和化定喘方治疗慢性阻塞性肺疾病急性加重期的临床研究

Study on the Therapeutic Effect of the Hehua Dingchuan Prescription(和化定喘方)on Acute Exacerbation of Chronic Obstructive Pulmonary

目的:探讨和化定喘方治疗慢性阻塞性肺疾病急性加重期(AECOPD)的疗效。方法:将100例AECOPD(气虚血瘀痰阻证)患者随机分为治疗组和对照组,每组50例。对照组患者予控制氧疗、抗生素、支气管扩张剂、糖皮质激素、祛痰等常规西医治疗。治疗组患者在西医常规治疗的基础上加用和化定喘方。两组患者均治疗14 d。观察两组患者治疗前后中医证候积分、改良英国医学研究委员会呼吸困难量表(mMRC)评分、慢性阻塞性肺疾病患者自我评估测试问卷(CAT)评分、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、第1秒用力呼气容积占用力肺活量的比值(FEV_(1)/FVC)、第1秒用力呼气容积占预计值百分比(FEV_(1)%pred)。结果:治疗组总有效率为95.83%(46/48),对照组总有效率为89.13%(41/46)。治疗组患者疗效优于对照组,差异有统计学意义(P<0.05)。两组患者治疗后中医证候积分、mMRC评分、CAT评分、PaCO_(2)均低于治疗前(P<0.05),PaO_(2)水平、FEV_(1)/FVC、FEV_(1)%pred均高于治疗前(P<0.05),且治疗组患者治疗后中医证候积分、mMRC评分、CAT评分、PaCO_(2)均低于对照组(P<0.05),PaO_(2)水平、FEV_(1)/FVC、FEV_(1)%pred均高于对照组(P<0.05)。结论:和化定喘方治疗AECOPD疗效显著,可有效改善咳嗽、咳痰、呼吸困难等临床症状,提高PaO_(2)水平,降低PaCO_(2)水平,改善肺功能。

Objective:To investigate the curative effect of the Hehua Dingchuan Prescription in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:Totally 100 cases of patients with AECOPD(Qi deficiency-blood stasis-phlegm stagnation syndrome)were randomly divided into treatment and control groups,50 cases in each group.Patients were treated by conventional western medicine treatment in control group,including the controled oxygen therapy,antibiotics,bronchodilator,glucocorticoid,expectorant,etc.On the basis of Western medicine treatment,patients were treated by Hehua Dingchuan Prescription in treatment group.Patients were treated for 14 days in two groups.The TCM syndrome scores,mMRC scores,CAT scores,PaO_(2),PaCO_(2),FEV_(1)/FVC and FEV_(1)%pred were observed in the two groups.Results:The total effective rate was 95.83%(46/48)in the treatment group and 89.13%(41/46)in the control group.The treatment group showed better curative effect than control group,and the difference was statistically significant(P<0.05).After treatment,patients showed lower TCM syndrome score,mMRC score,CAT score and PaCO_(2)than before treatment in two groups(P<0.05),while higher PaO_(2),FEV_(1)/FVC and FEV_(1)%pred than before treatment(P<0.05).Furthermore,the treatment group showed lower TCM syndrome score,mMRC score,CAT score and PaCO_(2)than control group after treatment(P<0.05),while higher levels of PaO_(2),FEV_(1)/FVC and FEV_(1)%pred than control group(P<0.05).Conclusion:Hehua Dingchuan Prescription is effective in the treatment of AECOPD.It can effectively relieve cough,sputum,dyspnea and other clinical symptoms,increase the level of PaO_(2),reduce the level of PaCO_(2),and improve lung function.