清肺化浊汤治疗慢性阻塞性肺疾病急性加重期痰热郁肺证的疗效观察
发布时间：2018-12-17 13:12
【摘要】：目的:通过观察清肺化浊汤对慢性阻塞性肺疾病急性加重期痰热郁肺证患者的临床证候疗效、血清TNF-α、肺功能及CAT评分的影响,探讨清肺化浊汤对AECOPD的疗效及可能的作用机制,为AECOPD临床治疗提供理论依据。方法:将符合纳入标准的60例AECOPD患者,采用随机数字表法分为两组,治疗组和对照组各30例。对照组采用西医常规治疗,予氧疗,长效抗胆碱能药物喷入、雾化化痰药及支气管舒张剂,静滴抗生素、化痰药物;治疗组在对照组的基础上,加服用清肺化浊汤(每日一剂,早晚分服),疗程为14天。以了解两组患者用药前后及两组组间临床症状体征改变、血清TNF-α、肺通气功能、血气分析、CAT评分的变化。结果:1.临床证候疗效:症状和体征的证候总积分,治疗组和对照组分别自身前后比较,治疗后组间比较,差异具有统计学意义(P0.05)。治疗后,两组组间证候积分比较,差异具有统计学意义(P0.05)。2.血清TNF-α:治疗后,治疗组与对照组患者血清TNF-α水平分别与治疗前相比,差异具有统计学意义(P0.05)。治疗后,治疗组患者血清TNF-α水平与对照组相比,差异具有统计学意义(P0.05)。3.肺功能:治疗后治疗组和对照组肺功能FEV1占预计值百分比分别与治疗前相比,差异具有统计学意义(P0.05),治疗后治疗组与对照组组间比较肺功能FEV1占预计值%差异无统计学意义(P0.05)。4.CAT评分:治疗后,治疗组与对照组患者CAT评分分别与治疗前相比,差异具有统计学意义(P0.05)。治疗后,治疗组患者CAT评分与对照组相比,差异具有统计学意义(P0.05)。5.血气分析(PO2、PCO2):治疗后对照组和治疗组分别与治疗前相比,P0.05,具有统计学意义,说明两组均能改善患者血气水平;对照组和治疗组组间比较,P0.05,无统计学意义,说明治疗组对患者血气的改善优于对照组。结论:1.清肺化浊汤联合西医常规治疗可改善AECOPD患者总的临床症状和体征,提高总有效率,且在改善咳痰、Up音方面有一定优势。2.清肺化浊汤联合西医常规治疗可改善AECOPD患者血清TNF-α水平,提示清肺化浊汤可能有减轻气道炎症作用。3.清肺化浊汤联合西医常规治疗可以改善AECOPD患者CAT评分,提高患者生活质量。4.清肺化浊汤联合西医常规治疗短期改善AECOPD患者肺功能FEV1占预计值%水平,改善情况与西药常规治疗相同。5.清肺化浊汤联合西医常规治疗可以改善AECOPD患者血气分析,改善情况优于西药常规治疗。
[Abstract]:Objective: to observe the effect of Qingfei Huazhuo decoction on the clinical syndrome, serum TNF- 伪, pulmonary function and CAT score in patients with acute exacerbation of chronic obstructive pulmonary disease. To explore the therapeutic effect and possible mechanism of Qingfei Huazhuo decoction on AECOPD, and to provide theoretical basis for clinical treatment of AECOPD. Methods: 60 patients with AECOPD were randomly divided into two groups: treatment group (n = 30) and control group (n = 30). The control group was treated with routine western medicine, oxygen therapy, injection of long-term anticholinergic drugs, atomization of phlegm and bronchodiastolic agents, intravenous drip of antibiotics, phlegm drugs. Treatment group on the basis of the control group, plus Qingfei Huazhuo decoction (one dose per day, morning and evening divided), the course of treatment is 14 days. To investigate the changes of clinical symptoms and signs, serum TNF- 伪, pulmonary ventilation function, blood gas analysis and CAT score before and after treatment. Results: 1. Clinical syndromes efficacy: symptoms and signs of the syndrome of the total score, treatment group and control group before and after comparison, after treatment, the difference was statistically significant (P0.05). After treatment, the two groups between the syndromes score comparison, the difference was statistically significant (P0.05). Serum TNF- 伪: after treatment, the level of serum TNF- 伪 in treatment group and control group was significantly higher than that before treatment (P0.05). After treatment, the serum TNF- 伪 level in the treatment group was significantly higher than that in the control group (P0.05). Pulmonary function: after treatment, the percentage of FEV1 in predicted value in treatment group and control group was significantly higher than that before treatment (P0.05). There was no significant difference in pulmonary function FEV1% between the treatment group and the control group after treatment (P0.05). 4.CAT score: after treatment, the CAT score of the treatment group and the control group were compared with those before treatment, respectively. The difference was statistically significant (P0.05). After treatment, the CAT score of the patients in the treatment group was significantly different from that in the control group (P0.05). Blood gas analysis (PO2,PCO2): control group and treatment group after treatment compared with before treatment, P0.05, with statistical significance, indicating that both groups can improve the blood gas level of patients; There was no significant difference between the control group and the treatment group (P 0.05), indicating that the improvement of blood gas in the treatment group was better than that in the control group. Conclusion: 1. Qingfei Huazhuo decoction combined with routine western medicine treatment can improve the total clinical symptoms and signs of AECOPD patients, improve the total effective rate, and improve sputum, Up sound has a certain advantage. 2. Qingfei Huazhuo decoction combined with routine western medicine treatment can improve the level of serum TNF- 伪 in patients with AECOPD, suggesting that Qingfei Huazhuo decoction may reduce airway inflammation. 3. Qingfei Huazhuo decoction combined with routine western medicine treatment can improve the CAT score of patients with AECOPD, improve the quality of life of patients. 4. Qingfei Huazhuo decoction combined with routine western medicine treatment for short-term improvement of pulmonary function of AECOPD patients with FEV1 accounted for% of the predicted level, the improvement of the situation is the same as the routine treatment of western medicine. 5. 5. Qingfei Huazhuo decoction combined with conventional western medicine can improve blood gas analysis of patients with AECOPD.
