清金止咳解痉汤治疗老年慢性支气管炎急性发作痰湿蕴肺证

Observation on the therapeutic effect of Qingjin Zhike Jiejing Decoction in treating acute attack of chronic bronchitis in the elderly with syndrome of phlegm-damp amassing in lung

目的探讨清金止咳解痉汤治疗老年慢性支气管炎急性发作痰湿蕴肺证的临床疗效。方法将老年慢性支气管炎急性发作患者102例随机分为对照组和观察组,各51例。对照组予常规西药治疗,观察组在对照组基础上联合清金止咳解痉汤治疗,2组疗程均为7 d,对比2组中医证候积分,炎症指标C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素6(IL-6),血气分析指标血氧饱和度(SaO_(2))、动脉血氧分压(PaO_(2))、二氧化碳分压(PCO_(2)),肺功能指标最大肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、FEV_(1)/FVC,SF-36评分及临床疗效,记录2组不良反应发生情况。结果治疗后观察组中医证候积分、CRP、TNF-α、IL-6、PCO_(2)指标水平均低于对照组(P<0.05),SaO_(2)、PaO_(2)、FVC、FEV_(1)、FEV_(1)/FVC指标水平及生活质量各维度评分均高于对照组(P<0.05);观察组总有效率(92.16%,47/51)高于对照组(76.47%,39/51)(P<0.05);2组均未发生严重不良反应,不良反应发生率组间比较差异无统计学意义(P>0.05)。结论清金止咳解痉汤结合常规西药治疗老年慢性支气管炎急性发作疗效良好,能够调节患者血气指标,抑制炎症反应,改善肺功能。

Objective To explore the clinical effi cacy of Qingjin Zhike Jiejing Decoction in the treatment of acute attack of chronic bronchitis in the elderly with syndrome of phlegm-damp amassing in lung.Methods 102 elderly patients with acute attack of chronic bronchitis were randomly divided into the control group and the observation group,with 51 cases in each group.The control group was treated with conventional Western medicine,while the observation group was treated with the combination of Qingjin Zhike Jiejing Decoction on the basis of the treatment of the control group.The treatment course for both groups was 7 days.The traditional Chinese medicine(TCM)syndrome scores,the inflammatory markers[C-reactive protein(CRP),the tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)],the blood gas analysis indicators[blood oxygen staturation(SaO_(2)),arterial oxygen partial pressure(PaO_(2)),carbon dioxide partial pressure(PCO_(2))],the lung function indicators[forced vital capacity(FVC),forced expiratory volume in the fi rst second(FEV_(1)),FEV_(1)/FVC)],the scores of the MOS item short from health survey(SF-36),and clinical efficacy in both groups were compared.The occurrence of adverse reactions in two groups was recorded.Results After treatment,TCM syndrome scores,the levels of CRP,TNF-αand IL-6,and PCO_(2)in the observation group were lower than those in the control group(P<0.05),while SaO_(2),PaO_(2),FVC,FEV_(1),FEV_(1)/FVC,and the scores of various dimensions of quality of life in the observation group were higher than those in the control group(P<0.05);The total effective rate of the observation group(92.16%,47/51)was higher than that of the control group(76.47%,39/51)(P<0.05).Both groups did not experience serious adverse reactions,and there was no statistically significant difference between the groups(P>0.05).Conclusion The combination of Qingjin Zhike Jiejing Decoction and conventional Western medicine has the good therapeutic eff ect on acute attack of elderly chronic bronchitis.This therapy can regulate blood gas indicators,inhibit inflammatory reactions,and improve lung function of the patients.