清热解毒扶正汤对AECOPD（痰热壅肺兼气阴两虚）的临床研究

发布时间：2018-10-26 15:59

【摘要】：目的:观察清热解毒扶正汤联合西药对慢性阻塞性肺疾病急性加重期(痰热壅肺兼气阴两虚)的临床疗效、改善中医临床症状的作用以及对血清SAA的影响。方法:将符合纳入标准的AECOPD患者72例按随机数字表法分为对照组和治疗组,两组患者在年龄、性别、病程方面无显著差异。最终入选患者62例,对照组31例,治疗组31例。对照组采用常规西医治疗,治疗组在常规西医治疗的基础上,同时加服清热解毒扶正汤,一日一剂,观察疗程14天。治疗前后分别记录临床观察指标,最后运用统计学的方法进行疗效判定。结果:(1)对照组显效率为35.48%,总有效率为83.87%,治疗组显效率为70.97%,总有效率90.32%,治疗组的疗效明显优于对照组。(2)治疗组和对照组均能改善中医证候总积分(P0.01),但治疗组在改善中医证候总积分方面明显优于对照组(P0.01)。(3)对照组在改善咳嗽、咯痰、喘息、气短、肺部Up音、发热、渴喜冷饮方面差异有统计学意义(P0.01);在改善自汗、倦怠乏力、盗汗、大便干结、手足心热、口干治疗前后差异无统计学意义(P0.05);治疗组能有效改善咳嗽、咯痰、喘息、气短、自汗、倦怠乏力、盗汗、肺部Up音、发热、渴喜冷饮、大便干结、手足心热、口干症状(P0.01),且效果均优于对照组(P0.05)。(4)两组均能有效改善血清CRP、SAA浓度(P0.01),治疗组在降低血清CRP、SAA浓度方面优于对照组(P0.05)。(5)两组患者肺功能较治疗前均有显著改善(P0.01),治疗后两组患者FEV1、FVC、FEV1%差异均有统计学意义(P0.05),而FEV1/FVC(%)差异则无统计学意义(P0.05)。(6)两组患者的白细胞计数、中性粒细胞(%)、淋巴细胞(%)较治疗前均有改善(P0.01),治疗后对照组与治疗组白细胞计数、中性粒细胞(%)、淋巴细胞百分比差异不显著(P0.05)。(7)两组患者治疗前后未见不良反应。结论:清热解毒扶正汤对慢性阻塞性肺疾病急性加重期(痰热壅肺兼气阴两虚)具有良好的疗效和安全性,能有效降低患者血清SAA及CRP浓度水平,尤其对于改善患者咳嗽、喘息、自汗、倦怠乏力、盗汗等症状具有显著作用,能提高临床治疗的有效率,具有较高的临床应用价值。
[Abstract]:Objective: to observe the clinical effect of Qingre jiedu Fuzheng decoction combined with western medicine on acute exacerbation of chronic obstructive pulmonary disease (COPD), improve the clinical symptoms of TCM and influence on serum SAA. Methods: 72 AECOPD patients who met the inclusion criteria were divided into control group and treatment group according to random digital table method. There was no significant difference in age, sex and course of disease between the two groups. Finally, 62 cases were selected, 31 cases in control group and 31 cases in treatment group. The control group was treated with routine western medicine, and the treatment group was treated with Qingre jiedu Fuzheng decoction on the basis of routine western medicine treatment. The clinical observation indexes were recorded before and after treatment, and the curative effect was determined by statistical method. Results: (1) in the control group, the effective rate was 35.48 and the total effective rate was 83.87. In the treatment group, the effective rate was 70.97 and the total effective rate was 90.32. The therapeutic effect of the treatment group was significantly better than that of the control group. (2) both the treatment group and the control group could improve the total score of TCM syndromes (P0.01). However, the treatment group was superior to the control group in improving the total score of TCM syndromes (P0.01). (3). The control group improved cough, sputum, wheezing, shortness of breath, lung Up sound, fever. The difference of thirst and cold drink was statistically significant (P0.01). In the improvement of self-sweat, fatigue, night sweat, stool dry knot, heart heat, dry mouth before and after treatment had no statistical significance (P0.05); In the treatment group, cough, sputum, wheezing, shortness of breath, self-sweating, fatigue, night sweat, lung Up sound, fever, thirst, cold drink, stool dry knot, heart and foot fever, dry mouth symptoms were improved (P0.01). The effect was better than that of the control group (P0.05). (4). Both groups could improve the serum CRP,SAA concentration (P0.01). The treatment group was reducing the serum CRP,. The concentration of SAA was better than that of the control group (P0.05). (5). The pulmonary function of the two groups was significantly improved than that before treatment (P0.01), and the difference of FEV1,FVC,FEV1% between the two groups after treatment was statistically significant (P0.05). However, there was no significant difference in FEV1/FVC (%) between the two groups (P0.05). (6). The leukocyte count, neutrophils (%) and lymphocytes (%) in the two groups were improved compared with those before treatment (P0.01). After treatment, there was no significant difference in leukocyte count, neutrophils (%) and lymphocyte percentage between control group and treatment group (P0.05). (7). Conclusion: Qingre jiedu Fuzheng decoction has good curative effect and safety in acute exacerbation of chronic obstructive pulmonary disease (phlegm and heat obstruction of lung and deficiency of qi and yin). It can effectively reduce serum SAA and CRP levels, especially in improving cough. Wheezing, self-sweating, fatigue, night sweating and other symptoms have a significant effect, can improve the effective rate of clinical treatment, has a higher clinical application value.
【学位授予单位】：云南中医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

【参考文献】