桃红四物汤加减联合西药治疗慢性阻塞性肺疾病急性发作期(瘀血阻肺)随机平行对照研究

Randomized Parallel Controlled Study on Taohong Siwu Decoction Combined with Western Medicine in Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease(Blood Stasis Obstructing Lung)

[目的]观察桃红四物汤加减联合西药治疗慢性阻塞性肺疾病急性发作期(瘀血阻肺)疗效。[方法]使用随机平行对照方法,将96例门诊及住院患者按随机数字表法随机分为两组。对照组48例沙丁胺醇0. 2~0. 4 mg/次,4次/d,喷入口腔深部;阿莫西林克拉维酸钾0. 25 g/次,3次/d;泼尼松龙30~40 mg/d,连续使用7 d;氨溴索30 mg/次,3次/d。治疗组48例桃红四物汤加减(桃仁20 g,红花16 g,当归、熟地黄、丹参各18 g,川芎、赤芍各10 g,桔梗、陈皮、半夏、葶苈子各12 g,炙甘草10 g),水煎400 m L,1剂/d,早晚温服;西药治疗同对照组。连续治疗7 d为1疗程。观测临床表现、肺功能(FEV1、FEV1%)、圣乔治呼吸问卷(SGRQ)、中医证候积分、不良反应。连续治疗2疗程(14 d),判定疗效。[结果]治疗组临床痊愈28例,显效11例,有效7例,无效2例,总有效率95. 83%;对照组临床痊愈22例,显效14例,有效4例,无效8例,总有效率83. 33%;治疗组疗效优于对照组(P <0. 05)。FEV1、FEV1%、SGRQ、中医证候积分两组均有改善(P <0. 01),治疗组改善优于对照组(P <0. 01)。[结论]桃红四物汤加减联合西药治疗慢性阻塞性肺疾病急性发作期(瘀血阻肺),疗效满意,无严重不良反应,值得推广。

[Objective]To observe the effect of Modified Taohong Siwu Decoction combined with western medicine on acute exacerbation of chronic obstructive pulmonary disease(COPD).[Method]A total of 96 outpatients and inpatients were randomly divided into two groups by random number table method.Forty-eight patients in the control group received salbutamol 0.2-0.4 mg/time,4 times a day,spraying into the entrance cavity,amoxicillin and clavulanate potassium 0.25 g/time,3 times a day,prednisolone 30-40 mg/day for 7 days,ambroxol 30 mg/time,3 times a day.Forty-eight cases in the treatment group were treated with Taohong Siwu Decoction,1 dose/d,taking in the morning and evening.The western medicine treatment was the same as that of the control group.Continuous treatment for 7 days was a course of treatment.The clinical manifestations,lung function(FEV1,FEV1%),St.George’s respiratory questionnaire(SGRQ),TCM syndrome score and adverse reactions were observed.After continuous treatment for 2 courses(14 days),the efficacy was determined.[Result]In the treatment group,28 cases were cured,11 cases were markedly effective,7 cases were effective and 2 cases were ineffective,and the total effective rate was95.83%.In the control group,22 cases were cured,14 cases were markedly effective,4 cases were effective and 8 cases were ineffective,and the total effective rate was 83.33%.The curative effect of the treatment group was better than that of the control group(P<0.05).FEV1,FEV1%,SGRQ and TCM syndrome scores were improved in both groups(P<0.01),and the improvement in the treatment group was better than that in the control group(P<0.01).[Conclusion]Taohong Siwu Decoction combined with western medicine in treating acute exacerbation of chronic obstructive pulmonary disease(obstruction of lung by blood stasis)has satisfactory curative effect and no serious adverse reactions,which is worthy of promotion.