宣肺理气化痰清热法治疗慢性阻塞性肺疾病急性加重期痰热郁肺证临床疗效及对肺功能、炎症因子水平的影响

Effect of Chinese medicine of Chinese medicine heat-clearing recipe on therapeutic effect,pulmonary function and inflammatory factors of acute exacerbation of chronic obstructive pulmonary disease with phlegm heat obstructing lung syndromes

目的观察宣肺理气化痰清热法对慢性阻塞性肺疾病急性加重期(AECOPD)痰热郁肺证患者治疗效果以及对肺功能和炎症因子的影响。方法将60例AECOPD患者按照随机数字表法分为2阻,对照组30例给予抗感染、平喘、氧疗等西医治疗,治疗组30例在对照组治疗基础上加用宣肺理气化痰清热法中药治疗。2组均治疗14 d。比较2组治疗前后肺功能[第1 s用力呼气容积(FEV_(1))、用力肺活量(FVC)、FEV_(1)/FVC]、肿瘤坏死因子α(TNF-α)、降钙素原(PCT)、白细胞介素6(IL-6)、血清淀粉样蛋白A(SAA)水平和慢性阻塞性肺疾病患者自我评估测试(CAT)、改良英国医学研究委员会(mMRC)呼吸困难问卷评分,并统计2组疗效。结果治疗组总有效率83.33%(25/30),对照组总有效率66.67%(20/30),治疗组临床疗效优于对照组(P<0.05)。2组治疗后IL-6、TNF-α、PCT、SAA水平均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后FVC、FEV_(1)、FEV_(1)/FVC均较本组治疗前升高(P<0.05),且治疗组治疗后均高于对照组(P<0.05)。2组治疗后CAT、mMRC呼吸困难问卷评分均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。结论宣肺理气化痰清热法治疗AECOPD痰热郁肺证能提高患者疗效,改善患者肺功能和临床症状,减缓炎性反应。

Objective To explore the effect of Chinese medicine of Xuanfei,Liqi,Huatan and Qingre on the therapeutic effect,pulmonary function and inflammatory factors in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)of phlegm heat obstructing lung syndrome(PHOLS),and its mechanism.Methods Totally 60 patients with AECOPD were randomly assigned into the treatment group(n=30)and the control group(n=30).All patients were managed by Western medicine treatment(WMT)(anti-infection,relieving asthma,airway dilatation),and those in the treatment group were additionally treated with Chinese medicine of Xuanfei,Liqi,Huatan and Qingre.The treatment period was 14 days,aiming to compare pulmonary function(forced expiratory volume in one second[FEV_(1)],forced vital capacity[FVC],forced vital capacity[FVC],FEV_(1)/FVC),tumor necrosis factor-α(TNF-α),procalcitonin(PCT),interleukin-6(IL-6),serum amyloid A(SAA),chronic obstructive pulmonary disease assessment test(CAT),modified Medical Research Council(mMRC)dyspnea scores;the curative effect was assessed.Results The overall effective rate in the treatment group and the control group was 83.33%(25/30)and 66.67%(20/30),respectively,the curative effect being better in the treatment group than the control group(P<0.05).After treatment,IL-6,TNF-α,PCT,SAA in groups were decreased(P<0.05),which were decreased(P<0.05)in the treatment group relevant to the control group;FVC,FEV 1,FEV 1/FVC in groups were increased(P<0.05),the treatment group was more common(P<0.05);CAT and mMRC scores in groups were decreased(P<0.05),the reduction in the treatment group was more prevalent(P<0.05).Conclusion For patients with AECOPD of PHOLS,Chinese medicine of Xuanfei,Liqi,Huatan and Qingre can improve curative effect,renhance pulmonary function,ameliorate clinical symptoms,and relieve the inflammatory response.