新加升降汤对痰热壅肺型慢性阻塞性肺疾病急性加重期影响的临床研究

Clinical study of the effects of Xinjia Shengjiang Decoction in the treatment of acute exacerbation of chronic obstructive pulmonary disease with syndrome of phlegm-heat obstructing lung

目的观察新加升降汤联合西医治疗痰热壅肺型慢性阻塞性肺疾病急性加重期患者的临床疗效。方法将104例痰热壅肺型慢性阻塞性肺疾病急性加重期患者,随机分为治疗组与对照组,每组52例。对照组予常规西医治疗,治疗组在对照组治疗措施的基础上加用新加升降汤。两组疗程均为14天,观察临床疗效,比较中医证候积分、CAT评分、6 min步行距离(6MWD)及肺通气功能相关指标(FEV_1/FVC%、FEV_1%)的变化情况。结果①试验结束时两组完成试验病例共100例,治疗组、对照组各50例。②治疗组、对照组临床总有效率分别为78.00%、62.00%;组间临床疗效比较,治疗组明显优于对照组(P<0.05)。③组间治疗第3、7、14天分别比较,中医证候积分、CAT评分及6MWD差异均有统计学意义,治疗组中医证候积分及CAT评分降低程度比对照组更加明显,治疗组6MWD距离增加程度比对照组更加明显(P<0.05)。④治疗前与治疗第3、7、14天分别比较,两组FEV_1/FVC%、FEV_1%水平差异均有统计学意义(P<0.05)。组间治疗第3、7、14天分别比较,FEV_1/FVC%、FEV_1%水平差异无统计学意义(P>0.05)。结论新加升降汤联合西药治疗痰热壅肺型慢性阻塞性肺疾病急性加重期患者的疗效满意,可明显改善患者的生活质量与运动能力。

Objective To observe the clinical efficacy of Xinjia Shengjiang Decoction combined with western medicine in treating patients of acute exacerbation of chronic obstructive pulmonary disease( AECOPD) with syndrome of phlegm-heat obstructing lung. Methods 104 AECOPD patients with syndrome of phlegm-heat obstructing lung were randomly divided into the treatment group and control group,52 cases in each group. The control group was treated with routine therapy of western medicine,and the treatment group was additionally treated with Xinjia Shengjiang Decoction based on the treatment for the control group,with a course of 14 days. The clinical efficacy was observed,and the changes of TCM syndrome score,COPD assessment test( CAT) scale score,6 minutes walk distance( 6MWD) and related indexes of pulmonary ventilation function( forced expiratory volume in one second[FEV_1] and forced vital capacity [FVC]) were compared. Results①At the end of trial,a total of 100 cases completed the trial,and 50 cases in each group.②The clinical total effective rate was 78. 00% in the treatment group and62. 00% in the control group. The clinical efficacy of the treatment group was significantly better than that of the control group( P < 0. 05).③For the comparison between the two groups on 3rd,7th and 14 th day respectively,there were statistically significant differences on the TCM syndrome score,CAT score and 6MWD.The decrease of TCM syndrome score and CAT score in the treatment group were more significant than those in the control group,and the increase of 6MWD in the treatment group was more significant than that in the control group( P < 0. 05).④For the comparison between treatment before and after treatment for 3,7,14 days respectively,there were statistically significant differences on the levels of FEV_1/FVC% and FEV_1% in both groups( P < 0. 05). There were no statistically significant differences on the levels of FEV_1/FVC% and FEV_1% between the two groups on 3rd,7th and 14 th day( P > 0. 05). Conclusion Xinjia Shengjiang Decoction combined with western medicine shows good efficacy in treating patients of acute exacerbation of chronic obstructive pulmonary disease with syndrome of phlegm-heat obstructing lung,which can significantly improve the life quality and exercise ability of patients.