清热利肺汤联合早期肺康复训练治疗老年慢性阻塞性肺疾病急性加重期临床研究

Clinical Study on Qingre Lifei Decoction Combined with Early Pulmonary Rehabilitation Training for Acute Exacerbation of Chronic Obstructive Pulmonary Disease in the Senile

目的:观察清热利肺汤联合早期肺康复训练治疗老年慢性阻塞性肺疾病(COPD)急性加重期的临床疗效。方法:选择120例老年COPD急性加重期患者,按随机数字表法分为治疗组与对照组各60例。对照组给予常规西医治疗,治疗组在对照组基础上给予清热利肺汤联合早期肺康复训练治疗。2组均以7 d为1个疗程,治疗2个疗程后评估中医证候积分、临床疗效、肺功能[第1秒用力呼气量(FEV_(1))占预计值百分比(FEV_(1)%)、FEV_(1)/用力肺活量(FVC)]及血清炎症因子[C-反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α (TNF-α)]水平。结果:治疗组总有效率为96.67%,对照组为85.00%,2组比较,差异有统计学意义(P<0.05)。治疗前,2组中医证候积分比较,差异无统计学意义(P>0.05);治疗后,2组中医证候积分较治疗前降低(P<0.05),且治疗组中医证候积分低于对照组(P<0.05)。治疗前,2组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FEV_(1)%、FEV_(1)/FVC水平较均较治疗前升高(P<0.05),且治疗组FEV_(1)%、FEV_(1)/FVC水平高于对照组(P<0.05)。治疗前,2组血清CRP、IL-6、TNF-α水平比较,差异无统计学意义(P>0.05);治疗后,2组CRP、IL-6、TNF-α水平均较治疗前降低(P<0.05),且治疗组上述各项指标均低于对照组(P<0.05)。结论:清热利肺汤联合早期肺康复训练治疗老年COPD急性加重期疗效显著,可缓解患者临床症状体征,改善肺功能,减轻机体炎症反应。

Objective:To observe the clinical effect of Qingre Lifei Decoction combined with early pulmonary rehabilitation training for acute exacerbation of chronic obstructive pulmonary disease(COPD) in the senile.Methods:A total of 120 cases of senile patients with acute exacerbation of COPD were selected and divided into the treatment group and the control group according to the random number table method,with 60 cases in each group.The control group was treated with routine western medicine,and the treatment group was additionally treated with Qingre Lifei Decoction combined with early pulmonary rehabilitation training based on the treatment of the control group.Both groups were treated for two courses,with 7 days being one course.After treatment,traditional Chinese medicine(TCM) syndrome scores,clinical effects,and levels of lung function [percentage of predicted value of forced expiratory volume in one second(FEV_(1)%),and ratio of forced expiratory volume in one second to forced vital capacity(FVC)] and inflammatory factors in serum [C-reactive protein(CRP),interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α)] were evaluated after two-course treatment.Results:The total effective rate was 96.67% in the treatment group and 85.00% in the control group,the difference being significant(P<0.05).Before treatment,there was no significant difference being found in the comparison of TCM syndrome scores between the two groups(P>0.05);after treatment,TCM syndrome scores in the two groups were decreased when compared with those before treatment(P<0.05),and the TCM syndrome score in the treatment group was lower than that in the control group(P<0.05).Before treatment,there was no significant difference being found in the comparison of levels of FEV_(1)% and FEV_(1)/FVC between the two groups(P>0.05);after treatment,levels of FEV_(1)% and FEV_(1)/FVC in the two groups were increased when compared with those before treatment(P<0.05),and the levels of FEV_(1)% and FEV_(1)/FVC in the control group were higher than those in the control group(P<0.05).Before treatment,there was no significant difference being found in the comparison of levels of CRP,IL-6 and TNF-α in serum between the two groups(P>0.05);after treatment,levels of CRP,IL-6 and TNF-α in serum in the two groups were decreased when compared with those before treatment(P<0.05),and the above indexes in the treatment group were lower than those in the control group(P<0.05).Conclusion:Qingre Lifei Decoction combined with early pulmonary rehabilitation training for acute exacerbation of COPD in the senile can relieve clinical symptoms and signs,improve lung function and reduce inflammatory responses in the body.