| 摘要: |
| 目的 评价宽胸理肺汤联合三子养亲汤治疗慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)痰浊壅肺证的临床疗效、安全性及其对肺功能、血常规的影响。 方法 将符合诊断标准的90例患者随机分为3组:对照组30例,以西医常规方法治疗;宽胸理肺汤组30例,在对照组基础上加服宽胸理肺汤;宽胸理肺汤联合三子养亲汤组30例,在宽胸理肺汤组基础上加服三子养亲汤。7 d为1疗程,观察3组临床疗效及治疗前后中医证候积分、肺功能、血常规改善情况。 结果 (1)宽胸理肺汤联合三子养亲汤组、宽胸理肺汤组和对照组总有效率分别为93.3%(28/30)、80.0%(24/30)和66.7%(20/30),其中宽胸理肺汤联合三子养亲汤组与对照组比较差异有统计学意义(P=0.01)。(2)中医证候积分结果显示宽胸理肺汤联合三子养亲汤组改善最佳,与其余两组比较差异均有统计学意义(P=0.018,P=0.000),宽胸理肺汤组改善亦优于对照组(P=0.027)。(3)宽胸理肺汤联合三子养亲汤能有效改善患者FEV1占预计值百分比、FEV1/FVC、白细胞计数及中性粒细胞比例,其效果优于对照组(P=0.003,P=0.000,P=0.001,P=0.003),与宽胸理肺汤组比较有所改善但差异无统计学意义;宽胸理肺汤组上述指标亦优于对照组(P=0.032,P=0.037,P=0.037,P=0.034)。(4)3组治疗过程中生命体征均平稳,未发现心、肝、肾等功能损害或其他严重并发症。 结论 在西药基础上合用宽胸理肺汤与三子养亲汤,能有效降低白细胞计数和中性粒细胞比例,改善肺功能,从而改善AECOPD痰浊壅肺证患者的临床症状和体征。 |
| 关键词: 宽胸理肺汤 三子养亲汤 慢性阻塞性肺疾病 急性加重期 中西医结合疗法 |
| DOI：10.3724/SP.J.1008.2015.01374 |
| 投稿时间：2015-03-02修订日期：2015-08-25 |
| 基金项目:上海市嘉定区科学技术发展基金(201125). |
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| Clinical efficacy of Kuanxionglifei Decoction combined with Sanziyangqin Decoction in treatment of acute exacerbation of chronic obstructive pulmonary disease |
| HUANG Xue-yuan,ZHANG Rui,ZHAO Jia-ying**,CHEN Ting,LI Sha-luo,YE Jiong |
(Department of Internal Emergency Medicine, Shanghai Jiading Hospital of Traditional Chinese Medicine, Shanghai 201800, China
*Corresponding author.) |
| Abstract: |
| Objective To evaluate the clinical efficacy and safety of Kuanxionglifei Decoction combined with Sanziyangqin Decoction (KXLFD-SZYQD) in treating acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with turbid phlegm obstructing lung syndrome, and to observe its effect on the lung function and routine blood tests. Methods Ninety patients meeting the diagnosis criteria were randomly divided into three groups. Thirty cases in KXLFD-SZYQD group were treated with western medicine and KXLFD-SZYQD, thirty cases in Kuanxionglifei Decoction (KXLFD) group were treated with KXLFD and western medicine, and thirty cases administered with western medicine alone were taken as controls. The therapeutic course was 7 d. The clinical therapeutic effects, accumulated scores of symptoms, pulmonary function and routine blood test were observed before and after treatment. Results (1) The total effective rates of KXLFD-SZYQD group, KXLFD group and control group were 93.3%(28/30), 80.0%(24/30) and 66.7%(20/30), respectively, with significant difference found between KXLFD-SZYQD group and control group (P=0.01). (2) The accumulated scores of symptoms showed that the improvement in KXLFD-SZYQD group was significantly greater than those in the other two groups (P=0.018, P=0.000), and the improvement of KXLFD group was significantly greater than that of the control group (P=0.027). (3) Compared with control group, KXLFD-SZYQD group also had significantly improved FEV1%, FEV1/FVC%, WBC and NEUT% (P=0.003, P=0.000, P=0.001,and P=0.003, respectively), and compared with KXLFD group, the improvement in KXLFD group was greater than that in the control group, but without significant difference (P=0.032, 0.037, 0.037,and 0.034, respectively). (4) The vital signs of the three groups were stable during the treatment, and there were no damage to the heart, liver or kidney and no other serious complications. Conclusion KXLFD-SZYQD combined with western medicine treatment can decrease WBC count and neutrophil percent, improve lung function and the clinical condition of AECOPD patients with turbid phlegm obstructing lung syndrome. |
| Key words: Kuanxionglifei Decoction Sanziyangqin Decoction chronic obstructive pulmonary disease acute exacerbation TCM WM therapy |
