清咳平喘颗粒在慢性阻塞性肺疾病急性加重期患者中的临床疗效观察

目的 观察清咳平喘颗粒治疗慢性阻塞性肺疾病（COPD）急性加重期患者的临床疗效。方法 回顾性选取2019年11月—2021年5月在上海市（复旦大学附属）公共卫生临床中心呼吸内科住院的COPD急性加重期患者70例为研究对象，根据药物治疗方法分为试验组和对照组，每组各35例。对照组根据病情常规给予低流量氧疗、抗感染、解痉平喘化痰等综合治疗，试验组在对照组治疗基础上加用清咳平喘颗粒，开水冲服，每次10 g，每日3次。两组均治疗10 d。观察两组患者治疗前后中医证候疗效，慢性阻塞性肺疾病症状评估测试（CAT）评分，肺功能、动脉血气、炎症指标及不良反应。结果 试验组中医证候疗效总有效率（88.6%）明显高于对照组（68.6%）（P＜0.05）。试验组及对照组患者治疗前CAT评分、动脉血气、肺功能指标比较差异均无统计学意义（P＞0.05），治疗后两组患者CAT评分和动脉二氧化碳分压（pCO₂）均较治疗前显著降低（P＜0.05），治疗后两组患者动脉血氧分压（pO₂）、第1秒用力呼气容积（FEV1）和第1秒用力呼气容积/用力肺活量（FEV1/FVC）均较治疗前显著升高（P＜0.05）；治疗后试验组患者CAT评分、动脉血气及肺功能指标较对照组改善均更明显，差异均有统计学意义（P＜0.05）。治疗前，两组患者外周血白细胞（WBC）计数、C反应蛋白（CRP）、血清降钙素原（PCT）水平比较均无统计学差异（P＞0.05），治疗后两组患者WBC、CRP、PCT水平均较本组治疗前显著降低（P＜0.05），且治疗后试验组WBC、CRP、PCT水平较显著低于对照组（P＜0.05）。试验组不良反应发生率14.3%与对照组（8.6%）比较，差异无统计学意义（P＞0.05）。结论 清咳平喘颗粒治疗COPD急性加重期患者有协同作用，缓解临床症状，改善肺功能，疗效及安全性均较好。

Clinical observation of Qingke Pingchuan Granule in patients with acute exacerbation of chronic obstructive pulmonary disease

Objective To observe the clinical efficacy of Qingke Pingchuan Granules in treatment of patients with chronic obstructive pulmonary disease (COPD) in acute exacerbations. Methods 70 patients with acute exacerbation of COPD hospitalized in the respiratory department of Shanghai Public Health Clinical Center (affiliated to Fudan University) from November 2019 to may 2021 were selected retrospectively. According to the drug treatment methods, they were divided into experimental group and control group, with 35 cases in each group. Pateints in the control group were given low flow oxygen therapy, anti-infection, antispasmodic, asthma and phlegm treatment according to the condition. Pateints in the experimental group were treated with Qingke Pingchuan Granule, 10 g each time, three times a day. Both groups were treated for ten days. The curative effects of TCM syndromes, chronic obstructive pulmonary disease symptom assessment test (CAT) score, pulmonary function, arterial blood gas, inflammatory indexes and adverse reactions were observed before and after treatment. Results The total effective rate of TCM syndrome in the experimental group (88.6%) was significantly higher than that in the control group (68.6%) (P<0.05). There was no significant difference in CAT score, arterial blood gas and pulmonary function between the experimental group and the control group before treatment (P>0.05). After treatment, the CAT score and arterial carbon dioxide partial pressure (pCO₂) of the two groups were significantly lower than those before treatment (P<0.05). Arterial oxygen partial pressure(pO₂), the first second forced expiratory volume (FEV1) and the first second forced expiratory volume/forced vital capacity (FEV1/FVC) were significantly higher than those before treatment (P<0.05). After treatment, the CAT score, arterial blood gas and pulmonary function indexes in the experimental group were significantly improved compared with those in the control group (P<0.05). Before treatment, there was no significant difference in peripheral blood leukocyte (WBC), C-reactive protein (CRP) and serum procalcitonin (PCT) levels between the two groups (P>0.05). After treatment, the levels of WBC, CRP and PCT in two groups were significantly lower than those before treatment (P<0.05), and the levels of WBC, CRP and PCT in the experimental group were significantly lower than those in the control group (P<0.05). The incidence of adverse reactions in the experimental group was 14.3%, and there was no significant difference between the experimental group and the control group (8.6%) (P>0.05). Conclusion Qingke Pingchuan Granule has synergistic effect in treatment of patients with acute exacerbation of COPD, alleviating clinical symptoms and improving pulmonary function. It has good curative effect and safety.