清肺通腑汤联合西药治疗慢性阻塞性肺疾病急性加重期临床研究

Clinical Study on Qingfei Tongfu Tang Combined with Western Medicine for Acute Exacerbation of Chronic Obstructive Pulmonary Disease

目的:观察清肺通腑汤联合西药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106例AECOPD患者,按随机数字表法分为对照组及观察组各53例。对照组接受常规西药治疗,观察组在对照组基础上加用清肺通腑汤治疗,2组均连续治疗2周。比较2组临床疗效,比较2组治疗前后中医证候积分、肺功能[用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、FEV_(1)/FVC]、血气分析指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、血清炎症因子[白细胞介素-8 (IL-8)、C-反应蛋白(CRP)、8异前列腺素F2α(8-iso-PGF2α)、白细胞计数(WBC)]水平的变化,观察2组不良反应发生情况。结果:观察组临床疗效总有效率为88.68%,对照组为73.58%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组中医证候积分均较治疗前下降,观察组中医证候积分低于对照组,差异均有统计学意义(P<0.05)。治疗后,2组FVC、FEV_(1)/FVC、PaO_(2)指标值均较治疗前上升,PaCO_(2)指标值均较治疗前下降,差异均有统计学意义(P<0.05);治疗后,观察组FVC、FEV_(1)/FVC、PaO_(2)指标值均高于对照组,PaCO_(2)指标值低于对照组,差异均有统计学意义(P<0.05)。治疗后,2组血清IL-8、CRP、WBC、8-iso-PGF2α水平均较治疗前下降,观察组上述4项水平均低于对照组,差异均有统计学意义(P<0.05)。2组均未出现明显不良反应,各项检查均正常。结论:清肺通腑汤联合西药治疗AECOPD疗效显著,可有效改善临床症状,提升肺功能,改善肺部炎症,且用药安全性较高。

Objective:To observe the clinical effect of Qingfei Tongfu tang combined with western medicine for acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:A total of 106 cases of AECOPD patients were selected and divided into the control group and the observation group according to the random number table method,with 53 cases in each group.The control group was given western medicine treatment,and the observation group was additionally treated with Qingfei Tongfu tang based on the treatment of the control group.Both groups were treated for two weeks.The clinical effects in the two groups were compared.Before and after treatment,the changes in Chinese medicine syndrome scores,lung function including forced vital capacity(FVC),forced expiratory volume in the first second(FEV_(1)) and FEV_(1)/FVC,blood gas analysis indexes including partial pressure of oxygen in arterial-blood(PaO_(2)) and partial pressure of carbon dioxide in artery(PaCO_(2)),serum inflammatory factors including interleukin-8(IL-8),C-reactive protein(CRP),8-iso-prostaglandinF2α(8-iso-PGF2α) and white blood cell counts(WBC) in the two groups were compared.The incidences of adverse reactions in the two groups were observed.Results:The total effective rate was 88.68%in the observation group,higher than that of73.58%in the control group,the difference being significant(P<0.05).After treatment,Chinese medicine syndrome scores in the two groups were decreased when compared with those before treatment,and the score in the observation group was lower than that in the control group,differences being significant(P<0.05).After treatment,the values of FVC,FEV_(1)/FVC and PaO_(2)in the two groups were increased when compared with those before treatment,and the values of PaCO_(2)were decreased,differences being significant(P<0.05).After treatment,the values of FVC,FEV_(1)/FVC and PaO_(2)in the observation group were higher than those in the control group,and the value of PaCO_(2)was lower,differences being significant(P<0.05).After treatment,the levels of IL-8,CRP,WBC and 8-iso-PGF2α in the two groups were decreased when compared with those before treatment,and the above four levels in the observation group were lower than those in the control group,differences being significant(P<0.05).There was no obvious adverse reaction in the two groups,and all examinations were normal.Conclusion:The therapy of Qingfei Tongfu tang combined with western medicine has a significant curative effect in the treatment of AECOPD,which can effectively improve clinical symptoms,lung function and pulmonary inflammation,with high medication safety.