加减血府逐瘀汤合二陈汤治疗慢性阻塞性肺疾病急性加重期痰瘀阻肺证临床研究

Clinical Research of Using Xuefu Zhuyu Decoction Combined with Erchen Decoction in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease with Phlegm Stasis Blocking Lung Symdrome

目的:探讨加减血府逐瘀汤合二陈汤治疗慢性阻塞性肺疾病急性加重期(AECOPD)痰瘀阻肺证患者的临床疗效。方法:选择2016年1月~2019年10月明光市中医院收治的150例痰瘀阻肺证型AECOPD患者,按照信封法随机分为两组。对照组(75例)给予抗感染、止咳、化痰等常规西医治疗,观察组(75例)在此基础上给予加减血府逐瘀汤合二陈汤治疗。观察两组疗效、中医症候积分、肺功能、炎性因子、凝血功能以及不良反应的差异。结果:观察组治疗有效率高于对照组(P<0.05)。观察组治疗后咳嗽气喘、咳痰、胸闷胸痛症状积分低于对照组(P<0.05),第1秒用力呼气容积(FEV1)、FEV1与用力肺活量(FEV1/FVC)、FEV1占预计值百分数(FEV1%pred)高于对照组(P<0.05),血清超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)水平低于对照组(P<0.05)。观察组治疗后凝血酶时间(TT)、凝血酶原时间(PT)水平高于对照组(P<0.05),纤维蛋白原(FBG)、D-二聚体低于对照组(P<0.05)。观察组治疗期间不良反应率低于对照组(P<0.05)。结论:加减血府逐瘀汤合二陈汤可降低AECOPD痰瘀阻肺证患者血清炎性因子水平,改善肺功能和血液粘滞状态,提高临床疗效,且安全性高。

Objective: To explore the clinical effect of Xuefu Zhuyu Decoction combined with Erchen Decoction in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD) with phlegm stasis blocking lung syndrome. Methods: From January 2016 to October 2019,150 patients with AECOPD of phlegm stasis blocking lung syndrome were randomly divided into two groups. The controlled group(75 cases) was treated with conventional western medicine, such as anti infection, antitussive, expectorant and so on. The observation group(75 cases) was treated with Xuefu Zhuyu Decoction and Erchen Decoction. The difference of curative effect, TCM symptom score, lung function, inflammatory factor, coagulation function and adverse reactions between the two groups were observed. Results: The effective rate of the observation group was higher than that of the controlled group(P<0.05). After treatment, the scores of cough and asthma, expectoration, chest distress and chest pain in the observation group were lower than those in the controlled group(P<0.05),the forced expiratory volume in one second(FEV1),FEV1/forced vital capacity(FEV1/FVC),FEV1%/PRED were higher than those in the controlled group(P<0.05),and the levels of hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-a(TNF-a) and interleukin-6(IL-6) in the serum were lower than those in the controlled group(P<0.05). The levels of thrombin time(TT) and prothrombin time(PT) in the observation group were higher than those in the controlled group(P<0.05),and the levels of fibrinogen(FBG) and D-dimer were lower than those in the controlled group(P<0.05). The adverse reaction rate of the observation group was lower than that of the controlled group(P<0.05). Conclusion: Modified Xuefu Zhuyu Decoction and Erchen Decoction can reduce the level of serum inflammatory factors, improve the pulmonary function and blood viscosity, improve the clinical efficacy, and have high safety.