摘要
目的 探讨健脾祛湿化瘀膏联合常规西药治疗缓解期支气管扩张症的临床疗效.方法 选取 2020 年 3 月至 2022年 3 月于秦皇岛市中医医院诊治的缓解期支气管扩张症患者 80 例为研究对象,随机分为观察组和对照组,每组 40 例.对照组常规应用扩张支气管、抗炎、抗感染等常规西药治疗,给予沙美特罗替卡松联合小剂量红霉素治疗.观察组在对照组治疗基础上联合应用健脾祛湿化瘀膏治疗.比较两组临床疗效,治疗前后中医证候评分变化、肺功能指标[肺一氧化碳弥散量(DLCO)、第一秒钟用力呼气容积(FEV1)、用力肺活量(FVC)]、炎症指标[C反应蛋白(CRP)、中性粒细胞(GRAN)、白细胞计数(WBC)]、24 h痰液总量以及治疗后 6 个月内急性加重次数、圣乔治呼吸问卷(SGOR)评分改善情况,不良反应发生情况.结果 观察组治疗有效率高于对照组(P＜0.05);治疗后两组各项中医证候积分降低,且观察组低于对照组,差异有统计学意义(P＜0.05);治疗后两组FEV1、FVC、DLCO升高,且观察组高于对照组,差异有统计学意义(P＜0.05);治疗后两组WBC、GRAN、CRP水平降低,且观察组低于对照组,差异有统计学意义(P＜0.05);治疗后两组24 h痰液总量以及治疗后6 个月内急性加重次数降低,且观察组低于对照组,差异有统计学意义(P＜0.05);治疗后两组呼吸症状、活动受限、疾病影响评分及SQRQ总分降低,且观察组低于对照组,差异有统计学意义(P＜0.05);治疗期间,两组均未出现皮疹等不良反应.结论 健脾祛湿化瘀膏联合常规西药治疗缓解期支气管扩张症可明显缓解临床症状及体征,控制病情进一步加重,减轻炎症反应,改善患者的肺功能及气流受阻状态,同时不会加重药物不良反应.
Abstract
Objective To explore the clinical effect of Jianpi Qushi Huayu ointment combined with conventional western medicine in the treatment of bronchiectasis in remission.Methods A total of 80 patients with bronchiectasis in remission who were treated in Qinhuangdao Hospital of Traditional Chinese Medicine from March 2020 to March 2022 were selected as the study objects and randomly divided into observation group and control group,with 40 cases in each group.The control group was treated with bronchial dilation,anti-inflammatory,anti-infection and other conventional western drugs,and was given salmeterol ticasone combined with low-dose erythromycin.Observation group was treated with Jianpi Qushi Huayu ointment on the basis of control group.The clinical efficacy,changes of TCM syndrome score,pulmonary function indicators[pulmonary carbon monoxide diffusion volume(DLCO),forced expiratory volume in the first second(FEV1),forced vital capacity(FVC)],inflammatory indicators[C-reactive protein(CRP),neutrophil(GRAN),white blood cell count(WBC)],24 h Total sputum volume,number of acute exacerbations within 6 months after treatment,improvement in St.George's Respiratory Questionnaire(SGOR)score before and after treatment,and occurrence of adverse reactions of the two groups were compared.Results The effective rate of the observation group was higher than that of the control group(P＜0.05).After treatment,the scores of TCM syndrome of the two groups decreased,and the observation group was lower than the control group,the difference was statistically significant(P＜0.05).After treatment,FEV1,FVC and DLCO of the two groups were increased,and the observation group was higher than the control group,the difference was statistically significant(P＜0.05).After treatment,the levels of WBC,GRAN and CRP in the two groups were decreased,and the observation group was lower than the control group,the difference was statistically significant(P＜0.05).After treatment,the total amount of sputum at 24 h and the number of acute exacerbations within 6 months after treatment were decreased,and the observation group was lower than the control group,the difference was statistically significant(P＜0.05).After treatment,respiratory symptoms,activity restriction,disease impact score and SQRQ total score of both groups were decreased,and the observation group was lower than the control group,the difference was statistically significant(P＜0.05).During treatment,no adverse reactions such as rash were found in both groups.Conclusion Jianpiqushi Huayu ointment combined with conventional western medicine can significantly relieve clinical symptoms and signs,control further aggravation of the disease,reduce inflammation,improve lung function and airflow obstruction of patients,and will not aggravate adverse drug reactions.
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