苇金消痈汤加减辅助治疗支气管扩张急性加重期痰热壅肺证的临床分析

发布时间：2018-03-26 04:36

本文选题：苇金消痈汤　切入点：支气管扩张　出处：《中国实验方剂学杂志》2016年15期

【摘要】：目的:探讨苇金消痈汤加减辅助治疗痰热壅肺型支气管扩张急性加重期的疗效以及对痰液和血清中基质金属蛋白酶-9(MMP-9)和基质金属蛋白酶抑制剂-1(TIMP-1)的影响。方法:收集支气管扩张急性加重期患者98例,参照随机按数字表法平均分为对照组和治疗组各49例;两组患者参照《成人支气管扩张症诊治专家共识》给予非药物干预。对照组抗感染采取盐酸左旋氧氟沙星注射液,0.4 g加入生理盐水400 m L,200 m L/次,2次/d;对铜绿假单胞菌感染者,0.6 g加入生理盐水600 m L,300 m L/次,2次/d。化痰采取氨溴索注射液,30 mg加入生理盐水100 m L,1次/d。治疗组在对照组治疗的基础上给予苇金消痈汤,1剂/d,常规水煎煮2次,分早晚2次内服。两组疗程均为2周。比较两组第1秒最大呼气量(FEV1),FEV1/用力肺活量(FVC),血氧分压(Pa O2),二氧化碳分压(Pa CO2),血氧饱和度(Sa O2)及临床症状评分;分析两组患者临床疗效;测定两组患者痰液和血清中MMP-9,TIMP-1水平。结果:治疗后治疗组FEV1,FEV1/FVC,Pa O2和Sa O2均明显高于对照组,而Pa CO2和咳嗽等临床积分均明显低于对照组(P0.01);治疗组和对照组临床治疗总有效率分别为95.92%和79.59%,治疗组明显优于对照组(P0.05);治疗后治疗组痰液和血清中MMP-9水平均明显低于对照组,而TIMP-1高于对照组(P0.01)。结论:在常规西医治疗的基础上,苇金消痈汤辅助治疗痰热壅肺型支气管扩张急性加重期疗效确切,抑制痰液和血清中MMP-9水平及上调TIMP-1水平可能在其中发挥重要作用。
[Abstract]:Objective: to investigate the effect of Weijin Xiaoyong decoction on acute exacerbation of bronchiectasis caused by phlegm-heat obstruction and its effect on matrix metalloproteinase-9 (MMP-9) and matrix metalloproteinase-inhibitor (TIMP-1) in sputum and serum. Methods:. 98 patients with acute exacerbation of bronchiectasis were collected. The patients were randomly divided into control group (n = 49) and treatment group (n = 49). Two groups of patients with bronchiectasis were given non-drug intervention according to the consensus of experts in the diagnosis and treatment of adult bronchiectasis. In the control group, 0.4 g levofloxacin hydrochloride injection was added to 400 mL normal saline 200 mL / twice a day. The patients infected with bacillus monocytogenes were treated with 0.6 g of normal saline and 300 mL of normal saline twice a day. The phlegm was treated with 30 mg ambroxol injection and 100 mL normal saline once a day. The treatment group was treated with Weijinxiaocarbung decoction 1 / d and the routine water decoction was boiled twice on the basis of the treatment of the control group. The course of treatment was 2 weeks. The maximal expiratory volume of FEV1 / FEV1 / forced vital capacity (FVC1), partial pressure of oxygen (Pao 2), partial pressure of carbon dioxide (PACO 2), saturation of blood oxygen (sa O 2) and clinical symptom score were compared between the two groups, and the clinical efficacy of the two groups was analyzed. Results: the levels of MMP-9 and TIMP-1 in sputum and serum of the two groups were significantly higher than those in the control group. The clinical scores of Pa CO2 and cough were significantly lower than those of the control group (P 0.01), the total effective rates of the treatment group and the control group were 95.92% and 79.59%, respectively, which were significantly better than those of the control group (P 0.05), and the levels of MMP-9 in sputum and serum were significantly lower in the treatment group than in the control group. TIMP-1 was higher than that of control group (P 0.01). Conclusion: on the basis of routine western medicine, Weijin Xiaoyong decoction is effective in treating acute exacerbation of bronchiectasis with phlegm-heat and lung obstruction. Inhibition of MMP-9 and up-regulation of TIMP-1 in sputum and serum may play an important role in it.
【作者单位】：即墨市中医医院;青岛大学医学院附属医院;
【基金】：山东省自然科学基金项目(ZR2009CL018)
【分类号】：R562.22

【相似文献】