机数字表法分为对照组和观察组各58例,两组均给予抗感染、止咳、平喘等对症治疗,在此基础上对照组给予盐酸氨溴索雾化吸入治疗,观察组在对照组基础上联合清肺止咳化痰汤治疗。两组均持续治疗1周,观察两组老年CB患者中医证候积分、症状改善时间、临床疗效,检测用力肺活量(Forced vital capacity,FVC)、第1秒用力呼出量(Forced expiratory volume in the first second,FEV1)、TNF-α、IL-6、IL-4水平。结果:治疗后两组中医证候积分显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05);观察组止咳时间、啰音消失时间、平喘时间、体温复常时间显著低于对照组(P<0.05);观察组有效率93.10%,显著高于对照组的77.59%(P<0.05);治疗后两组FVC、FEV1、FEV1/FVC显著高于治疗前(P<0.05),且观察组显著高于对照组(P<0.05);治疗后两组TNF-α、IL-6、IL-4水平显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05)。结论:清肺止咳化痰汤联合盐酸氨溴索雾化吸入可有效改善急性发作期老年CB患者临床症状和肺功能,减轻炎症反应。

Objective： To observe the clinical curative effect of Decoction for Clearing Lung Heat and Stopping Cough and Resolving Phlegm combined with atomization inhalation of ambroxol hydrochloride on acute exacerbation of chronic bronchitis（ CB） in the elderly and its influence on lung function,levels of tumor necrosis factor alpha（ TNF-α）,Interleukin-6（ IL-6）,Interleukin-4（ IL-4）. Methods： One hundred and sixteen cases of elderly CB patients with acute attack in our hospital were selected as the research object. According to the random digital table method,58 cases were divided into the observation group and 58 cases into the control group. The two groups were treated with anti infection,stopping cough,calming asthma and other symptomatic treatment. On this basis,the control group was treated with atomization inhalation of ambroxol hydrochloride,and the observation group was combined with Decoction for Clearing Lung Heat and Stopping Cough and Resolving Phlegm on the basis of the control group. The two groups＇ scores of TCM syndrome,symptom improvement time and clinical efficacy were observed. Their Forced vital capacity（ FVC）,Forced expiratory volume in the first second（ FEV1）,Tumor necrosis factor alpha（ TNF-α）,Interleukin-6（ IL-6）,Interleukin-4,IL-4） levels were measured. Results： After the treatment,the scores of TCM syndrome in two groups were significantly lower than those before the treatment（ P〈 0. 05）,and the observation group was significantly lower than the control group（ P〈 0. 05）. The time of stoppingcough,Rale disappearance time,the time of calming asthma and the time of returning body temperature to normal of the observation group were significantly lower than those of the control group（ P〈 0. 05）.Tthe effective rate of the observation group was 93. 10%,significantly higher than that of the control group,77. 59%（ P〈 0. 05）; After the treatment,the two groups＇ FVC,FEV1 and FEV1/FVC were significantly higher than those before the treatment（ P〈 0. 05）,and the observation group was significantly higher than that of the control group（ P〈 0. 05）. The levels of TNF-alpha,IL-6 and IL-4 in the two groups were significantly lower than those before the treatment（ P〈 0. 05）,and the observation group was significantly lower than the control group（ P〈 0. 05）. Conclusion： Decoction for Clearing Lung Heat and Stopping Cough and Resolving Phlegm combined with atomization inhalation of ambroxol hydrochloride can effectively improve the clinical symptoms and lung function of elderly patients during acute exacerbation of CB,and alleviate inflammatory response.