三拗芎葶汤对COPD急性加重期(痰热壅肺证)肺功能和TNF-α影响的临床研究

Clinical study of san ao qiong ting decoction on the effect of pulmonary function and TNF-alpha in acute exacerbation of COPD(phlegm heat type)

目的:观察三拗芎葶汤治疗COPD急性加重期(痰热壅肺证)的临床疗效及安全性。方法:将90例COPD急性加重期(痰热壅肺证)的患者随机分为试验组(45例)和对照组(45例)。试验组予以西医基础治疗联合三拗芎葶汤,对照组予西医基础治疗,上述治疗持续2周。分别对治疗前、后肺功能、TNF-α和临床疗效进行测定评估,并在治疗结束后6周随访患者的肺功能和血浆TNF-α含量情况。结果:经治疗后评价临床疗效,试验组总有效率为89%、对照组总有效率为71%,试验组总有效率显著优于对照组。各组的血浆TNF-α含量和肺功能的FVE1/FVC和FVE1值,治疗后均显著优于治疗前。治疗后与治疗结束后随访比较,试验组的血浆TNF-α含量和肺功能的FVE1/FVC和FVE1值显著改善,治疗结束后随访优于治疗后。试验组与对照组比较,经过治疗后的相同时期的血浆TNF-α含量和肺功能的FVE1/FVC和FVE1值,试验组均显著优于对照组。两组不良事件发生率无差异。结论:西医基础治疗联合三拗芎葶汤治疗COPD急性加重期(痰热壅肺证)能更有效地降低TNF-α水平,提高肺功能,缓解临床症状,并且能够持续改善患者的TNF-α和肺功能情况。

Objective： To observe the clinical efficacy and safety of san ao qiong ting decoction in treating COPD（lung phlegm heat syndrome）.Methods： 90 patients with acute exacerbation of COPD（phlegm heat obstructing lung syndrome） were randomly divided into experimental group（45 cases） and control group（45 cases）. The experimental group was given basic treatment of Western medicine combined with san ao qiong ting decoction,control group was only treated with western medicine,treatment in both groups lasted for 2 weeks. the lung function,TNF-alpha and clinical efficacy were separately evaluated Before treatment and at the end of treatment. Pulmonary function and TNF-alpha were followed up 6 weeks after treatment. Results： Clinical efficacy was evaluated after treatment,the total effective rate of each group was89%（experimental group） and71%（control group） separately. The total effective rate of the experimental group was better than that of the control group,and the difference was statistically significant（P 〈 0. 05）. Compared with the end of treatment,the content of TNF-alpha in blood and the value of FVE1/FVC and FVE1 of pulmonary function in each group were better than those before treatment,and the difference was statistically significant（P 〈 0. 05）. Also,Compared the end of treatment and follow-up after the end of treatment,the blood TNF-alpha level,FVE1/FVC and FVE1 values of pulmonary function in the experimental group were significantly different（P 〈 0. 05）,Follow-up to the end of the treatment was better than the end of the treatment. However,there was no significant difference in blood TNF-alpha level,FVE1/FVC and FVE1 values of pulmonary function in control group（P 〉 0. 05）. In the experimental group,the blood TNF-alpha content and the values of FVE1/FVC and FVE1 of pulmonary function in the same period after treatment were better than those in the control group,and the difference was statistically significant（P 〈 0. 05）. The incidence of adverse events in the two groups was not statistically significant by X2 test. Conclusion： Combination of Western medicine basic therapy and san ao xiong ting decoction can reduce the level of TNF-alpha,improve the lung function and relieve the clinical symptoms more effectively,and it can persistently improve the TNF-alpha and lung function of the patients with acute exacerbation of COPD（phlegm heat obstructing the lung syndrome）.