宣肺化痰汤加减联合西药治疗慢性阻塞性肺疾病急性加重期临床研究

目的：观察宣肺化痰汤加减联合西药治疗慢性阻塞性肺疾病急性加重期（AECOPD） 痰浊蕴肺证的临床效果。方法：以随机数字表法将124例AECOPD痰浊蕴肺证患者分为观察组（以宣肺化痰汤加减联合西药治疗） 和对照组（仅以西药治疗），每组62例。2组均治疗2周后评估临床疗效、中医证候积分、肺功能指标及炎症指标水平。结果：治疗2周后，总有效率观察组95.16%，高于对照组83.87%（P＜0.05）。中医证候积分2组均低于治疗前（P＜0.05），且观察组低于对照组（P＜0.05）。第1秒用力呼气容积（FEV1）、用力肺活量（FVC）、FEV1/FVC、第1秒用力呼气容积占预计值的百分比（FEV1%pred） 2组均高于治疗前（P＜0.05），且观察组上述4项肺功能指标值均高于对照组（P＜0.05）。血清超敏C-反应蛋白（hs-CRP）、白细胞介素-6（IL-6） 及肿瘤坏死因子-α（TNF-α） 水平2组均低于治疗前（P＜0.05），且观察组上述3项炎症指标水平均低于对照组（P＜0.05）。结论：宣肺化痰汤加减联合西药治疗AECOPD痰浊蕴肺证疗效显著，可有效改善临床症状、肺功能及炎症指标。

Clinical Study on Modified Xuanfei Huatan Decoction Combined with WesternMedicine for Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Abstract： Objective： To observe the clinical effect of modified Xuanfei Huatan Decoction combinedwith western medicine on patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD) with syndrome of turbid phlegm accumulation in the lung. Methods： A total of 124 cases ofAECOPD patients with syndrome of turbid phlegm accumulation in the lung were randomly divided into theobservation group (treated with modified Xuanfei Huatan Decoction combined with western medicine) andthe control group (treated with western medicine only)， with 62 cases in each group. After two weeks oftreatment，both groups were evaluated for clinical effects，traditional Chinese medicine (TCM) syndromescores， lung function indicators， and serum inflammatory index levels. Results： After two weeks oftreatment， the total effective rate in the observation group was better than that in the control group(95.16% vs 83.87%) (P＜0.05). The TCM syndrome scores in both groups were lower than those beforetreatment (P＜0.05)，and the TCM syndrome scores in the observation group were lower than those in thecontrol group (P＜0.05). The forced expiratory volume in one second (FEV1)， forced vital capacity (FVC)，FEV1/FVC，and the percentage of FEV1 to the expected value (FEV1%pred) in both groups were higher thanthose before treatment (P＜0.05)；the above four indexes in the observation group were higher than thosein the control group (P＜0.05). The levels of serum high-sensitivity C-reactive protein (hs-CRP)，interleukin-6 (IL-6) and tumor necrosis factor- α (TNF- α) were all lower than those before treatment (P＜0.05)， and the levels of the above three indicators in the observation group were lower than those in thecontrol group (P＜0.05). Conclusion： The combination of modified Xuanfei Huatan Decoction and westernmedicine has a significant therapeutic effect on AECOPD patients with syndrome of turbid phlegmaccumulation in the lung，which has a positive improvement effect on clinical symptoms，lung function andinflammatory indicator.