西药联合小青龙汤加减治疗慢性阻塞性肺疾病急性加重期外寒内饮证的临床效果

Clinical effect of western medicine combined with modified Xiaoqinglong decoction in the treatment of acute exacerbation of chronic obstructive pulmonary disease with syndrome of external cold and internal retention

目的观察西药联合小青龙汤加减治疗慢性阻塞性肺疾病(慢阻肺)急性加重期外寒内饮证的临床效果。方法选择本院2019年2月至2020年2月收治的68例急性发作期外寒内饮证患者作为研究对象,按照随机数字表法将其分为对照组及联合组,各34例。对照组给予西药治疗,联合组在对照组基础上给予小青龙汤加减治疗。比较两组患者的中医证候积分(主症积分、次症积分、总积分),肺功能指标[单位肺体积一氧化碳弥散量(DLCO/VA)、吸气分数(IC/TLC)],Caprini评分,血浆巨噬细胞刺激蛋白(MSP)、白细胞介素-4(IL-4)及肿瘤坏死因子-α(TNF-α)水平。结果治疗后,两组的中医证候积分(主症积分、次症积分、总积分)均降低,且联合组低于对照组(P<0.05)。治疗后,两组的DLCO/VA、IC/TLC均升高,且联合组高于对照组(P<0.05);治疗后,联合组的Caprini评分低于对照组(P<0.05)。治疗后,两组的血浆MSP、IL-4及TNF-α水平均降低,且联合组低于对照组(P<0.05)。结论西药联合小青龙汤加减治疗慢阻肺急性加重期外寒内饮证的临床效果显著,可有效缓解患者的中医证候,同时可改善肺通气功能、炎性因子水平,值得临床推广应用。

Objective To observe the clinical effect of western medicine combined with modified Xiaoqinglong decoction in the treatment of acute exacerbation of chronic obstructive pulmonary disease with syndrome of external cold and internal retention.Methods A total of 68 patients with acute exacerbation of chronic obstructive pulmonary disease with syndrome of external cold and internal retention treated in our hospital from February 2019 to February 2020 were selected as the research objects.The patients were divided into control group and combined group according to random number table method,with 34 cases in each group.The control group was treated with western medicine,and the combined group was treated with modified Xiaoqinglong decoction on the basis of the control group.The TCM syndrome scores(main symptom score,secondary symptom score and total score),pulmonary function indexes[carbon monoxide diffusion volume per unit lung volume(DLCO/VA),inspiratory fraction(IC/TLC)],Caprini score,plasma macrophage stimulating protein(MSP),interleukin-4(IL-4)and tumor necrosis factor-α(TNF-α)levels were compared between the two groups.Results After treatment,the TCM syndrome scores(main symptom score,secondary symptom score and total score)in the two groups decreased,and those in the combined group were lower than the control group(P<0.05).After treatment,DLCO/VA and IC/TLC in the two groups increased,and those in the combined group were higher than the control group(P<0.05);after treatment,the Caprini score in the combined group was lower than that in the control group(P<0.05).After treatment,plasma MSP,IL-4 and TNF-α levels in the two groups decreased,and those in the combined group were lower than the control group(P<0.05).Conclusion Western medicine combined with modified Xiaoqinglong decoction in the treatment of acute exacerbation of chronic obstructive pulmonary disease with syndrome of external cold and internal retention has significant clinical effect,it can effectively alleviate the TCM syndrome,and improve the pulmonary ventilation function and inflammatory factor levels of patients,which is worthy of clinical promotion and application.