越婢加半夏汤佐治痰热郁肺证慢阻肺的临床观察

Clinical Observation on Treating Chronic Obstructive Pulmonary Disease Due to Phlegm-Heat Stagnation in Lung with Yuebi Banxia Decoction

目的研究应用越婢加半夏汤佐治痰热郁肺证慢阻肺(COPD)的临床疗效。方法选取本院痰热郁肺证COPD患者973例,按照随机数字表法分为对照组(487例)和观察组(486例),对照组采用常规沙美特罗替卡松治疗,观察组在对照组基础上联用越婢加半夏汤,治疗21天后,观察比较各组治疗前后临床疗效、中医证候积分、动脉血氧和肺功能指标。结果各组治疗后FEV_(1)、FEV_(1)/FVC%和动脉血氧饱和度(SaO_(2))水平较治疗前升高(P<0.05),且观察组治疗后总有效率、FEV_(1)、FEV_(1)/FVC%和SaO_(2)水平高于对照组(P<0.01);各组治疗后中医证候积分、动脉血二氧化碳分压(PaCO_(2))水平较治疗前显著降低(P<0.01),且观察组治疗后中医证候积分、PaCO_(2)水平低于对照组(P<0.01)。结论应用越婢加半夏汤佐治痰热郁肺证慢阻肺,可改善患者的临床症状和肺功能指标,并缓解动脉血气紊乱,临床可进一步推广应用。

Objective To study the clinical effect of Yuebi Banxia Decoction in treating chronic obstructive pulmonary disease(COPD)due to phlegm-heat stagnation in lung.Methods A total of 973 patients with COPD due to phlegm-heat stagnation in lung treated in the Fifth People’s Hospital of Zhuhai were selected and assigned into a control group(n=487)and an observation group(n=486)according to the random number table method.The control group was treated with salmeterol/fluticasone,and the observation group was additionally treated with Yuebi Banxia Decoction.The clinical effect,TCM syndrome score,arterial oxygen saturation(SaO_(2)),and pulmonary function indicators were observed and measured before and after treatment.Results After treatment,the levels of forced expiratory volume in the 1st second(FEV_(1)),FEV_(1)/forced vital capacity(FVC)%,and SaO_(2) elevated in each group(P<0.05),and the observation group had higher total response rate,FEV_(1),FEV_(1)/FVC%,and SaO_(2) than the control group(P<0.01).After treatment,the TCM syndrome score and arterial carbon dioxide pressure(PaCO_(2))level declined in each group(P<0.01),and the observation group had lower TCM syndrome score and PaCO_(2) than the control group(P<0.01).Conclusion Yuebi Banxia Decoction can alleviate the clinical symptoms,improve pulmonary functions,and ameliorate arterial blood gas disorders in the patients with phlegm-heat stagnation in lung,being worthy of popularization in clinical practice.