清肺消炎汤结合西医常规疗法治疗慢性阻塞性肺疾病急性发作临床研究

Clinical research of Qingfei-Xiaoyan Decoction combined with conventional western medicine in patients with acute exacerbation of chronic obstructive pulmonary disease

目的观察清肺消炎汤结合西医常规疗法治疗COPD急性发作的临床疗效。方法将亳州市人民医院2017年1月-2018年6月符合入选标准的82例COPD急性发作患者采用随机数字表法分为2组,每组41例。对照组以西医常规疗法治疗,治疗组在对照组基础上加服清肺消炎汤。2组均连续治疗2周。采用改良版英国医学研究委员会呼吸问卷(Modified Version of British Medical Reseach Council Respiratory Questionnaire,mMRC)进行呼吸困难严重程度评估,采用COPD患者自我评估测试问卷(COPD assessment test,CAT)进行症状、活动能力、心理、睡眠和社会影响的评估;采用便携肺功能测量仪检测FEV1占预计值百分比、FEV1/FVC,采用ELISA法检测血清CRP和降钙素原(procalcitonin,PCT)水平,评价临床疗效。结果治疗组总有效率为95.1%(39/41)、对照组为73.2%(30/41),2组比较差异有统计学意义(χ^2=4.999,P=0.025)。治疗后,治疗组CAT[(9.18±0.12)分比(14.01±1.56)分,t=11.359]、mMRC[(0.63±0.07)分比(0.95±0.12)分,t=7.921]评分均低于对照组(P<0.01);FEV1占预计值百分比[(51.05±5.63)%比(45.77±5.31)%,t=10.453]和FEV1/FVC[(59.15±6.44)比(54.24±6.02),t=5.621]均高于对照组(P<0.01);血清CRP[(8.06±0.87)mg/L比(10.55±1.21)mg/L,t=10.216]、PCT[(4.20±0.48)μg/L比(6.33±0.69)μg/L,t=7.004]水平低于对照组(P<0.01)。结论清肺消炎汤结合西医常规疗法可有效改善COPD急性发作患者的临床症状及肺功能,抑制炎症反应,提高临床疗效。

Objective To observe the clinical efficacy of Qingfei-Xiaoyan Decoction combined with conventional western medicine in patients with acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods Eighty-two patients with acute exacerbation of COPD were selected in Bozhou People’s Hospital from January 2017 to June 2018 and randomly divided into a control group and a treatment group(41 in each group)using randomized number table method.Patients in the control group were treated with conventional western medicine and those in the treatment group with Qingfei-Xiaoyan Decoction on the basis of the control group for 2 weeks.Dyspnea of patients was evaluated with the modified British Medical Research Council dyspnea questionnaire(mMRC).Impact of the disease was measured with the COPD Assessment Test(CAT).The serum levels of C-reactive protein(CRP)and procalcitonin(PCT)were measured by ELISA.Results The total efficacy rate in trementat group 95.1%(39/41)was significantly higher than that in the control group 73.2%(30/41)(χ^2=4.999,P=0.025).After the treatment,the scores of mMRC(0.63±0.07 vs.0.95±0.12;t=7.921,P<0.01)and CAT(9.18±0.12 vs.14.01±1.56;t=11.359,P<0.01)in the treatment group were significantly lower than those in the control group.After the treatment,the forced expiratory volume in one second(FEV1)percentage predicted(51.05%±5.63%vs.45.77%±5.31%;t=10.453,P<0.01)and FEV1/forced vital capacity(FVC)(59.15±6.44 vs.54.24±6.02;t=5.621,P<0.01)in the treatment group were significantly higher than those in the control group.After the treatment,the serum levels of CRP(8.06±0.87 mg/L vs.10.55±1.21 mg/L;t=10.216,P<0.01)and PCT(4.20±0.48μg/L vs.6.33±0.69μg/L;t=7.004,P<0.01)in the treatment group were significantly lower than those in the control group.Conclusions Qingfei-Xiaoyan Decoction can inhibite inflammation,improve symptoms and lung function,increase the efficacy in patients with acute exacerbation of COPD.