小青龙汤与穴位贴敷联合常规疗法治疗慢性阻塞性肺疾病急性加重期临床研究

Clinical Study on Xiaoqinglong Tang and Point Application Combined with Routine Therapy for Acute Exacerbation of Chronic Obstructive Pulmonary Disease

目的:观察小青龙汤与穴位贴敷联合常规疗法治疗慢性阻塞性肺疾病急性加重期(AECOPD)的临床疗效。方法:选取76例外寒内饮型AECOPD患者按随机数字表法分为治疗组及对照组,每组38例。2组均给予吸氧、抗感染、抗炎、舒张支气管等现代医学综合治疗,治疗组加予口服小青龙汤与穴位贴敷治疗。2组均治疗14 d。比较2组的临床疗效,观察2组患者治疗前、治疗14 d后中医症状评分、血气分析指标[动脉血氧分压(PaO2)、二氧化碳分压(PaCO2)]及肺功能指标[第1秒用力呼气量占预计值百分比(FEV1%)、第1秒用力呼气量与用力肺活量的百分比(FEV1/FVC%)]的变化。结果:治疗14 d后,治疗组临床疗效总有效率为89.5%,对照组为65.8%,2组比较,差异有统计学意义(P<0.01)。2组咳嗽、咳痰、喘息、哮鸣、紫绀评分及总分均较治疗前下降(P<0.05),治疗组5项症状评分及总分均低于对照组(P<0.05)。2组PaO2均较治疗前升高(P<0.05),PaCO2均较治疗前下降(P<0.05),治疗组PaO2高于对照组(P<0.05),PaCO2低于对照组(P<0.05)。2组FEV1/FVC%及FEV1%均较治疗前升高(P<0.05),治疗组FEV1/FVC%及FEV1%均高于对照组(P<0.05)。结论:在现代医学常规疗法基础上加用小青龙汤内服联合穴位贴敷治疗,能有效提高外寒内饮型AECOPD患者的临床疗效,改善肺功能,相对于单一采用现代医学疗法治疗效果更好。

Objective: To observe the clinical effect of Xiaoqinglong tang and point application combined with routine therapy for acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods:A total of 76 cases of AECOPD patients of exterior cold with interior fluid retention type were divided into the treatment group and the control group according to the random number table method, 38 cases in each group. Both groups were given modern medical comprehensive treatment including oxygen inhalation,anti-infection,anti-inflammation and bronchodilation,and the treatment group was additionally given the oral administration of Xiaoqinglong tang and treated with point application. Both groups were treated for14 days. The clinical effect in the two groups was compared. Before treatment and after 14 days of treatment,the changes of Chinese medicine symptom scores and indexes of blood gas analysis[arterial partial pressure of oxygen(PaO2) and partial pressure of carbon dioxide(PaCO2)] and lung function[the percentage of forced expiratory volume in one second to the predicted value(FEV1%) and the percentage of FEV1 to forced vital capacity(FEV1/FVC%)]were observed. Results:After 14 days of treatment,the total effective rate was 89.5% in the treatment group and 65.8% in the control group,the difference being significant(P<0.01). The scores of coughing,expectoration,gasp,wheezing and cyanosis as well as the total scores in the two groups were decreased when compared with those before treatment(P<0.05),and the above scores in the treatment group were lower than those in the control group(P<0.05). The PaO2 in the two groups were increased when compared with those before treatment,and the PaCO2 were decreased(P<0.05). PaO2 in the treatment group was higher than that in the control group(P<0.05), and PaCO2 was lower(P<0.05). FEV1/FVC% and FEV1% in the two groups were increased when compared with those before treatment(P<0.05). FEV1/FVC% and FEV1% in the treatment group were higher than those in the control group(P<0.05). Conclusion: Based on modern medical routine therapy, the additional application of Xiaoqinglong tang combined with point application can effectively improve the clinical effect of AECOPD patients and improve their lung function,which has better curative effect than single modern medical therapy.