自拟温肺祛瘀化痰汤结合西医常规疗法治疗慢性阻塞性肺疾病急性发作临床研究

目的评价自拟温肺祛瘀化痰汤结合西医常规疗法治疗COPD急性发作的临床疗效。方法选择2018年1月-2019年4月本院COPD急性发作患者103例,按随机数字表法分为对照组51例和研究组52例,其中对照组给予西医常规疗法治疗,研究组在对照组基础上联用自拟温肺祛瘀化痰汤治疗。2组均治疗14 d。分别于治疗前后进行中医证候评分;采用肺功能仪检测FVC、FEV1及FEV1/FVC;采用ELISA法检测血清TNF-α、IL-8、CRP;记录治疗期间不良反应,评价临床疗效。结果研究组总有效率为88.5%(46/52)、对照组为70.6%(36/51),2组比较差异有统计学意义(χ^2=5.067,P=0.024)。治疗后,研究组中医证候评分[(7.3±0.9)分比(12.9±1.2)分,t=27.979]低于对照组(P<0.01);FVC[(2.69±0.35)L比(2.12±0.24)L,t=9.621]、FEV1[(1.58±0.22)L比(1.13±0.18)L,t=11.349]、FEV1/FVC[(0.59±0.07)比(0.53±0.08),t=4.053]均高于对照组(P<0.01);血清IL-8[(51.48±6.27)ng/L比(69.27±7.32)ng/L,t=13.255]、CRP[(2.12±0.46)mg/L比(3.51±0.53)mg/L,t=14.223]、TNF-α[(41.38±6.22)ng/L比(52.24±7.29)ng/L,t=8.139]水平均低于对照组(P<0.01)。治疗期间,对照组不良反应发生率为11.8%(6/51)、研究组为15.4%(8/52),2组比较差异无统计学意义(χ^2=0.321,P=0.571)。结论自拟温肺祛瘀化痰汤结合西医常规疗法可有效改善COPD急性发作患者的临床症状及肺功能,降低炎性细胞因子水平。

Clinical study on the treatment of acute attack of chronic obstructive pulmonary disease with self-made Wenfei-Quyu-Huatan Decoction combined with conventional western medicine

Objective To evaluate the clinical effect of self-made Wenfei-Quyu-Huatan Decoction combined with conventional western medicine in the treatment of acute attack of chronic obstructive pulmonary disease(COPD).Methods A total of 103 patients with acute attack of COPD who were admitted to our hospital from January 2018 to April 2019 were divided into control group(51 cases)and the intervention group(52 cases)according to the random number table method.The control group was treated with conventional western medicine,and the intervention group was treated with self-made Wenfei-Quyu-Huatan Decoction based on control group.Both groups were treated for 14 days.TCM syndrome scores were recorded before and after the treatment,the FVC,FEV1 and FEV1/FVC were detected by pulmonary function meter,the content of TNF-α,IL-8 and CRP in serum were detected by ELISA,and adverse reactions during the treatment were recorded and clinical efficacy was evaluated.Results The total effective rate was 88.5%(46/52)in the intervention group and 70.6%(36/51)in the control group,and the difference between the two groups was statistically significant(χ^2=5.067,P=0.024).After the treatment,the TCM syndrome score of the intervention group was significantly lower than the control group(7.3±0.9 vs.12.9±1.2;t=27.979,P<0.01);FVC(2.69±0.35 L vs.2.12±0.24 L,t=9.621),FEV1(1.58±0.22 L vs.1.13±0.18 L,t=11.349)and FEV1/FVC(0.59±0.07 vs.0.53±0.08,t=4.053)in the intervention group were significantly higher than the control group(P<0.01);the serum IL-8(51.48±6.27 ng/L vs.69.27±7.32 ng/L,t=13.255),CRP(2.12±0.46 mg/L vs.3.51±0.53 mg/L,t=14.223)and TNF-α(41.38±6.22 ng/L vs.52.24±7.29 ng/L,t=8.139)level were significantly lower than the control group(P<0.01).During the treatment,the incidence of adverse reactions was 11.8%(6/51)in the control group and 15.4%(8/52)in the intervention group,and there was no significant difference between the two groups(χ^2=0.321,P=0.571).Conclusions The self-made Wenfei-Quyu-Huatan Decoction combined with the conventional western medicine can improve the clinical symptoms,lung function and reduce the level of inflammatory cytokines in patients with COPD acute attack.