加味凉膈散治疗慢性阻塞性肺疾病急性加重期疗效观察

目的观察加味凉膈散治疗慢性阻塞性肺疾病急性加重期(AECOPD)的临床疗效及对氧化应激、炎症反应的影响。方法将2018年3月—2019年4月在东莞市中医院呼吸科住院的124例痰热郁肺型AECOPD患者随机分为治疗组及对照组各62例,各完成60例。对照组按照中国COPD诊治指南予常规治疗,治疗组在对照组常规治疗基础上加用加味凉膈散汤剂,每日1剂,2组疗程均为7 d。观察2组治疗前后的中医症状积分、Wexner便秘量表评分、外周血白细胞总数(WBC)、血清淀粉样蛋白A(SAA)、动脉血氧分压[p(O2)]、二氧化碳分压[p(CO2)]以及外周血丙二醛(MDA)、超氧化物歧化酶(SOD)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平的变化。结果治疗组治疗后中医症状积分、便秘量表评分均较治疗前显著降低(P均<0.05),且均显著低于对照组(P均<0.05)。2组治疗后WBC、SAA、p(CO2)、MDA、IL-6、TNF-α水平均较治疗前显著降低(P均<0.05),且治疗组显著低于对照组(P<0.05)。2组治疗后p(O2)、SOD较治疗前显著上升(P均<0.05),且治疗组显著高于对照组(P均<0.05)。结论加味凉膈散能明显改善AECOPD患者临床症状,有利于控制感染,其作用机制可能与减轻患者的氧化应激状态及炎症反应有关。

Curative effect of modified Lianggesan power on acute exacerbation of chronic obstructive pulmonary disease

Objective It is to observe the curative effect of modified Lianggesan power on acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and its effect on oxidative stress and inflammation.Methods 120 AECOPD inpatients of type of phlegm-heat stagnating in the lung treated in Dongguan Hospital of Traditional Chinese Medicine were randomly divided into control group and treatment group,62 cases in each group,60 cases finally completed the study.The control group received conventional treatment in accordance with the Chinese COPD diagnosis and treatment guidelines.The treatment group was added with Jiawei Liangge power on the basis of the conventional treatment of the control group,1 dose per day for 7 days.The scores of TCM syndrome,Wexner constipation scale,levels of peripheral blood white blood cell count(WBC),serum amyloid A(SAA),arterial blood oxygen partial pressure[p(O2)],carbon dioxide partial pressure[p(CO2)],peripheral blood malondialdehyde(MDA),superoxide dismutase(SOD),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)before and after treatment were observed in both groups.Results The scores of TCM syndrome and constipation scale of the treatment group after treatment were significantly lower than those before treatment(P<0.05),and were significantly lower than those of the control group(P<0.05).After treatment,the levels of WBC,SAA,p(CO2),MDA,IL-6 and TNF-αwere significantly lower than those before treatment(P<0.05),and the treatment group was significantly lower than the control Group(P<0.05).After treatment,p(O2)and SOD were higher than those before treatment in the two groups(P<0.05),and the treatment group was significantly higher than the control group(P<0.05).Conclusion Modified Liangge powder can improve the clinical symptoms and control the infection in AECOPD patients.The mechanism may be related to the improvement of oxidative stress and inflammation.