厚朴麻黄汤辅助治疗COPD加重期痰浊阻肺证疗效及对患者中医症候、血气指标和肺功能的影响

Efficacy of Using Houpu Mahuang Decoction Supplemented with Western Medicine in the Treatment of COPD Exacerbation with Turbid Phlegm Obstructing Lung Syndrome and Its Influence on Traditional Chinese Medicine Symptoms, Blood Gas Indexes and Lung Function

目的:观察厚朴麻黄汤辅助西药治疗慢性阻塞性肺病(COPD)加重期痰浊阻肺证疗效及对患者中医症候、血气指标和肺功能的影响。方法:纳入2016年2月~2017年12月间收治的COPD加重期患者84例作为研究对象,采用随机数表法分为观察组和对照组,每组各42例。对照组予以西药治疗,观察组在此基础上加用厚朴麻黄汤。治疗2周后,比较两组临床疗效;治疗前、治疗2周后,评估两组中医症候积分、血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、血氧饱和(SaO_(2))、碱剩余(BE)]、肺功能[第一秒用力呼气容积(FEV1)、用力肺活量(FVC)、肺总量(TLC)、呼气峰流速值占预计值百分比(PEF_(pred)%)]。结果:(1)治疗2周后,观察组治疗总有效率高于对照组(P<0.05);(2)治疗2周后,两组咳嗽、痰多、喘息、气短及总证候积分均低于治疗前(P<0.05),观察组降幅大于对照组(P<0.05);(3)治疗2周后,两组PaO_(2)、SaO_(2)均高于治疗前(P<0.05),两组PaCO_(2)、BE均低于治疗前(P<0.05),观察组变动幅度均大于对照组(P<0.05);(4)治疗2周后,两组FEV1、FVC、TLC、PEFpred%均高于治疗前(P<0.05),观察组增幅大于对照组(P<0.05)。结论:厚朴麻黄汤辅助西药治疗COPD加重期痰浊阻肺证患者有一定增益效果,有临床应用价值。

Objective:To explore the efficacy of using Houpu Mahuang Decoction supplemented with western medicine in the treatment of exacerbation of chronic obstructive pulmonary disease(COPD)with turbid phlegm obstructing lung syndrome and its influence on TCM symptoms,blood gas indexes and lung function.Methods:Eighty-four patients with COPD exacerbation who were treated from February 2016 to December 2017 were included as the research subjects.They were divided into an observation group and a controlled group according to the random number table method,with 42 cases in each group.The controlled group was treated with western medicine,and the observation group was additionally given Houpo Mahuang Decoction on this basis.After 2 weeks of treatment,the clinical efficacy was compared between the two groups.Before treatment and after 2 weeks of treatment,the TCM symptoms scores,blood gas indexes[arterial pressure of blood oxygen(PaO_(2)),arterialpressure of blood carbon dioxide(PaCO_(2)),blood oxygen saturation(SaO_(2)),base excess(BE)]and lung function[forced expiratory volume in the first second(FEV1),forced vital capacity(FVC),total lung capacity(TLC),percentage of peak expiratory flow rate in predicted value(PEFpred%)]were evaluated in the two groups.Results:(1)After 2 weeks of treatment,the total effective rate of treatment in the observation group was higher than that in the controlled group(P<0.05).(2)After 2 weeks of treatment,the scores of cough,excessive phlegm,wheezing and shortness of breath and total syndrome scorein the two groups were lower than those before treatment(P<0.05),and the declines in the observation group were greater than those in the controlled group(P<0.05).(3)After 2 weeks of treatment,the PaO_(2) and SaO_(2) in the two groups were higher than those before treatment(P<0.05),and the PaCO_(2) and BE in the two groups were lower than those before treatment(P<0.05),and the changes in the observation group were larger than those in the controlled group(P<0.05).(4)After 2 weeks of treatment,the FEV1,FVC,TLC and PEF_(pred)%in the two groups were higher than those before treatment(P<0.05),and the increases in the observation group were greater than those in the controlled group(P<0.05).Conclusion:Houpu Mahuang Decoction supplemented with western medicine has a certain beneficial effect and has clinical application value on COPD exacerbation with turbid phlegm obstructing lung syndrome.