小柴胡汤合葛根芩连汤加减治疗慢性阻塞性肺疾病稳定期的临床观察

Clinical observation of Xiaochaihu Decoction combined with Gegen Qinlian Decoction in treatment of chronic obstructive pulmonary disease in stable stage

目的:观察小柴胡汤合葛根芩连汤加减治疗慢性阻塞性肺疾病(Chronic obstructive pulmonary disease,COPD)稳定期肺脾气虚兼湿热证的临床疗效。方法:对2021年7月~2022年3月的COPD稳定期肺脾气虚兼湿热证患者78例行回顾性分析,依据治疗差异分为对照组39例(予常规西药治疗)和试验组39例(予常规西药+小柴胡汤合葛根芩连汤加减治疗)。对比两组临床疗效、证候积分、肺功能[第1秒用力呼气容积(Force the expiratory volume for the first second,FEV 1 )、第1秒用力呼气容积/用力肺活量(Force the expiratory volume for the first second/Forced Vital Capacity,FEV 1 /FVC)]、6min步行距离(6minute walking distance,6MWD)、慢阻肺生活质量量表(COPD Assessment Test,CAT)及安全性。结果:对照组、试验组总疗效率分别为74.36%、92.31%,试验组总疗效率更高( P <0.05)。两组治疗后,证候总积分均下降,但试验组证候总积分下降幅度更大( P <0.05)。两组治疗后FEV 1 、FEV 1 /FVC值均上升,且试验组比对照组高( P <0.05)。两组治疗后6MWD的距离均延长,且试验组明显长于对照组( P <0.05)。两组治疗后CAT评分(包括咳嗽、咳痰、胸闷、睡眠、情绪、精力评分)均降低,且试验组明显低于对照组( P <0.05)。治疗期间,对照组不良反应总发生率为2.56%(1/39),试验组不良反应总发生率为5.12%(2/39),两组不良反应总发生率相比较,差异无统计学意义( P >0.05)。结论:小柴胡汤合葛根芩连汤加减治疗可改善COPD稳定期肺脾气虚兼湿热证的患者生活质量、肺功能,提高临床疗效。

Objective: To observe the clinical effect of Xiaochaihu Decoction combined with Gegenqinlian Decoction in the treatment of Chronic obstructive pulmonary disease(COPD) combined with dampness-heat syndrome. Methods: 78patients with lung Qi deficiency and damp-heat syndrome in stable COPD from July 2021to March 2022were retrospectively analyzed, and were divided into 39cases in control group(treated with conventional western medicine) and 39cases in experimental group(treated with conventional western medicine plus Xiaochaihu decoction and Gegen Qinlian decoction) according to treatment differences. The clinical efficacy, syndrome score, lung function [Force the expiratory volume for the first second(FEV 1 ), Force the expiratory volume for the first second/Forced Vital Capacity(FEV 1 /FVC)], 6minute walking distance(6MWD) and COPD Assessment Test(CAT) and safety were compared between the two groups. Results: The total curative effect rate of control group and experimental group were 74.36% and 92.31%, respectively, and the total curative effect rate of experimental group was higher( P <0.05). After treatment, the total score of syndrome decreased in the two groups, but the decrease of total score in experimental group was greater( P <0.05). The FEV 1 and FEV 1 / FVC values of the two groups increased after treatment, and the experimental group was higher than the control group( P <0.05).The distance of 6MWD in the two groups was extended after treatment, and the experimental group was significantly longer than the control group( P <0.05). After treatment, CAT scores(including cough, phlegm, chest tightness, sleep, mood and energy scores) were decreased in the two groups, and the test group was significantly lower than the control group( P <0.05). During treatment, the total incidence of adverse reactions was 2.56%(1/39) in the control group and 5.12%(2/39) in the experimental group. There was no statistical significance in the total incidence of adverse reactions between the two groups( P >0.05). Conclusion: Modified Xiaochaihu Decoction and Gegen Qinlian Decoction can improve the quality of life, lung function and clinical efficacy of patients with stable COPD of lung-spleen qi deficiency and damp-heat syndrome.