升丹二陈汤治疗急性加重期慢性阻塞性肺病气虚痰瘀证30例

Clinical effect of Shengdan Erchen decoction in treatment of acute exacerbation of chronic obstructive pulmonary disease with Qi deficiency and phlegm stasis:An analysis of 30 cases

目的:观察升丹二陈汤治疗急性加重期慢性阻塞性肺病(AECOPD)气虚痰瘀证的临床疗效。方法:将60例AECOPD气虚痰瘀证患者随机分为治疗组和对照组,每组各30例。2组均予以西医常规治疗,治疗组加用升丹二陈汤治疗,对照组加用布地格福吸入气雾剂治疗。观察2组的肺功能[第1秒用力呼气容积(FEV1)、呼气峰流量(PEF)和气道峰压(Ppeak)],6 min步行试验(6MWT),呼吸困难评分量表(Borg)评分,呼吸困难(mMRC)评分,COPD患者自我评估测试(CAT)疗效,中医证候疗效及急性加重次数。结果:2组治疗后FEV1、PEF、Ppeak、6MWT、Borg评分、mMRC评分均较治疗前改善,且治疗组改善幅度优于对照组,差异均有统计学意义(P<0.05)。CAT疗效总有效率治疗组为90.00%(27/30),高于对照组的73.33%(22/30),组间比较,差异有统计学意义(P<0.01)。中医证候疗效总有效率治疗组为96.67%(29/30),对照组为66.67%(20/30),组间比较,差异有统计学意义(P<0.01)。治疗组急性加重次数少于对照组,差异亦有统计学意义(P<0.01)。结论:升丹二陈汤可以减轻AECOPD气虚痰瘀证患者的临床症状,提高活动耐力及生活质量,值得临床推广应用。

Objective:To investigate the clinical effect of Shengdan Erchen decoction in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with Qi deficiency and phlegm stasis.Methods:A total of 60 AECOPD patients with Qi deficiency and phlegm stasis were randomly divided into treatment group and control group,with 30 patients in each group.In addition to conventional Western medicine treatment,the patients in the treatment group were given Shengdan Erchen decoction,and those in the control group were given budesonide,glycopyrronium bromide,and formoterol fumarate inhalation aerosol.The two groups were observed in terms of pulmonary function(forced expiratory volume in 1 second[FEV1],peak expiratory flow[PEF],and peak airway pressure[Ppeak]),six-minute walk test(6MWT),Borg Dyspnea Scale score,modified Medical Research Council(mMRC)dyspnea score,outcome based on COPD assessment test(CAT),treatment outcome of TCM syndrome,and number of times of acute exacerbation.Results:After treatment,both groups had significant improvements in FEV1,PEF,Ppeak,6MWT,Borg score,and mMRC score,and the treatment group had significantly greater improvements than the control group(P<0.05).As for the outcome based on CAT,the treatment group had a significantly difference in overall response rate than the control group[90.00%(27/30)vs 73.33%(22/30),P<0.01].As for the treatment outcome of TCM syndrome,there was a significant difference in overall response rate between the treatment group and the control group[96.67%(29/30)vs 66.67%(20/30),P<0.01].The treatment group had a significantly lower number of times of acute exacerbation than the control group(P<0.01).Conclusion:Shengdan Erchen decoction can alleviate clinical symptoms and improve activity endurance and quality of life in AECOPD patients with Qi deficiency and phlegm stasis,and therefore,it holds promise for clinical application.