目的 观察清金贝蒌汤加减联合布地奈德治疗痰热郁肺型慢性阻塞性肺疾病(Chronic obstructive pulmonary disease,COPD)的临床疗效.方法 选取2021年2月-2022年6月期间重庆市大足区人民医院收治的86例痰热郁肺型COPD患者作为试验对象开展研究,按照随机数字表法分为对照组和试验组,每组各43例.在常规治疗基础上,对照组给予吸入用布地奈德混悬液雾化吸入,试验组给予布地奈德+清金贝蒌汤治疗,两组患者均治疗10 d.观察比较两组患者临床疗效、不良反应情况,治疗前后中医症状积分、肺功能[第1秒用力呼气量(First second forced expiratory volume,FEV1)、第1秒用力呼气量占预计百分比(Expected percentage of forced expira-tory volume in the first second,FEV1％)、用力肺活量(Forced vital capacity,FVC)及第1秒用力呼气量占用力肺活量百分比(The percentage of forced expiratory volume to forced vital capacity in the first second,FEV1/FVC)]、血气分析指标[血氧分压(Partial pressure of oxygen,PaO2)、二氧化碳分压(Partial pressure of carbon dioxide,PaCO2)、动脉氧合指数(Ratio of partial pressure of O2 in arterial blood to fraction of inspired oxygen,PaO2/FiO2)]水平变化.结果 治疗后试验组临床疗效总有效率95.35％(41/43)与对照组90.70％(39/43)比较,差异无统计学意义(P＞0.05);试验组临床控制率62.79％(27/43)明显高于对照组44.19％(19/43),差异有统计学意义(P＜0.05).治疗后两组患者中医症状喘急、咳嗽、痰量、痰色及痰质积分均较治疗前降低,差异有统计学意义(P＜0.05);且试验组中医症状喘急、咳嗽、痰量、痰色及痰质积分均明显低于对照组,差异有统计学意义(P＜0.05).治疗后两组患者肺功能FVE1、FEV1％、FVC、FEV1/FVC指标均较治疗前升高,差异有统计学意义(P＜0.05);且试验组肺功能FVE1、FEV1％、FVC、FEV1/FVC指标均明显高于对照组,差异有统计学意义(P＜0.05).治疗后两组患者PaO2、PaO2/FiO2水平均较治疗前升高,PaCO2均较治疗前降低,差异有统计学意义(P＜0.05);且试验组PaO2、PaO2/FiO2水平均明显高于对照组,PaCO2水平明显低于对照组,差异有统计学意义(P＜0.05).治疗期间,试验组不良反应发生率9.30％(4/43)与对照组6.98％(3/43)比较,差异无统计学意义(P＞0.05).结论 清金贝蒌汤加减辅助布地奈德治疗痰热郁肺型COPD安全、有效,有利于提高患者肺功能、改善血气状态.
Clinical Efficacy of Modified Qingjin Beilou Decoction Combined with Budesonide in the Treatment of Chronic Obstructive Pulmonary Disease of Phlegm-heat Obstruc-ting Lung type
Objective To investigate the clinical value of modified Qingjin Beilou Decoction combined with budesonide in the treatment of chronic obstructive pulmonary disease(COPD)of phlegm-heat obstructing lung type.Methods A total of 86 patients with COPD of phlegm-heat obstructing lung type admitted to The People's Hospital of Dazu,Chongqing,from February 2021 to June 2022 were selected as the experimental subjects for the study,and they were randomly divided into control group and test group according to random number table method,with 43 patients in each group.On the basis of routine treatment,the patients in control group were treated with inhalation of budesonide suspension and the patients in test group were treated with budesonideand Qingjin Beilou decoction.The patients in both groups were treated for 10 days.The clinical efficacy,adverse reactions,TCM symptom scores before and after treatment,pulmonary function indexes including forced expiratory volume in the first second(FEV1),expected percentage of forced expiratory volume in the first second(FEV 1％),forced vital capacity(FVC)and the percentage of forced expiratory volume to forced vital capacity in the first second(FEV1/FVC),and blood gas analysis indexes including partial pressure of blood oxygen(PaO2),partial pressure of carbon dioxide(PaCO2),ratio of PaO2 in arterial blood to fraction of inspired oxygen(PaO2/FiO2)were compared between the two groups.Results After the treatment,there was no significant difference in the total effective rate between the test group(95.35％)and the control group(90.70％)(P＞0.05).But,the clinical control rate was 62.79％in the test group,which was higher than that in the control group(44.19％)(P＜0.05).After treatment,the TCM symptom scores of dyspnea,cough,sputum volume,sputum color and sputum quality in the two groups were decreased significantly compared with those before treatment(P＜0.05),and the scores of each dimension in the test group were low-er than those in the control group(P＜0.05).After treatment,the pulmonary function indexes including the levels of FVE1,FEV1％,FVC,FEV1/FVC in both groups were increased significantly compared with those before treatment(P＜0.05),and the pulmonary function indexes in the test group were higher than those in the control group(P＜0.05).After treatment,the levels of PaO2 and PaO2/FiO2 in the two groups were significantly improved compared with those before treatment,and PaCO2 level was lower than that before treatment(P＜0.05).In addition,PaO2 and PaO2/FiO2 levels in the test group were significantly higher than those in control group,and PaCO2 level was significantly lower than that in control group(P＜0.05).During the treatment,there was no significant difference in the incidence of adverse reactions between the test group(9.30％)and the control group(6.98％)(P＞0.05).Conclusion Modified Qingjin Beilou decoction as-sisted with budesonide is safe and effective in the treatment of COPD of phlegm-heat obstructing lung type,which is bene-ficial to improve the lung function and blood gas status of patients,and is worth popularizing.
Chronic Obstructive Pulmonary DiseaseSyndrome of Phlegm-heat Obstructing LungBudesonideQingjin Beilou DecoctionLung FunctionBlood Gas Status
万方数据
维普
