Clinical Effect of Yinma Zhisou Decoction Combined with Western Medicine in the Treatment of Acute COPD(Stagnation of PhlegmDampness in Lung)

[Objectives]To explore the effectiveness and safety of Yinma Zhisou Decoction in the treatment of AECOPD with phlegm-heat obstructing lung syndrome,and observe the symptoms of Yinma Zhisou decoction in the treatment of AECOPD patients with phlegm-heat stagnation lung syndrome improvement,inflammatory indicators,lung function,blood gas analysis,etc.[Methods]A total of 92 cases who met the inclusion criteria and exclusion criteria were included in the study according to 1∶1 were randomly divided into treatment group and control group,control group with conventional Western medicine treatment,the treatment group on the basis of control group with Yinma Zhisou decoction treatment,a course of 10 d.The changes in TCM syndrome score,arterial blood gas analysis,pulmonary function,serum inflammatory indicator,mMRC score,and the CAT scores between the two groups after treatment were observed.All collected data were statistically analyzed with SPSS 26.0.[Results](i)Comparison of the curative effect between the two groups.After treatment,the total effective rate of the treatment group was 93.5%,which was higher than that of the control group(76.1%,P<0.05).The curative effect of the treatment group was better than that of the control group(P<0.05).(ii)Comparison of single TCM symptom scores.After treatment,the single TCM symptom scores of the two groups were lower than before(P<0.05),but the improvement of wheezing,cough,phlegm and chest pain in the treatment group was better than that in the control group(P<0.05).There was no significant difference in the improvement of wheezing sound(P>0.05),but there was a trend of difference.(iii)Comparison of mMRC score and CAT score between the two groups.After treatment,the mMRC score and CAT score of the two groups were significantly improved(P<0.05),and the difference was statistically significant.(iv)Comparison of blood gas analysis indicators between the two groups.Intra-group comparison after treatment:PaOof the control group and the treatment group after treatment was significantly improved compared with that before treatment(P<0.05),and the difference was statistically significant.Comparison between the two groups after treatment:PaOand PaCOof the two groups after treatment(P>0.05),and the difference was not statistically significant.It indicated that Yinma Zhisou decoction had more advantages in improving hypoxia.(v)Comparison of pulmonary function between the two groups.After treatment,the FEV1/FVC of the treatment group and the control group was significantly different(P<0.05),and there was a statistical difference(P<0.05).(vi)Comparison of inflammatory indicators between the two groups.Intra-group comparison after treatment:the inflammatory indicators WBC,CRP and PCT in the control group and the treatment group were significantly lower than before treatment(P<0.05),and the differences were statistically significant.It indicated that Yinma Zhisou decoction could effectively control inflammation and reduce inflammation reaction.[Conclusions]Compared with the control group,Yinma Zhisou decoction has obvious advantages in improving cough,expectoration and wheezing,and can significantly improve the total effective rate.Compared with Western medicine alone,Yinma Zhisou decoction can significantly improve patients’hypoxia,reduce mMRC and CAT scores,improve body activity tolerance,improve airway symptoms,and significantly reduce WBC,CRP,PCT and other serum inflammatory indicators.It can be seen that Yinma Zhisou decoction combined with Western medicine treatment is obviously better than simple Western medicine treatment,the curative effect is better,and the safety is better,and there are no serious adverse reactions in the course of the trial.

Meta-analysis of Therapeutic Efficacy of Purgation and Catharsis Method for Treating Severe Pneumonia

[Objectives]To make a systematic evaluation on the therapeutic efficacy of purgation and catharsis method combined with western medicine in treatment of severe pneumonia.[Methods]The literatures were retrieved from China Knowledge Infrastructure(CNKI),Chinese science and technology journal full-text database(VIP database,VIP),Wanfang Data,the Chinese biomedical database,PubMed,Embase,and the Cochrane Library.The retrieval time was set to the period from the creation of the database to June 2020.The randomized controlled trial(RCT)was conducted on the comparison between the purgation and catharsis method combined with western medicine and the western medicine alone in the treatment of severe pneumonia.The literature information was extracted and the methodological quality of the included literature was evaluated according to the bias risk assessment tool developed by the Cochrane Collaboration.Meta-analysis was performed with the aid of RevMan 5.3 software for the patient response rate,acute physiology and chronic health evaluations II(APACHE II),clinical pulmonary infection score(CPIS),oxygenation index(OI),procalcitonin(PCT),mechanical ventilation time,etc.[Results]A total of 20 articles were included,involving a total of 1661 patients,and the literature quality was low.Meta analysis results showed that compared with the treatment by western medicine alone,the purgation and catharsis method combined with western medicine can further improve the response rate[RR=1.21,95%CI(1.14,1.27),P<0.00001],and reduce the APACHE II score[WMD=-5.92,95%CI(-7.94,-3.89),P<0.00001],reduce CPIS score[WMD=-1.41,95%CI(-1.70,-1.12),P<0.00001],increase oxygenation index[WMD=39.52,95%CI(29.39,49.65),P<0.00001],reduce PCT level[WMD=-2.85,95%CI(-3.68,-2.01),P<0.00001],shorten the mechanical ventilation time[WMD=-13.00,95%CI(-16.51,-9.48),P<0.00001].[Conclusions]Within the scope of the study included,the purgation and catharsis method combined with western medicine in the treatment of severe pneumonia can further reduce the pulmonary infection,reduce PCT levels,increase oxygenation index,and improve vital organ functions,thereby improving clinical efficacy,shortening the mechanical ventilation time(MVT),and reducing the economic burden of patients.