苏子降气汤辅助治疗慢性阻塞性肺疾病急性加重69例临床观察

Clinical Effect of Suzi Jiangqi Decoction as Adjuvant Therapy for Acute Exacerbation of Chronic Obstructive Pulmonary Disease:An Analysis of 69 Cases

目的观察苏子降气汤辅助治疗慢性阻塞性肺疾病急性加重(acute exacerbation chronic obstructive pulmonary disease,AECOPD)患者的临床疗效。方法将138例AECOPD患者随机分为试验组和对照组,每组69例。对照组给予西医常规治疗,试验组在西医常规治疗基础上给予苏子降气汤治疗。观察两组治疗前后中医证候评分、肺功能[1秒用力呼气容积(forced expiratory volume in one second,FEV1),用力肺活量(forced vital capacity,FVC)及FEV 1/FVC]、血气分析指标[动脉血氧饱和度(arterial oxygen saturation,SaO2)、动脉血氧分压(arterial PO2,PaO2)、动脉血二氧化碳分压(arterial PCO2,PaCO2)]、血清炎症因子[降钙素原(procalcitonin,PCT)、白细胞介素-38(interleukin,IL-38)及超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)]和D-二聚体(D-Dimer,D-D)水平。结果治疗后两组患者喘息、咳嗽、哮鸣、纳呆、咳痰及胸膈满闷评分均较治疗前显著降低(P<0.05);FEV 1、FVC及FEV 1/FVC均较治疗前显著增加(P<0.05);SaO2、PaO2均显著升高(P<0.05),PaCO2显著降低(P<0.05);PCT、IL-38、hs-CRP、D-D水平均较治疗前显著降低(P<0.05)。试验组咳嗽、纳呆、咳痰及胸膈满闷评分降低程度均显著大于对照组(P<0.05);FEV1、FVC及FEV1/FVC升高程度显著大于对照组(P<0.05);PaO2升高程度和PaCO2降低程度显著大于对照组(P<0.05);IL-38、hs-CRP水平降低程度均显著大于对照组(P<0.05)。试验组疗效优于对照组(P<0.05)。结论苏子降气汤治疗AECOPD可有效抑制PCT、IL-38、hs-CRP等炎症相关因子生成,降低D-D水平,改善患者肺功能、血气分析指标及中医证候评分。

Objective To investigate the clinical effect of Suzi Jiangqi Decoction as the adjuvant therapy for acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 138 patients with AECOPD were randomly divided into experimental group and control group,with 69 patients in each group.The patients in the control group were given conventional Western medicine treatment,and those in the experimental group were given Suzi Jiangqi Decoction in addition to the conventional Western medicine treatment.The two groups were observed in terms of traditional Chinese medicine(TCM)syndrome score,pulmonary function[forced expiratory volume in one second(FEV1),forced vital capacity(FVC),and FEV1/FVC],blood gas parameters[arterial oxygen saturation(SaO2),arterial partial pressure of oxygen(PaO2),and arterial partial pressure of carbon dioxide(PaCO2)],serum inflammatory factors[procalcitonin(PCT),interleukin-38(IL-38),and high-sensitivity C-reactive protein(hs-CRP)],and D-Dimer(D-D)before and after treatment.Results After treatment,both groups had significant reductions in the scores of wheezing,cough,poor appetite,expectoration,and abdominal distention and fullness(P<0.05),significant increases in FEV1,FVC,FEV1/FVC,SaO2,and PaO2(P<0.05),and significant reductions in PaCO2,PCT,IL-38,hs-CRP,and D-D(P<0.05).Compared with the control group,the experimental group had significantly greater reductions in the scores of cough,poor appetite,expectoration,and abdominal distention and fullness(P<0.05),significantly greater increases in FEV1,FVC,and FEV1/FVC(P<0.05),a significantly greater increase in PaO2 and a significantly greater reduction in PaCO2(P<0.05),and significantly greater reductions in IL-38 and hs-CRP(P<0.05).The experimental group had a significantly better clinical outcome than the control group(P<0.05).Conclusion In the treatment of AECOPD,Suzi Jiangqi Decoction can effectively inhibit the production of inflammatory factors such as PCT,IL-38,and hs-CRP,reduce the level of D-D,and improve pulmonary function,blood gas parameters,and TCM syndrome score.