生脉散合杏苏二陈方辅助西医基础治疗气阴两虚兼痰浊证急性加重期慢性阻塞性肺疾病患者的临床观察

Clinical Efficacy of Shengmai Powder Modified with Xingsu Erchen Formula in Adjuvant Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease with Qi-Yin Deficiency Syndrome Combined with Phlegm-Turbidity

目的 探讨生脉散合杏苏二陈方辅助西医基础治疗气阴两虚兼痰浊证急性加重期慢性阻塞性肺疾病(Acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者的临床疗效。方法 选取2020年3月—2022年3月期间六安市中医院收治的气阴两虚兼痰浊AECOPD患者80例,按照随机数字表法分为对照组和研究组,每组各40例。对照组采用常规西医基础疗法,研究组在对照组基础上联合生脉散合杏苏二陈汤。治疗1个月后,观察比较两组患者临床疗效,治疗前后中医证候评分、动脉血气指标[血氧饱和度(Oxygen saturation,SaO_(2))、动脉血氧分压(Partial pressure of oxygen,PaO_(2))、动脉血二氧化碳分压(Arterial carbon dioxide partial pressure,PaO_(2))]、炎症相关指标[白细胞介素-6(Interleukin-6,IL-6)、C反应蛋白(C-reactive protein,CRP)、降钙素原(Procalcitonin,PCT)]及肺通气功能相关指标[第1秒用力呼气容积(Forced expiratory volume in one second,FEV_(1))、用力肺活量(Forced Vital Capacity,FVC)、一秒率(Forced expiratory volume in one second/Forced Vital Capacity,FEV_(1)/FVC)]表达水平。结果 治疗后两组患者咳嗽、咳痰、喘息、发热、食欲下降、大便干结评分均较治疗前降低,差异有统计学意义(P<0.05);且研究组咳嗽、咳痰、喘息、发热、食欲下降、大便干结评分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者SaO_(2)、PaO_(2)指标均较治疗前升高,PaCO_(2)指标均较治疗前降低,差异有统计学意义(P<0.05);且研究组SaO_(2)、PaO_(2)指标均较对照组明显升高,PaCO_(2)指标较对照组明显降低,差异有统计学意义(P<0.05)。治疗后两组患者炎症指标IL-6、CRP、PCT表达水平均较治疗前降低,差异有统计学意义(P<0.05);且研究组炎症指标IL-6、CRP、PCT表达水平均较对照组明显降低,差异有统计学意义(P<0.05)。治疗后两组患者FEV_(1)、FVC、FEV_(1)/FVC值均较治疗前明显升高,差异有统计学意义(P<0.05);且研究组FEV_(1)、FVC、FEV_(1)/FVC值均明显高于对照组,差异有统计学意义(P<0.05)。治疗后研究组临床总有效率92.50%(37/40)明显高于对照组75.00%(30/40),差异有统计学意义(P<0.05)。结论 生脉散合杏苏二陈汤通过改善气阴两虚兼痰浊证AECOPD患者的肺通气功能,同时还可调节机体免疫炎症反应,从而提高整体治疗效果。

Objective To explore the clinical efficacy of Shengmai Powder modified with Xingsu Erchen Formula in adjuvant treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with qi-yin deficiency syndrome combined with phlegm-turbidity.Methods Eighty AECOPD patients with qi-yin deficiency syndrome combined with phlegm-turbidity admitted to the Lu′an Hospital of Traditional Chinese Medicine from March 2020 to March 2022 were enrolled and randomly divided into a control group and a study group,with 40 cases in each group.The control group received conventional Western medical treatment,while the study group received Shengmai Powder modified with Xingsu Erchen Decoction in addition to conventional treatment.After one month of treatment,the clinical efficacy,traditional Chinese medicine(TCM)syndrome scores before and after treatment,arterial blood gas indicators[oxygen saturation(SaO_(2)),partial pressure of oxygen(PaO_(2)),and partial pressure of carbon dioxide(PaCO_(2))],inflammation-related indicators[interleukin-6(IL-6),C-reactive protein(CRP),and procalcitonin(PCT)],and lung ventilation function-related indicators[forced expiratory volume in one second(FEV1),forced vital capacity(FVC),and FEV1/FVC ratio] were observed and compared between the two groups.Results After treatment,the scores for cough,sputum,wheezing,fever,decreased appetite,and constipation were significantly reduced in both groups compared to those before treatment(P<0.05),and the scores in the study group were significantly lower than those in the control group(P<0.05).The SaO_(2) and PaO_(2) levels were significantly increased,while the PaCO_(2) levels were significantly decreased in both groups after treatment compared to those before treatment(P<0.05),and the levels in the study group were significantly higher for SaO_(2) and PaO_(2),and lower for PaCO_(2) than those in the control group(P<0.05).The expression levels of IL-6,CRP,and PCT were significantly decreased in both groups after treatment compared to those before treatment(P<0.05),and the levels in the study group were significantly lower than those in the control group(P<0.05).The FEV1,FVC,and FEV1/FVC were significantly increased in both groups after treatment compared to those before treatment(P<0.05),and the values in the study group were significantly higher than those in the control group(P<0.05).The total effective rate after treatment in the study group was 92.50%(37/40),which was significantly higher than 75.00%(30/40)in the control group(P<0.05).Conclusion Shengmai Powder modified with Xingsu Erchen Decoction can improve lung ventilation function in AECOPD patients with qi-yin deficiency syndrome combined with phlegm-turbidity,and also regulate the body′s immune inflammatory response,thereby improving the overall treatment effectiveness.