芩葶清肺汤联合双侧足三里穴位注射、穴位敷贴治疗痰热淤肺证AECOPD患者的疗效评价

目的　研究芩葶清肺汤联合双侧足三里穴位注射、穴位敷贴治疗痰热淤肺证慢性阻塞性肺疾病急性加重期（acute exacerbation of chronic obstructive pulmonary disease，AECOPD）患者的疗效。方法　选取2018年6月至2021年6月于郑州市中医院就诊的136例痰热淤肺证AECOPD患者，简单随机分为对照组（68例）、联合组（68例）。对照组女30例，男38例；年龄（55.07±6.03）岁。联合组女31例，男37例；年龄（56.25±5.62）岁。对照组采用双侧足三里穴位注射（黄芪注射液）、穴位敷贴治疗，联合组采用芩葶清肺汤联合双侧足三里穴位注射、穴位敷贴治疗。比较2组临床疗效，治疗前及治疗14 d后中医证候积分、肺功能用力肺活量（FVC）、第1秒用力呼气肺活量（FEV₁）、深吸气量（IC）]、红细胞免疫功能红细胞免疫调节因子的C3b受体花环抑制率（RFIR）、红细胞免疫复合物花环（RBC-ICR）、红细胞C3b受体花环（RBC-C3bR）、红细胞免疫调节因子的C3b受体花环促进率（RFER）]、血清脂质运载蛋白-1（LCN-1）、LCN-2水平。行χ²检验、独立样本t检验。结果　联合组临床总有效率94.12%（64/68）高于对照组82.35%（56/68）（P<0.05）。治疗14 d后联合组中医证候积分低于对照组（6.24±1.87）分比（8.03±2.16）分]（P<0.05）。治疗14 d后联合组FVC、FEV₁、IC高于对照组（均P<0.05）；治疗14 d后联合组RFER、RBC-C3bR高于对照组，RFIR、RBC-ICR低于对照组（均P<0.05）；治疗14 d后联合组血清LCN-1、LCN-2水平低于对照组（均P<0.05）。2组治疗期间均未发生严重不良反应。结论　芩葶清肺汤、双侧足三里穴位注射、穴位敷贴联合治疗痰热淤肺证AECOPD患者可有效改善临床症状，提高肺功能、红细胞免疫功能，减轻炎症状态，疗效显著，且安全性良好。

Efficacy evaluation of Qinting Qingfei decoction combined with bilateral Zusanli acupoint injection and acupoint application in the treatment of AECOPD patients with phlegm heat stasis lung syndrome

Objective　To study the efficacy of Qinting Qingfei decoction combined with bilateral Zusanli acupoint injection and acupoint application in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients with phlegm heat stasis lung syndrome. Methods　A total of 136 AECOPD patients with phlegm heat stasis lung syndrome in Zhengzhou Hospital of Traditional Chinese Medicine from June 2018 to June 2021 were selected and were simply randomly divided into a control group (68 cases) and a combined group (68 cases). There were 30 females and 38 males in the control group, aged (55.07±6.03) years; there were 31 females and 37 males in the combined group, aged (56.25±5.62) years. The control group was treated with bilateral Zusanli acupoint injection (Huangqi injection) and acupoint application, and the combined group was treated with Qinting Qingfei decoction combined with bilateral Zusanli acupoint injection and acupoint application. The clinical efficacy and TCM syndrome scores, pulmonary function forced vital capacity (FVC), forced expiratory vital capacity in the first second (FEV₁), and inspiratory capacity (IC)], red blood cell immune function red blood cell immunomodulator C3b receptor rosette inhibition rate (RFIR), red blood cell immune complex rosette (RBC-ICR), red blood cell C3b receptor rosette (RBC-C3bR), and red blood cell immune regulator C3b receptor rosette promotion rate (RFER)], and serum lipocalin-1 (LCN-1) and LCN-2 levels before treatment and after 14 days of treatment were compared between the two groups.χ² test and independent sample t test were used. Results　The total effective rate of the combined group was 94.12% (64/68), which was higher than that of the control group 82.35% (56/68)] (P<0.05). After 14 days of treatment, the TCM syndrome score of the combined group was lower than that of the control group (6.24±1.87) vs. (8.03±2.16)] (P<0.05). After 14 days of treatment, the FVC, FEV₁, and IC of the combined group were higher than those of the control group (all P<0.05); the RFER and RBC-C3BR in the combined group were higher than those in the control group, and the RFIR and RBC-ICR were lower than those in the control group (all P<0.05); the serum levels of LCN-1 and LCN-2 in the combined group were lower than those in the control group (both P<0.05). No serious adverse reactions occurred in both groups during treatment. Conclusion　Qinting Qingfei decoction combined with bilateral Zusanli acupoint injection and acupoint application in the treatment of AECOPD patients with phlegm heat stasis lung syndrome can effectively improve the clinical symptoms, improve the lung function and red blood cell immune function, and reduce the inflammatory state, with significant curative effect and good safety.