【学位授予单位】：湖南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259
本文编号：2384244
[Abstract]:Objective: to observe the effect of Qingfei Huazhuo decoction on the clinical syndrome, serum TNF- 伪, pulmonary function and CAT score in patients with acute exacerbation of chronic obstructive pulmonary disease. To explore the therapeutic effect and possible mechanism of Qingfei Huazhuo decoction on AECOPD, and to provide theoretical basis for clinical treatment of AECOPD. Methods: 60 patients with AECOPD were randomly divided into two groups: treatment group (n = 30) and control group (n = 30). The control group was treated with routine western medicine, oxygen therapy, injection of long-term anticholinergic drugs, atomization of phlegm and bronchodiastolic agents, intravenous drip of antibiotics, phlegm drugs. Treatment group on the basis of the control group, plus Qingfei Huazhuo decoction (one dose per day, morning and evening divided), the course of treatment is 14 days. To investigate the changes of clinical symptoms and signs, serum TNF- 伪, pulmonary ventilation function, blood gas analysis and CAT score before and after treatment. Results: 1. Clinical syndromes efficacy: symptoms and signs of the syndrome of the total score, treatment group and control group before and after comparison, after treatment, the difference was statistically significant (P0.05). After treatment, the two groups between the syndromes score comparison, the difference was statistically significant (P0.05). Serum TNF- 伪: after treatment, the level of serum TNF- 伪 in treatment group and control group was significantly higher than that before treatment (P0.05). After treatment, the serum TNF- 伪 level in the treatment group was significantly higher than that in the control group (P0.05). Pulmonary function: after treatment, the percentage of FEV1 in predicted value in treatment group and control group was significantly higher than that before treatment (P0.05). There was no significant difference in pulmonary function FEV1% between the treatment group and the control group after treatment (P0.05). 4.CAT score: after treatment, the CAT score of the treatment group and the control group were compared with those before treatment, respectively. The difference was statistically significant (P0.05). After treatment, the CAT score of the patients in the treatment group was significantly different from that in the control group (P0.05). Blood gas analysis (PO2,PCO2): control group and treatment group after treatment compared with before treatment, P0.05, with statistical significance, indicating that both groups can improve the blood gas level of patients; There was no significant difference between the control group and the treatment group (P 0.05), indicating that the improvement of blood gas in the treatment group was better than that in the control group. Conclusion: 1. Qingfei Huazhuo decoction combined with routine western medicine treatment can improve the total clinical symptoms and signs of AECOPD patients, improve the total effective rate, and improve sputum, Up sound has a certain advantage. 2. Qingfei Huazhuo decoction combined with routine western medicine treatment can improve the level of serum TNF- 伪 in patients with AECOPD, suggesting that Qingfei Huazhuo decoction may reduce airway inflammation. 3. Qingfei Huazhuo decoction combined with routine western medicine treatment can improve the CAT score of patients with AECOPD, improve the quality of life of patients. 4. Qingfei Huazhuo decoction combined with routine western medicine treatment for short-term improvement of pulmonary function of AECOPD patients with FEV1 accounted for% of the predicted level, the improvement of the situation is the same as the routine treatment of western medicine. 5. 5. Qingfei Huazhuo decoction combined with conventional western medicine can improve blood gas analysis of patients with AECOPD.
【学位授予单位】：湖南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259
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