二陈汤合三子养亲汤联合肺泡灌洗治疗痰湿阻肺型慢性阻塞性肺疾病急性加重期的临床研究

Clinical efficacy on Erchen Decoction and Sanzi Yangqin Decoction combined with bronchoalveolar lavage for acute exacerbation of chronic obstructive pulmonary disease of phlegm damp aggregates lung type

目的 观察二陈汤合三子养亲汤联合肺泡灌洗治疗慢性阻塞性肺疾病急性加重期(AECOPD)患者的临床疗效。方法 将80例痰湿阻肺型AECOPD患者按照随机数字表法分为2组,2组均予常规西医治疗,治疗组40例予二陈汤合三子养亲汤颗粒剂联合肺泡灌洗,对照组40例(后脱落1例)予含10%中药安慰剂口服联合肺泡灌洗。治疗1周后,比较2组治疗前后血常规、超敏C反应蛋白(hs-CRP)、血清降钙素原(PCT)、白细胞介素8(IL-8)、肿瘤坏死因子α(TNF-α)、支气管肺泡灌洗液细胞数及构成比。结果 2组治疗后血常规WBC、NEU%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hs-CRP、PCT、IL-8、TNF-α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组治疗后支气管肺泡灌洗液WBC、NEU%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MAC%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)。结论 二陈汤合三子养亲汤联合肺泡灌洗能促使痰湿阻肺型AECOPD患者体内痰液排出,减轻患者全身及气道炎性反应,治疗效果显著。

Objective To observe the clinical efficacy on Erchen Decoction and Sanzi Yangqin Decoction combined with bronchoalveolar lavage for acute exacerbation of chronic obstructive pulmonary disease(AECOPD)of phlegm damp aggregates lung type.Methods A total of 80 patients with AECOPD(phlegm damp aggregates lung type)were randomly assigned into the treatment group(n=40)and the control group(n=40,1 case of shedding).All patients were managed by routine Western medicine,those in the treatment group were additionally treated with Erchen Decoction and Sanzi Yangqin Decoction combined with bronchoalveolar lavage,and those in the control group were additionally treated with oral traditional Chinese medicine(TCM)placebo combined with bronchoalveolar lavage.Treated for 1 week,the aim was to compare blood routine,high sensitive C-reactive protein(hs-CRP),serum procalcitonin(PCT),interleukin 8(IL-8),tumor necrosis factor alpha(TNF-α),the number and constituent ratio of bronchial alveolar lavage fluid cells.Results After treatment,white blood cell(WBC)count and neutrophil ratio(NEU%)of blood routine in groups were significantly decreased(P<0.05),the decrease was more pronounced in the treatment group compared with the control group(P<0.05).The hs-CRP,PCT,IL-8,TNF-αin groups were decreased(P<0.05),and the decrease in the treatment group was more common than that in the control group(P<0.05).WBC count and NEU%of bronchial alveolar lavage fluid in groups were significantly decreased(P<0.05),which in the treatment group were more common(P<0.05).The proportion of macrophages(MAC%)in groups was significantly increased(P<0.05),the improvement in the treatment group were more relevant to the control group(P<0.05).Conclusion For patients with AECOPD(phlegm damp aggregates lung type),Erchen Decoction and Sanzi Yangqin Decoction combined with bronchoalveolar lavage has a significant therapeutic effect,which can promote elimination of sputum,and alleviate systemic and airway inflammation.