清肺颗粒治疗慢性阻塞性肺疾病急性加重痰热郁肺证的临床观察

Clinical observation of Qingfei granule in the treatment of acute exacerbation of chronic obstructive pulmonary disease with phlegm-heat obstructing lung syndrome

目的观察清肺颗粒治疗慢性阻塞性肺疾病急性加重(AECOPD)痰热郁肺证的临床疗效。方法将60例AECOPD痰热郁肺证患者按随机数字表法分为2组。治疗组30例在西医基础治疗上联合清肺颗粒治疗,对照组30例在西医基础治疗上联合清肺颗粒模拟剂治疗。2组均治疗10 d后比较疗效,观察比较2组治疗前后中医症状评分(包括咳嗽、咯痰、喘息、胸闷、口干苦、身热及便秘)、改良版英国医学研究委员会呼吸问卷(mMRC)评分及慢性阻塞性肺疾病(COPD)患者自我评估测试问卷(CAT)评分变化情况,并比较2组住院天数。结果治疗组总有效率93.33%,住院天数(10.73±2.53) d,对照组总有效率70.00%,住院天数(14.47±2.47) d,治疗组疗效优于对照组(P<0.05),住院天数短于对照组(P<0.05); 2组治疗后中医症状咳嗽、咯痰、喘息、胸闷、口干苦、身热、便秘评分及总分与本组治疗前比较均明显降低(P<0.05),且治疗组治疗后各项中医症状评分及总分均低于对照组(P<0.05); 2组治疗后m MRC评分及CAT评分与本组治疗前比较均明显降低(P<0.05),且治疗组治疗后mMRC评分及CAT评分均低于对照组(P<0.05)。结论清肺颗粒治疗AECOPD痰热郁肺证疗效确切,可更好地缓解咳嗽、咯痰、喘息、胸闷、身热等中医症状,改善患者呼吸功能,缓解呼吸困难情况,改善健康状态,缩短住院时间,减轻患者负担,安全有效。

Objective To observe the effect of Qingfei granule in the treatment of acute exacerbation of chronic obstructive pulmonary disease （AECOPD） with phlegm-heat obstructing lung syndrome. Methods 60 patients with AECOPD with phlegm-heat obstructing lung syndrome were divided into two groups according to the random number table method. 30 patients in control group were treated by conventional western medicine. 30 patients in treatment group were treated by Qingfei granules on the basic of control group. After 10 days of treatment, the curative effects of the two groups were compared, and the scores of TCM symptoms （including cough, expectoration, wheezing, chest tightness, dry mouth, body heat and constipation）, the modified British Medical Research Council Respiratory Questionnaire （mMRC） and the self-assessment questionnaire （CAT） of patients with chronic obstructive pulmonary disease （COPD） were observed and compared before and after treatment. The length of hospital day of the 2 groups were compared. Results The total effective rate was 93.33 % in the treatment group and 70.00 % in the control group. The hospitalization days was （10.73±2.53） d in the treatment group and （14.47±2.47） d in the control group. The therapeutic effect of the treatment group was better than that of the control group（ P 〈0.05）. The days of hospitalization in treatment group were shorter than that of the control group（ P 〈0.05）. After treatment, the scores of TCM symptoms such as cough, expectoration, wheezing, chest tightness, dry mouth, body heat and constipation and total scores in the two groups were significantly lower than those before treatment（ P 〈0.05）,and the scores of TCM symptoms and total scores in the treatment group were lower than those in the control group （ P 〈0.05）. After treatment, the mMRC and CAT scores of the two groups were significantly lower than those before treatment （ P 〈 0.05 ）, and the mMRC and CAT scores of the treatment group were lower than those of the control group （ P 〈 0.05 ）. Conclusion Qingfei granule in the treatment of acute exacerbation of chronic obstructive pulmonary disease （AECOPD） with phlegm-heat obstructing lung syndrome are effective, which can better relieve TCM symptoms such as cough, expectoration, wheezing, chest tightness, dry mouth, body heat and constipation, improve respiratory function, relieve dyspnea, improve health and shorten hospital day, reduce the burden on patients, is safe and effective.