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纸质出版日期:2016
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何延忠, 周淼. 涤浊化痰汤治疗急性加重期慢性阻塞性肺疾病痰瘀阻肺证临床观察[J]. 中国实验方剂学杂志, 2016,22(19):135-139.
HE Yan-zhong, ZHOU Miao. Clinical Observation of Dizhuo Huatan Decoction on AECOPD with Syndrome of Phlegm and Blood Stasis Obstructing Lung[J]. Chinese journal of experimental traditional medical formulae, 2016, 22(19): 135-139.
何延忠, 周淼. 涤浊化痰汤治疗急性加重期慢性阻塞性肺疾病痰瘀阻肺证临床观察[J]. 中国实验方剂学杂志, 2016,22(19):135-139. DOI: 10.13422/j.cnki.syfjx.2016190135.
HE Yan-zhong, ZHOU Miao. Clinical Observation of Dizhuo Huatan Decoction on AECOPD with Syndrome of Phlegm and Blood Stasis Obstructing Lung[J]. Chinese journal of experimental traditional medical formulae, 2016, 22(19): 135-139. DOI: 10.13422/j.cnki.syfjx.2016190135.
目的:探讨涤浊化痰汤对急性加重期慢性阻塞性肺疾病(AECOPD)痰瘀阻肺证患者肺功能和炎症因子的影响,并探讨其作用机制。方法:156例AECOPD患者随机分为对照组和观察组。对照组给予控制性氧疗,抗感染,激素,支气管舒张剂等综合治疗措施。对照组给予异丙托溴铵气雾剂,4次/d,1次2喷;注射用头孢米诺钠,2 g/次,静脉滴注,2次/d;口服乙酰半胱氨酸颗粒,0.4 g/次,3次/d。观察组在对照组的基础上加用涤浊化痰汤,1剂/d。两组疗程均为2周。检测治疗前后肺功能,记录第1秒用力呼气容积占用力肺活量的百分比(FEV1/FVC)和第1秒用力呼气容积占预计值百分比(FEV1%);动脉血气分析指标包括血氧分压(PaO2),二氧化碳分压(PaCO2)和血氧饱和度(SaO2),治疗前后各检测1次;痰瘀阻肺证评分、呼吸困难严重程度采用改良版英国医学研究委员会呼吸问卷(mMRC)和慢阻肺患者自我评估测试(CAT),治疗前后各评价1次;检测治疗前后核转录因子-κB(NF-κB),血清白细胞介素-10(IL-10),肿瘤坏死因子-α(TNF-α)和超敏C-反应蛋白(hs-CRP)水平。结果:观察组临床疗效总有效率高于对照组(P<0.05);观察组气流受限严重程度的肺功能分级低于对照组(P<0.05);治疗后观察组痰瘀阻肺证,mMRC,CAT评分低于对照组(P<0.01);治疗后观察组FEV1和FEV1/FVC均高于对照组(P<0.01)。治疗后观察组PaCO2低于对照组,PaO2和SaO2高于对照组(P<0.01)。治疗后观察组NF-κB,TNF-α和hs-CRP水平低于对照组,IL-10高于对照组(P<0.01)。结论:在西医常规治疗的基础上,加用涤浊化痰汤治疗AECOPD痰瘀阻肺证能进一步减轻临床症状,改善肺功能,减轻炎症反应,提高临床疗效。
Objective: To discuss the effects of Dizhuo Huatan decoction on lung function and inflammatory factors in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with syndrome of phlegm and blood stasis obstructing lung
and investigate its action mechanism. Method: One hundred and fifty-six patients were randomly divided into control group and observation group. Patients in control group took controlled oxygen therapy
anti-infection
hormone
bronchodilators
ipratropium bromide aerosol
4 times/day
2 sprays/time
cefminox sodium for injection
2 g/time
2 times/day
acetylcysteine granules
0.4 g/time
3 times/day. Based on the treatment of control group
patients in observation group also received Dizhuo Huatan decoction
1 dose/day. The treatment course was 2 weeks for both groups. Before and after treatment
lung function was detected
forced vital capacity rate of one second (FEV/FVC) and forced expiratory volume in 1 second (FEV1%) were recorded. Blood oxygen pressure (PaO2)
partial pressure of carbon dioxide (PaCO2) and oxygen saturation were detected before and after treatment. Scores of syndrome of phlegm and blood stasis obstructing lung and difficulty in breathing severity were evaluated by Modified the medical research council respiratory questionnaire (mMRC) and COPD patients self assessment test (CAT) before and after treatment. The levels of nuclear factor-κB (NF-κB)
serum interleukin-10 (IL-10)
tumor necrosis factor-α (TNF-α) and hypersensitive C-reactive protein (hs-CRP) were detected. Result: The total clinical effect rate in observation group was higher than that in control group (P<0.05). Pulmonary function grading of airflow limitation severity in observation group was lower than that in control group (P<0.05). Scores of syndrome of phlegm and blood stasis obstructing lung
mMRC and CAT in observation group were lower than those in control group (P<0.01). FEV1 and FEV1/FVC in observation group were higher than those in control group after treatment (P<0.01). PaCO2 in observation group was lower than that in control group
and levels of PaO2 and SaO2were higher than those in control group after treatment (P<0.01). Levels of NF-κB
TNF-α and hs-CRP in observation group were lower than those in control group
while the level of IL-10 was higher than that in control group after treatment (P<0.01). Conclusion: Based on the treatment of routine western medicine
Dizhuo Huatan decoction can ameliorate symptoms and lung function and relieve inflammatory response when it is used for AECOPD with syndrome of phlegm and blood stasis obstructing lung.
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