清金化浊方联合西医常规疗法治疗感染性慢性阻塞性肺疾病急性加重疗效及抑制气道黏液高分泌机制研究

目的 观察清金化浊方联合西医常规疗法治疗感染性慢性阻塞性肺疾病急性加重(AECOPD)痰热蕴肺证患者的疗效,探讨其抑制气道黏液高分泌可能的作用机制.方法 采用区组随机方法将102例住院患者分为观察组与对照组各51例.对照组予支气管舒张剂、控制性氧疗、抗生素、糖皮质激素、机械通气等措施,观察组在此基础上予清金化浊方,每日...

Study on Efficacy of Qingjin Huazhuo Decoction Combined with Western Medicine Conventional Therapy in the Treatment of Acute Exacerbation of Infectious Chronic Obstructive Pulmonary Disease and Mechanism of Inhibiting Airway Mucus Hypersecretion

Objective To observe the efficacy of Qingjin Huazhuo Decoction combined with western medicine conventional therapy in the treatment of infectious acute exacerbation of chronic obstructive pulmonary disease(AECOPD);To analyze its possible mechanism of inhibiting airway mucus hypersecretion.Methods Totally 102 hospitalized patients were randomly divided into observation group and control group using block randomization method,with 51 cases in each group.The control group was given bronchodilator,controlled oxygen therapy,antibiotics,glucocorticoids,mechanical ventilation and other treatment measures according to the condition,and the observation group was given Qingjin Huazhuo Decoction on this basis,one dosage per day,twice a day,orally.The course of treatment for both groups was 7 days,under whole hospitalization observation.The changes of TCM symptom score,sputum traits score,severity of dyspnea,blood routine infection indexes and airway mucus hypersecretion indexes were observed before and after treatment in two groups,and monitored adverse reaction.Results Compared with before treatment,the scores of cough,wheezing and shortness of breath,expectoration,fever,and constipation in the two groups decreased after treatment(P<0.05,P<0.01),and the thirst score of the observation group decreased after treatment(P<0.01);comparing the difference between the two groups before and after treatment,the scores of cough,wheezing and shortness of breath,expectoration,thirst,and constipation in the observation group were better than those in the control group(P<0.01,P<0.05).Compared with before treatment,the scores of sputum traits and the severity of dyspnea in the two groups decreased after treatment(P<0.01);comparing the difference between the two groups before and after treatment,the scores of sputum traits and the severity of dyspnea in the observation group were better than those of the control group(P<0.01).Compared with before treatment,blood routine infection indicators(peripheral blood white blood cell count,neutrophil percentage),airway mucus hypersecretion indicators(sputum MUC5 AC content,sputum MUC5 AC mRNA expression)after treatment in the two groups decreased(P<0.05,P<0.01);Comparing the difference between the two groups before and after treatment,the blood routine infection indexes and airway mucus hypersecretion indexes of the observation group were better than those of the control group(P<0.05).There were 3 cases of diarrhea in the observation group and 2 cases of diarrhea in the control group.There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Qingjin Huazhuo Decoction combined with western medicine conventional therapy can significantly improve the symptoms,sputum traits and the severity of dyspnea of patients with infectious AECOPD with phlegm heat accumulation in lung syndrome,reduce the blood routine infection indexes.The mechanism of inhibiting airway mucus hypersecretion may be down-regulation of MUC5 AC content and MUC5 AC m RNA expression in sputum.