小青龙汤加减治疗急性发作期慢性阻塞性肺疾病的疗效及对炎症因子的影响

The Efficacy of Modified Minor Green Dragon Decoction on Chronic Obstructive Pulmonary Disease in Acute Attack Period and its Influence on Inflammatory Factors

目的:观察小青龙汤加减治疗急性发作期慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)的临床疗效及对炎症因子的影响。方法:选择2020年2月至2021年2月在上海市嘉定区中医院治疗的急性发作期COPD患者70例为研究对象,随机分为对照组和治疗组,每组各35例。对照组给予西医常规治疗,治疗组在对照组治疗的基础上给予小青龙汤加减治疗,两组均连续治疗7 d。观察两组患者治疗前后第一秒呼气量(first expiratory volume 1,FEV_(1)%)、用力肺活量(forced vital capacity,FVC)、FEV_(1)/FVC%、呼吸困难量表(mMRC)、6分钟步行距离、C反应蛋白(C-reactive protein,CRP)、降钙素原(procalcitonin,PCT)、白细胞介素-6(interleukin 6,IL-6)水平及临床疗效等。结果:对照组有效率为74.29%,治疗组有效率为91.43%,治疗组有效率高于对照组,但差异无统计学意义(P>0.05)。两组患者治疗后FEV_(1)、FVC、FEV_(1)/FVC均较治疗前升高,差异有统计学意义(P<0.05),且组间比较,差异有统计学意义(P<0.05)。两组患者治疗后,mMRC分级明显降低,6分钟步行距离明显增加,差异有统计学意义(P<0.05),且组间比较,差异有统计学意义(P<0.05)。两组患者治疗后CRP、PCT、IL-6水平明显降低,差异有统计学意义(P<0.05),且组间比较,差异有统计学意义(P<0.05)。两组患者给药过程中未发生药物相关不良反应。结论:小青龙汤加减联合西医常规治疗可提高急性发作期COPD的临床疗效,有效恢复患者的肺功能,并可通过降低炎症因子水平减轻机体的炎症反应。

Objective:To observe the clinical efficacy of Modified Minor Green Dragon Decoction on chronic obstructive pulmonary disease(COPD) in acute attack period and its influence on inflammatory factors.Methods:A total of 70 patients with COPD in acute attack period who were treated in Jiading District Hospital of Traditional Chinese Medicine of Shanghai from February 2020 to February 2021 were randomly divided into the control group and the treatment group,with 35 cases in each group.The control group was given standard Western medicine treatment,while the treatment group was given Modified Minor Green Dragon Decoction on the basis of the treatment of the control group.Both groups were treated continuously for 7 days.The changes of the first expiratory volume 1(FEV_(1)%),forced vital capacity(FVC),FEV_(1)/FVC%,dyspnea scale(mMRC),6-minute walking distance,C-reactive protein(CRP),procalcitonin(PCT),interleukin-6(IL-6) levels before and after treatment and clinical efficacy were observed in the two groups.Results:The effective rate of the control group was 74.29%,and that of the treatment group was 91.43%.The effective rate of the treatment group was higher than that of the control group,but the difference was not statistically significant(P>0.05).After treatment,FEV_(1),FVC and FEV_(1)/FVC of the two groups were significantly higher than those before treatment,and all the differences were significantly different(P<0.05);The differences between the two groups were also statistically significant(P<0.05).The grading of mMRC was significantly decreased,while the 6-minute walking distance was significantly increased in the two groups,and all the differences were significantly different(P<0.05);The differences between the two groups were also statistically significant(P<0.05).The levels of CRP,PCT and IL-6 in the two groups were significantly decreased,and all the differences were significantly different(P<0.05);The differences between the two groups were also statistically significant(P<0.05).There were no drug-related adverse reactions in the two groups during administration.Conclusion:Modified Minor Green Dragon Decoction combined with routine Western medicine treatment can improve the clinical efficacy of COPD in acute attack period,effectively recover the lung function of patients,and reduce the inflammatory reaction of the body by reducing the levels of inflammatory factors.