加味小青龙汤对急性发作期外寒内饮型COPD患者炎症因子的影响

Modified Xiaoqinglong Decoction on Acute Effects of External Cold Drink in Inflammatory Factors in Patients with Type COPD

目的：分析加味小青龙汤对急性发作期外寒内饮型COPD患者炎症因子的影响。方法：选取从2016年2月—2017年3月本院内科住院部及门诊收治的肺胀病证急性加重期外寒内饮型患者100例作为研究对象,随机平均分为两组。对照组采取西医常规治疗进行感染控制、支气管扩张、氧疗、祛痰止咳等对症支持;观察组在此基础上,加服加味小青龙汤治疗。观察记录两组患者治疗前后中医证候各单项症状积分差值、炎症因子水平及肺功能指标变化。结果：观察组治疗前后中医证候积分及各单项症状（咳嗽、咯痰、喘息、哮鸣、气短）积分差值明显大于对照组（P〈0.05）,治疗后各单项症状积分及中医证候总积分显著下降。观察组经治疗炎症因子（IL-8、IL-4、TNF-α）水平明显低于对照组（P〈0.05）。经治疗观察组治疗后第1秒用力呼气量（FEV1）、第1秒用力呼气量占用力肺活量比率（FEV1/FVC）、最大呼气中段平均流速（MMEF）均呈上升趋势且明显由于对照组（P〈0.05）。结论：加味小青龙汤治疗外寒内饮型肺胀病证患者疗效确切,能显著改善患者中医临床症状、肺功能及炎症因子水平。

Objective： To analyze the clinical efficacy of Modified Xiaoqinglong Decoction in treating exogenous cold and lung distension syndrome. Methods： From February 2016 to March 2017 in our hospital,100 patients of lung distension syndrome in acute exacerbation period of cold drink as the research objects,were randomly divided into two groups. The control group was treated with routine western medicine for symptomatic treatment,such as infection control,bronchiectasis,oxygen therapy,expectorant,cough,etc. The observation group was treated with modified Xiaoqinglong Decoction on this basis. We observed and recorded the two groups＇ TCM symptoms of each individual symptom score difference,inflammatory factors and pulmonary function index changes. Results： The observation group＇ s TCM syndrome score group before and after treatment and individual symptoms（cough,phlegm,wheezing,shortness of breath） integral difference was significantly higher than that of the control group（P〈0. 05）. After treatment,each individual symptom scores and the total score of TCM syndrome decreased significantly. The levels of inflammatory factors（IL-8,IL-4 and TNF-α） in the observation group were significantly lower than those in the control group（P〈0. 05）.The observation group＇s FEV1 after treatment（FEV1）,FEV1 FVC ratio accounted for（FEV1/FVC）,maximal midexpiratory mean velocity（MMEF） increased significantly compared with those of the control group（P〈0. 05）. Conclusion： Modified Xiaoqinglong Decoction has a definite effect on the treatment of TCM syndrome of lung cold syndrome with exogenous cold,and can significantly improve the clinical symptoms,pulmonary function and inflammatory factors in patients.