三子养亲汤合参苓白术散配方颗粒治疗痰浊壅肺证急性发作期慢性阻塞性肺疾病临床研究

Clinical Study on Formula Granules of Sanzi Yangqin Tang Combined with Shenling Baizhu Powder for Acute Exacerbation of Chronic Obstructive Pulmonary Disease with Turbid Phlegm Obstructing Lung Syndrome

目的:观察三子养亲汤合参苓白术散配方颗粒治疗急性发作期痰浊壅肺证慢性阻塞性肺疾病(COPD)的临床疗效。方法:将120例COPD急性发作期痰浊壅肺证患者按照随机数字表法分为对照组和观察组各60例。对照组给予西医常规基础治疗,观察组在对照组的基础上加用三子养亲汤合参苓白术散配方颗粒治疗。连续治疗1周。比较分析2组临床治疗效果、中医证候评分、自我评估测试问卷(CAT)评分、改良版英国医学研究委员会呼吸问卷(mMRC)评分、肺通气功能指标[用力肺活量(FVC)、第1秒用力肺活量(FEV_(1))、FEV_(1)/FVC]、气道损害相关指标[血清降钙素原(PCT)、C-反应蛋白(CRP)]水平变化。结果:治疗过程中观察组脱落5例,对照组脱落4例。观察组总有效率为94.55%,对照组为78.57%,2组比较,差异有统计学意义(P<0.05)。治疗前,2组咳痰、喘咳、胸闷证候评分比较,差异无统计学意义(P>0.05);治疗后,2组咳痰、喘咳、胸闷证候评分均较治疗前降低(P<0.05),观察组3项证候评分均低于对照组(P<0.05)。治疗前,2组CAT、mMRC评分比较,差异无统计学意义(P>0.05);治疗后,2组CAT、mMRC评分均较治疗前降低(P<0.05),且观察组CAT、mMRC评分均低于对照组(P<0.05)。治疗前,2组FVC、FEV_(1)、FEV_(1)/FVC水平比较,差异无统计学意义(P>0.05);治疗后,2组FVC、FEV_(1)、FEV_(1)/FVC水平均较治疗前升高(P<0.05),且观察组3项肺通气功能指标均明显高于对照组(P<0.05)。治疗前,2组血清PCT、CRP水平比较,差异无统计学意义(P>0.05);治疗后,观察组血清PCT、CRP水平均较治疗前降低(P<0.05),且对照组PCT、CRP水平均低于对照组(P<0.05)。结论:采用三子养亲汤合参苓白术散配方颗粒治疗急性发作期痰浊壅肺证COPD,能缓解患者临床症状,改善肺通气功能,并可有效降低机体炎症反应。

Objective:To observe the clinical effect of the therapy of formula granules of Sanzi Yangqin tang combined with Shenling Baizhu powder on acute exacerbation of chronic obstructive pulmonary disease(COPD)with turbid phlegm obstructing the lung syndrome.Methods:A total of 120 patients with acute exacerbation of COPD with turbid phlegm obstructing the lung syndrome were divided into the control group and the observation group according to the random number table method,with 60 cases in each group.The control group was treated with routine basic treatment of western medicine and the observation group was additionally treated with formula granules of Sanzi Yangqin tang combined with Shenling Baizhu powder based on the treatment of the control goup.Both groups were treated for one week continuously.The clinical effects,Chinese medicine syndrome scores,scores of COPD Assessment Test(CAT)and modified Medical Research Council(mMRC)scale and changes of indexes of pulmonary ventilation function,including forced vital capacity(FVC),forced expiratory volume in one second(FEV1),FEV1/FVC,and content of indexes related to airway damage,including serum procalcitonin(PCT)and C-reactive protein(CRP),in the two groups were analyzed and compared.Results:During the treatment,5 cases fell of in the observation group and 4 cases fell of in the control group.The total effective rate was 94.55%in the observation group and 78.57%in the control group,the difference being significant(P<0.05).Before treatment,there was no significant difference being found in the comparisons of syndrome scores of expectoration,panting and cough and chest oppression between the two groups(P>0.05);after treatment,the syndrome scores of expectoration,panting and cough and chest oppression in the two groups were decreased when compared with those before treatment(P<0.05),and the above three 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 comparisons of scores of CAT and mMRC between the two groups(P>0.05);after treatment,the scores of CAT and mMRC were decreased when compared with those before treatment(P<0.05),and the above two 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 comparisons of levels of FVC,FEV1 and FEV1/FVC between the two groups(P>0.05);after treatment,the levels of FVC,FEV1 and FEV1/FVC in the two groups were decreased when compared with those before treatment(P<0.05),and the above three indexes of pulmonary ventilation function in the observation group were significantly higher than those in the control(P<0.05).Before treatment,there was no significant difference being found in the comparison of levels of serum PCT and CRP between the two groups(P>0.05);after treatment,the levels of serum PCT and CRP in the two groups were decreased when compared with those before treatment(P<0.05),and the above two levels in the observation group was lower than those in the control group(P<0.05).Conclusion:The therapy of formula granules of Sanzi Yangqin tang combined with Shenling Baizhu powder for acute exacerbation of COPD with turbid phlegm obstructing the lung syndrome can relieve the clinical symptoms,improve the pulmonary ventilation function,and effectively reduce the inflammatory responses.