苏子降气汤合苓甘五味姜辛汤加减辅助西药治疗寒饮伏肺型慢性阻塞性肺疾病急性加重期的疗效观察
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摘要
目的:观察苏子降气汤合苓甘五味姜辛汤加减辅助西药治疗寒饮伏肺型慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)的效果,为临床治疗提供参考。方法:选取2017年6月至2018年6月北京同仁堂中医医院中医内科收治的120例寒饮伏肺型AECOPD患者,按照随机数字表法分为对照组和观察组,每组60例。对照组患者采用西医常规治疗,观察组患者在对照组基础上联合应用苏子降气汤合苓甘五味姜辛汤加减治疗。比较两组患者治疗前后中医症候积分、血清炎症指标水平,记录症状改善情况、住院时间,评定临床疗效。结果:治疗后,两组患者咳嗽咯痰、发热恶寒、胸膈满闷和苔白脉浮紧等症候积分以及D-二聚体、超敏C反应蛋白、血清淀粉样蛋白A和肿瘤坏死因子α等血清炎症指标水平均较治疗前明显降低,且观察组患者上述证候积分、指标水平均明显低于对照组,差异均有统计学意义(P<0.05);观察组患者急性加重次数、咳喘控制时间和住院时间均明显少于对照组,差异均有统计学意义(P<0.05)。观察组患者治疗总有效率为91.67%(55/60),明显高于对照组的73.33%(44/60),差异有统计学意义(P<0.05)。结论:苏子降气汤合苓甘五味姜辛汤加减辅助西药治疗寒饮伏肺型AECOPD,可有效改善患者寒饮咳嗽等中医症候,降低血清炎症指标水平,促进患者恢复,提高临床疗效。
OBJECTIVE: To observe the efficacy of Suzi Jiangqi decoction combined with Linggan Wuwei Jiangxin decoction in modified adjuvant of western medicine in treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD), so as to provide reference for its clinical treatment. METHODS: 120 patients with AECOPD admitted into Beijing Tongrentang Hospital of Traditional Chinese Medicine(TCM)from Jun. 2017 to Jun. 2018 were selected and divided into control group and observation group via random number table, with 60 cases in each group. The control group was given conventional western therapy, while the observation group was given Suzi Jiangqi decoction and Linggan Wuwei Jiangxin decoction on the basis of control group. The TCM syndrome scores and serum inflammatory indicators before and after treatment were compared between the two groups, the symptom improvement time and hospital stays were recorded,and the clinical efficacy was evaluated. RESULTS: After treatment, the symptom scores of cough and expectoration, fever and aversion to cold, chest distress, white coating on tongue, floating and tense pulse, serum inflammatory indicators of D-dimer, hypersensitivity C-reactive protein, serum amyloid A and tumor necrosis factor α of both groups had been significantly decreased, and those of the observation group were significantly lower than the control group, with statistically significant differences(P<0.05); the frequency of acute exacerbation, asthma-control time and hospital stays of observation group were significantly less than those of the control group, with statistically significant differences(P<0.05). The total effective rate of observation group was 91.67%(55/60), which was significantly higher than that of the control group(73.33%, 44/60), with statistically significant difference(P<0.05). CONCLUSIONS: Suzi Jiangqi decoction combined with Linggan Wuwei Jiangxin decoction in modified adjuvant of western medicine in treatment of AECOPD can effectively improve patients' TCM symptoms, lower serum inflammatory indicators levels, promote recovery and clinical efficacy.
OBJECTIVE: To observe the efficacy of Suzi Jiangqi decoction combined with Linggan Wuwei Jiangxin decoction in modified adjuvant of western medicine in treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD), so as to provide reference for its clinical treatment. METHODS: 120 patients with AECOPD admitted into Beijing Tongrentang Hospital of Traditional Chinese Medicine(TCM)from Jun. 2017 to Jun. 2018 were selected and divided into control group and observation group via random number table, with 60 cases in each group. The control group was given conventional western therapy, while the observation group was given Suzi Jiangqi decoction and Linggan Wuwei Jiangxin decoction on the basis of control group. The TCM syndrome scores and serum inflammatory indicators before and after treatment were compared between the two groups, the symptom improvement time and hospital stays were recorded,and the clinical efficacy was evaluated. RESULTS: After treatment, the symptom scores of cough and expectoration, fever and aversion to cold, chest distress, white coating on tongue, floating and tense pulse, serum inflammatory indicators of D-dimer, hypersensitivity C-reactive protein, serum amyloid A and tumor necrosis factor α of both groups had been significantly decreased, and those of the observation group were significantly lower than the control group, with statistically significant differences(P<0.05); the frequency of acute exacerbation, asthma-control time and hospital stays of observation group were significantly less than those of the control group, with statistically significant differences(P<0.05). The total effective rate of observation group was 91.67%(55/60), which was significantly higher than that of the control group(73.33%, 44/60), with statistically significant difference(P<0.05). CONCLUSIONS: Suzi Jiangqi decoction combined with Linggan Wuwei Jiangxin decoction in modified adjuvant of western medicine in treatment of AECOPD can effectively improve patients' TCM symptoms, lower serum inflammatory indicators levels, promote recovery and clinical efficacy.
