清金化痰汤加减联合西医治疗肺热壅盛型AECOPD的临床疗效观察

发布时间：2018-03-01 16:01

本文关键词： 清金化痰汤肺热壅盛 AECOPD　出处：《广州中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:观察清金化痰汤加减联合西医治疗肺热壅盛型慢性阻塞性肺病急性加重(AECOPD)对比单纯西医疗法,在治疗前后CAT评分、症状体征评分、降钙素原(PCT)、中性粒细胞百分比、胸片、住院时间的变化,从而对比联合中医汤剂治疗后的临床疗效,能否在改善症状及缩短住院时间中发挥重要作用。方法:采用随机、对照、前瞻性研究方法。选取符合纳入标准的肺热壅盛型AECOPD患者60例,通过随机数字法将入组病人随机分配至实验组与对照组,每组各30例。对照组接受常规西医治疗措施,具体治疗方案为:0.9%氯化钠溶液2ml+硫酸沙丁胺醇吸入溶液2ml+吸入用异丙托溴铵溶液2ml+吸入用布地奈德混悬液2ml氧气雾化吸入,每日3次,疗程为5天;0.9%氯化钠溶液10ml+氨溴索注射液30mg静脉推注,每天3次,5天后改用口服;0.9%氯化钠溶液100ml+多索茶碱0.1g静脉滴注每12小时1次疗程为5天;经验性使用抗生素、退热、补液营养支持等治疗手段。实验组在对照组基础上加用清金化痰汤加减化裁。观察两组在治疗前后的CAT及症状体征评分、PCT、NEU%、胸片及住院时间,运用SPSS22.0版软件进行统计学分析,从而对清金化痰汤治疗肺热壅盛型AECOPD的临床疗效做出系统评价,对今后临床上的广泛应用提供理论支持。结果:两组患者治疗前在性别、年龄、CAT评分、症状体征评分、PCT、NEU%的差异均无统计学意义(P0.05)。治疗后,上述数据及住院时间行组间比较可得P0.05,表明实验组疗效优于对照组。结果显示,清金化痰汤在治疗肺热壅盛型AECOPD较单纯西医治疗有显著临床效果。结论:通过对清金化痰汤联合西医治疗肺热壅盛型AECOPD的临床疗效观察,证实在改善临床症状、缩短住院时间等方面,清金化痰汤联合西医治疗行之有效,值得在临床广泛应用。
[Abstract]:Objective: to observe the efficacy of Qingjin Huatan decoction combined with western medicine in the treatment of acute exacerbation of chronic obstructive pulmonary disease (COPD) with heat of lung heat. Before and after treatment, CAT score, symptom and sign score, procalcitonin protopril, percentage of neutrophils, chest radiography were observed. The change of hospitalization time, so as to compare the clinical effect of combined Chinese medicine decoction treatment, whether it can play an important role in improving symptoms and shortening hospital stay. Prospective study methods. Sixty patients with AECOPD with lung heat accumulation were selected and randomly assigned to the experimental group and the control group with 30 cases in each group. The patients in the control group were treated with routine western medicine, and the patients in the control group were treated with routine western medicine, and the patients in each group were randomly assigned to the experimental group and the control group. The specific treatment plan was: 2 ml sodium chloride solution 2ml salbutamol sulfate inhalation solution 2ml inhalation ipratropium bromide solution 2ml inhaled budesonide suspension 2ml oxygen atomization inhalation, 3 times a day. The course of treatment was 5 days with 0.9% sodium chloride solution 10ml ambroxol injection 30mg intravenously, and then oral sodium chloride solution 100ml doxorophylline 0.1 g intravenously injected every 12 hours for 5 days. The experimental group was treated with Qingjinhuatan decoction on the basis of the control group. The CAT, symptom and sign scores, chest film and hospitalization time of the two groups were observed before and after treatment, and the statistical analysis was carried out with SPSS22.0 software. Therefore, the clinical efficacy of Qingjin Huatan decoction in the treatment of AECOPD with lung heat obstruction was systematically evaluated, and theoretical support was provided for its wide clinical application in the future. Results: before treatment, the patients in the two groups had cat scores of gender and age. There was no significant difference in the scores of symptoms and signs between the two groups (P 0.05). After treatment, the above data and the length of stay were compared between the two groups, which indicated that the effect of the experimental group was better than that of the control group, and the results showed that there was no significant difference between the two groups. Conclusion: the clinical effect of Qingjin Huatan decoction (QJHuatang) in the treatment of AECOPD with lung heat obstruction is more significant than that of western medicine alone. Conclusion: the clinical symptoms are improved by observing the clinical effect of Qingjin Huatan decoction combined with western medicine in the treatment of AECOPD with lung heat blockage. The treatment of Qingjin Huatan decoction combined with western medicine is effective and worthy of wide clinical application.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R563.9

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