文章摘要
刘 燕,徐红日,王成祥,马 洁,刘 娟,王蓓蓓,吴庆华.麻杏石甘汤合千金苇茎汤加减联合西药治疗COPD急性加重期痰热壅肺证临床研究[J].,2020,(13):2471-2474
麻杏石甘汤合千金苇茎汤加减联合西药治疗COPD急性加重期痰热壅肺证临床研究
Clinical Study of Maxingshigan Decoction and Qianjinweigan Decoction Plus Combined with Western Medicine in the Treatment of Patients with Lung Syndrome of Phlegm Heat Stagnation in Acute Exacerbation of COPD
投稿时间:2020-02-04  修订日期:2020-02-27
DOI:10.13241/j.cnki.pmb.2020.13.014
中文关键词: 慢性阻塞性肺疾病  急性加重期  痰热壅肺证  麻杏石甘汤  千金苇茎汤  肺功能
英文关键词: Chronic obstructive pulmonary disease  Acute exacerbation  Lung syndrome of phlegm heat stagnation  Maxingshigan decoction  Qianjinweigan decoction  Lung function
基金项目:国家自然科学基金面上项目(81573924)
作者单位E-mail
刘 燕 北京市中西医结合医院呼吸内科 北京 100039 liuyan20206262@163.com 
徐红日 北京中医药大学第三附属医院急诊科 北京 100029  
王成祥 北京中医药大学第三附属医院急诊科 北京 100029  
马 洁 北京市中西医结合医院呼吸内科 北京 100039  
刘 娟 北京市中西医结合医院呼吸内科 北京 100039  
王蓓蓓 北京市中西医结合医院呼吸内科 北京 100039  
吴庆华 北京市中西医结合医院呼吸内科 北京 100039  
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中文摘要:
      摘要 目的:探讨麻杏石甘汤合千金苇茎汤加减联合西药治疗慢性阻塞性肺疾病(COPD)急性加重期痰热壅肺证患者的临床疗效及对肺功能和血清炎性因子的影响。方法:选取2018年1月至2018年12月在我院就诊的COPD急性加重期痰热壅肺证患者80例,将入选的全部患者随机分为两组,每组40例。观察组在西医常规治疗基础上联合麻杏石甘汤合千金苇茎汤加减口服汤剂治疗7天,对照组给予西医常规治疗7天。记录两组患者治疗前以及治疗后的肺功能指标、血清炎性因子和改良英国医学研究会呼吸困难指数(mMRC)评分,比较两组患者的临床疗效。结果:两组患者治疗后的第1秒用力呼气容积占用力肺活量百分比(FEV1/FVC)和用力肺活量(FVC)较治疗前有所改善,但是观察组与对照组相比较,未见明显差异(P>0.05);两组治疗后血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平较治疗前明显改善,观察组血清TNF-α水平更低(P<0.05);观察组治疗后的mMRC评分明显低于对照组(P<0.05);总有效率方面,观察组和对照组分别为80.00%、72.50%,两组相比较未见明显差异(P>0.05);显效率方面,观察组优于对照组,差异具有统计学意义(P<0.05)。结论:麻杏石甘汤合千金苇茎汤加减联合西药治疗COPD急性加重期痰热壅肺证患者,能够明显改善呼吸困难、咳嗽咳痰等症状,降低血清TNF-α水平,从而提高显效率。
英文摘要:
      ABSTRACT Objective: To explore the clinical effect of Maxingshigan decoction and Qianjinweigan decoction plus combined with western medicine in the treatment of patients with lung syndrome of phlegm heat stagnation in acute exacerbation of chronic obstructive pulmonary disease(COPD) and the influence on lung function and serum inflammatory factors. Methods: From January 2018 to December 2018, 80 patients with lung syndrome of phlegm heat stagnation in acute exacerbation of COPD were selected, they were randomly divided into two groups, 40 cases in each group. The observation group was treated with Maxingshigan decoction and Qianjinweigan decoction for 7 days on the basis of conventional western medicine treatment, the control group was treated with conventional western medicine for 7 days. The lung function indexes, serum inflammatory factors and modified British Medical Research Association dyspnea index(mMRC) scores of the two groups before and after treatment were recorded and the clinical effects of the two groups were compared. Results: Forced vital capacity(FVC) and forced expiratory volume in the first second/FVC(FEV1 / FVC) of the two groups were improved after treatment compared with before treatment, but there was no significant difference between the observation group and the control group(P>0.05). The levels of serum C-reactive protein (CRP) and tumor necrosis factor-α (TNF-α) in the two groups were significantly improved after treatment compared with before treatment, the level of serum TNF-α was lower in the observation group(P<0.05). The mMRC score of the observation group was significantly lower than that of the control group after treatment(P<0.05). In term of total efficiency, the observation group and the control group was 80.00% and 72.50% respectively, there was no significant difference between the two groups(P>0.05). In term of apparent efficiency, the observation group is better than the control group, the difference was statistically significant(P<0.05). Conclusion: Maxingshigan decoction and Qianjinweigan decoction plus combined with western medicine treat patients with lung syndrome of phlegm heat stagnation in acute exacerbation of COPD can obviously improve breathing difficulties, cough cough sputum and other symptoms, reduce serum TNF-α level, thereby increase the apparent efficiency.
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