引文
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[6] 温斌,魏静,李莉娟,等.博利康尼联合沐舒坦雾化吸入治疗对老年慢性阻塞性肺炎患者炎症与免疫功能的影响[J].临床肺科杂志,2016,21(7):1223-1226.
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[11] 余白桦,张丹芳,陈瑞发.苓甘五味姜辛汤加味治疗慢性阻塞性肺疾病临床研究[J].河南中医,2016,36(5):768-770.
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[13] 陈海清,张雪岷,惠平,等.血清PCT与Hs2CRP和SAA水平在老年慢性阻塞性肺疾病急性加重期下呼吸道感染诊断中的临床意义[J].中华医院感染学杂志,2016,26(17):3930-3932.
[14] 王林梅,齐景宪,冯青青.慢性阻塞性肺疾病急性加重期和稳定期患者血清IL-8、TNF-α及免疫因子的检测[J].郑州大学学报:医学版,2018,53(2):255-258.
[15] 郑忻,曲妮妮,马丽佳,等.苏子降气汤对慢性阻塞性肺疾病急性发作期(痰浊壅肺证)肺功能的影响及部分机制[J].世界中医药,2018,13(6):1487-1491.
[2] 林建荣.温阳降气止咳方针刺治疗“寒饮伏肺”型咳嗽变异性哮喘临床疗效观察[D].福州:福建中医药大学,2018.
[3] 中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版)[J].中华结核和呼吸杂志,2013,36(4):255-264.
[4] 国家中医药管理局.中医病证诊断疗效标准(2012版)[M].北京:中国中医药出版社,2012:4-6.
[5] 潘蔚,杜娟,栾念旭.慢性阻塞性肺疾病急性加重期患者并发呼吸机相关性肺炎的危险因素分析[J].临床肺科杂志,2017,22(1):135-137.
[6] 温斌,魏静,李莉娟,等.博利康尼联合沐舒坦雾化吸入治疗对老年慢性阻塞性肺炎患者炎症与免疫功能的影响[J].临床肺科杂志,2016,21(7):1223-1226.
[7] 周炜,邵雪华,彭敏飞,等.慢性阻塞性肺疾病急性加重期下呼吸道产超广谱β-内酰胺酶肠杆菌科细菌感染的耐药性分析[J].中国医师杂志,2016,18(7):1041-1044.
[8] 贾建营,赵海云.清气化痰汤加减治疗慢性阻塞性肺疾病急性加重期(痰热壅肺证)疗效观察[J].中国中医急症,2016,25(11):2153-2155.
[9] 仕丽,王檀,胡少丹,等.温肺通痹颗粒治疗间质性肺疾病寒饮伏肺,肺络痹阻患者36例[J].中国老年学杂志,2015,35(3):784-785.
[10] 刘志刚,孙宜芬,孟红旗.苏子降气汤治疗慢性阻塞性肺病急性加重疗效观察[J].临床肺科杂志,2016,21(8):1442-1445.
[11] 余白桦,张丹芳,陈瑞发.苓甘五味姜辛汤加味治疗慢性阻塞性肺疾病临床研究[J].河南中医,2016,36(5):768-770.
[12] 王一江.慢性阻塞性肺疾病急性加重期伴肺动脉栓塞的危险因素分析[J].实用临床医药杂志,2016,20(24):29-31.
[13] 陈海清,张雪岷,惠平,等.血清PCT与Hs2CRP和SAA水平在老年慢性阻塞性肺疾病急性加重期下呼吸道感染诊断中的临床意义[J].中华医院感染学杂志,2016,26(17):3930-3932.
[14] 王林梅,齐景宪,冯青青.慢性阻塞性肺疾病急性加重期和稳定期患者血清IL-8、TNF-α及免疫因子的检测[J].郑州大学学报:医学版,2018,53(2):255-258.
[15] 郑忻,曲妮妮,马丽佳,等.苏子降气汤对慢性阻塞性肺疾病急性发作期(痰浊壅肺证)肺功能的影响及部分机制[J].世界中医药,2018,13(6):1487-1491.