定喘汤治疗痰热郁肺证慢性阻塞性肺疾病临床研究

Clinical Study on Dingchuan Tang for Chronic Obstructive Pulmonary Disease with Phlegm-Heat Depressing the Lung Syndrome

目的:观察定喘汤治疗痰热郁肺证慢性阻塞性肺疾病(COPD)的临床疗效。方法:选取痰热郁肺证COPD患者100例,随机分为观察组和对照组各50例。对照组给予抗炎、抗感染、无创机械通气等常规西医治疗,观察组在对照组的基础上给予定喘汤治疗。观察比较2组临床疗效,比较2组治疗前后中医症状积分及二氧化碳分压(PaCO_(2))、氧分压(PaO_(2))及动脉血氧饱和度(SaO_(2))等血气指标,肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、超敏C-反应蛋白(hs-CRP)及降钙素原(PCT)等炎症因子水平;比较2组死亡率、并发症发生率及住院时间、不良反应发生情况。结果:观察组临床总有效率为94.00%,对照组为76.00%,2组比较,差异有统计学意义(P<0.05)。治疗前,2组咳嗽、咳痰、胸闷等症状积分比较,差异无统计学意义(P>0.05);治疗后,2组上述症状积分均较治疗前降低(P<0.05),且观察组症状积分低于对照组(P<0.05)。治疗前,2组PaO_(2)、PaCO_(2)、SaO_(2)水平比较,差异无统计学意义(P>0.05)。治疗后,2组PaO_(2)、SaO_(2)水平较治疗前升高(P<0.05),PaCO_(2)水平较治疗前降低(P<0.05);且观察各项指标改善较对照组更显著(P<0.05)。治疗前,2组TNF-α、IL-6、hs-CRP、PCT水平比较,差异无统计学意义(P>0.05);治疗后,2组上述指标均较治疗前降低(P<0.05),且观察组各项指标均低于对照组(P<0.05)。观察组死亡率、并发症发生率均低于对照组(P<0.05),观察组住院时间短于对照组(P<0.05)。治疗过程中,2组均未发生严重不良反应。结论:定喘汤治疗痰热郁肺证COPD疗效显著,可有效缓解患者临床症状,调节血气指标,降低炎症反应,从而缩短住院时间,降低死亡率及并发症发生率,且用药安全性良好。

Objective:To observe the clinical effect of Dingchuan tang for chronic obstructive pulmonary disease(COPD)with phlegm-heat depressing the lung syndrome.Methods:A total of 100 cases of patients with COPD with phlegm-heat depressing the lung syndrome were randomly divided into the observation group and the control group,with 50 cases in each group.The control group was given routine treatment of western medicine including anti-inflammation,anti-infection and noninvasive ventilation,and the observation group was additionally treated with Dingchuan tang based on the treatment of the control group.The clinical effects in the two groups were observed and compared.Before and after treatment,the Chinese medicine syndrome scores,the blood gas indicators including partial pressure of carbon dioxide(PaCO_(2)),partial pressure of oxygen(PaO_(2))and oxygen saturation(SaO_(2)),and the levels of inflammatory factors including tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP)and procalcitonin(PCT)in the two groups were observed and compared.The mortality,complications,hospitalization time and incidence of adverse reactions in the two groups were compared.Results:The total effective rate was 94.00%in the observation group and 76.00%in the control group,the difference being significant(P<0.05).Before treatment,there was no significant difference being found in the comparison of symptom scores including cough,expectoration and chest discomfort between the two groups(P>0.05).After treatment,the above symptom scores in the two groups were decreased when compared with those before treatment(P<0.05),and the scores in the observation group were lower than those in the control group(P<0.05).Before treatment,there was no significant difference being found in the comparison of levels of PaO_(2),PaCO_(2)and SaO_(2)between the two groups(P>0.05).After treatment,the levels of PaO_(2)and SaO_(2)in the two groups were increased when compared with those before treatment(P<0.05),and PaCO_(2)level was decreased(P<0.05);the improvement of the indexes in the observation group was more significant than that in the control group(P<0.05).Before treatment,there was no significant difference being found in the comparison of levels of TNF-ɑ,IL-6,hs-CRP and PCT between the two groups(P>0.05).After treatment,the above levels in the two groups were decreased when compared with those before treatment(P<0.05),and the levels in the observation group were lower than those in the control group(P<0.05).The mortality and incidence of complications in the observation group were lower than those in the control group(P<0.05),and the hospitalization time was shorter(P<0.05).During treatment,there was no serious adverse reactions in the two groups.Conclusion:Dingchuan tang has a significant curative effect in treating COPD with phlegm-heat depressing the lung syndrome,and can effectively relieve clinical symptoms,regulate blood gas indicators and reduce inflammatory responses,so as to reduce mortality and incidence of complications,and shorten hospitalization time,with good medication safety.