清肺化痰健脾活血法联合西医治疗慢性阻塞性肺疾病急性加重期的疗效观察及对肺功能指标、炎症水平的影响

Efficacy Observation of Clearing Lung,Resolving Phlegm,Invigorating Spleen and Activating Blood Method Combined with Western Medicine in Treatment of AECOPD and Its Effect on Pulmonary Function Indexes and Inflammation

目的评价清肺化痰健脾活血法联合西医治疗慢性阻塞性肺疾病急性加重期(AECOPD)的疗效观察及对肺功能指标、炎症水平的影响。方法将2019年3月—2021年2月来该院就诊的82例AECOPD患者分为观察组(41例)和参照组(41例)。参照组依据COLD指南采用西医标准化治疗,观察组在参照组治疗的基础上,口服清肺化痰健脾活血汤治疗。两组均治疗12 d。比较两组治疗前后中医证候积分变化,比较治疗总有效率,比较两组治疗前后血清炎症因子、FVC、FEV1、FEV1/FVC、mMRC和CAT评分变化情况。结果观察组治疗总有效率高于参照组(P<0.05);观察组治疗后咳嗽、痰量、喘息、胸闷、大便干结、口渴和发热的中医证候积分低于治疗前和同期对照组(P<0.05);观察组治疗后FVC、FEV1和FEV1/FVC水平较治疗前升高,且高于同期对照组(P<0.05);观察组治疗后血清炎症因子hs-CRP、IL-8低于治疗前,且低于同期对照组,IL-10水平高于治疗前,且较同期对照组低(P<0.05);观察组治疗后mMRC和CAT评分低于治疗前和同期对照组(P<0.05)。结论清肺化痰健脾活血汤联合西药常规治疗AECOPD可取得较为理想的临床治疗效果,可有效缓解临床症状、降低炎症因子水平,促进病情恢复、改善预后,临床应用价值较高。

Objective To evaluate the curative effect of clearing lung,resolving phlegm,invigorating spleen and promoting blood circulation method combined with western medicine in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and its effect on pulmonary function indexes and inflammation.Methods A total of 82 patients with AECOPD who came to the hospital from March 2019 to February 2021 were selected as the research subjects,and the patients were divided into tbe observation group and the reference group according to the randomized control method,with 41 cases in each group.The reference group was treated with standardized treatment of Western medicine according to COLD guideline,and the observation group was treated with Qingfei Huatan Jianpi Huoxue Decoction(清肺化痰健脾活血汤)on the basis of the treatment of the reference group.Both groups were treated for 12 days.The changes of TCM syndrome scores before and after treatment were compared between the two groups,the total effective rate of treatment was compared,and the changes of serum inflammatory factors,the levels of forced vital capacity(FVC),1 st second respiratory volume(FEV1)and FEV1/FVC,the scores of modified British medical research association dyspnea index(mMRC)and COPD assessment test(CAT)were compared between the two groups before and after treatment.Results The total effective rate of the observation group was higher than that of the reference group(P<0.05).The scores of TCM symptoms(cough,sputum volume,wheezing,chest tightness,dry stool,thirst and fever)in the observation group after treatment were lower than those in the control group before treatment and at the same period(P<0.05).After treatment,the levels of FVC,FEV1 and FEV1/FVC in the observation group were higher than those before treatment,and higher than those in the control group(P<0.05).After treatment,the serum inflammatory factors hypersensitive C-reactive protein(hs-CRP)and interleukin 8(IL-8)in the observation group were lower than those before treatment,and lower than those of the control group at the same period,and the level of interleukin 10(IL-10)in the observation group was higher than those before treatment,and lower than those of the control group at the same period(P<0.05).The scores of mMRC and CAT in the observation group were lower than those before treatment and athe sam e period(P<0.05).Conclusion The conventional treatment of AECOPD by Qingfei Huatan Jianpi Huoxue Decoction combined with western medicine can achieve a relatively ideal clinical treatment effect,effectively alleviate the clinical symptoms,reduce the levels of inflammatory factors,promote the recovery of the disease and improve the prognosis,and has high clinical application value.