论文部分内容阅读
目的:探讨清咳平喘颗粒辅助治疗慢性阻塞性肺疾病急性加重期(AECOPD)痰热壅肺证的临床疗效。方法:选取160例AECOPD痰热壅肺证患者,随机分为观察组和对照组,每组各80例。对照组予以常规治疗措施,观察组在此基础上辅以清咳平喘颗粒治疗。于治疗前、治疗7天后分别观察2组的临床证候积分、血气分析及肺功能指标。结果:2组患者治疗前临床证候积分比较,差异无显著性意义(P>0.05)。治疗7天后,2组临床证候积分均低于治疗前(P<0.05);且观察组临床证候积分低于对照组(P<0.05)。2组患者治疗前pH、血氧分压(PaO2)、血二氧化碳分压(PaCO2)比较,差异无显著性意义(P>0.05)。治疗7天后,2组PaO2均较治疗前升高(P<0.05);观察组PaCO2降低(P<0.05),对照组治疗前后PaCO2变化差异无显著性意义(P>0.05);2组间PaO2比较,差异无显著性意义(P>0.05),观察组PaCO2低于对照组(P<0.05)。2组治疗前最大肺活量(FVC)、肺功能第1秒用力呼气量(FEV1)、第1秒用力呼气量占预计值的百分比(FEV1%)比较,差异无显著性意义(P>0.05)。治疗7天后,2组FVC、FEV1、FEV1%均较治疗前升高(P<0.05);观察组FEV1、FEV1%均高于对照组(P<0.05)。观察组临床控制41例,显效19例,进步17例,无效3例,总有效率96.25%;对照组临床控制23例,显效20例,进步26例,无效11例,总有效率86.25%;观察组总有效率高于对照组(P<0.05)。结论:在西医常规治疗的基础上,辅以清咳平喘颗粒治疗AECOPD痰热壅肺证,可有效缓解急性期呼吸困难症状,改善肺功能和血气指标,取得较好的临床疗效,优于单纯西药治疗。
Objective: To investigate the clinical effect of Qing Ke Ping Chuan Granule in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: 160 patients with AECOPD phlegm and heat lungs were selected and randomly divided into observation group and control group, 80 cases in each group. The control group was given routine treatment, the observation group was supplemented with Qingke Pingchuan granule on this basis. Before treatment, the clinical syndrome scores, blood gas analysis and lung function indexes of two groups were observed after 7 days of treatment. Results: There was no significant difference between the two groups in clinical syndrome scores before treatment (P> 0.05). After 7 days of treatment, the scores of clinical syndromes in both groups were lower than those before treatment (P <0.05), and the clinical syndrome scores in the observation group were lower than those in the control group (P <0.05). There was no significant difference in pH, PaO2 and PaCO2 between two groups before treatment (P> 0.05). PaO2 decreased in the observation group (P <0.05), and there was no significant difference in PaCO2 before and after treatment in the control group (P> 0.05). After the treatment for 7 days, the PaO2 in both groups increased significantly (P <0.05) There was no significant difference between the two groups (P> 0.05). PaCO2 in the observation group was lower than that in the control group (P <0.05). There were no significant differences in the maximum vital capacity (FVC), forced expiratory volume in one second of pulmonary function (FEV1) and forced expiratory volume in one second (FEV1%) before treatment in both groups (P> 0.05 ). After 7 days of treatment, the FVC, FEV1 and FEV1% of 2 groups were significantly higher than those before treatment (P <0.05). The FEV1 and FEV1% of the observation group were higher than those of the control group (P <0.05). In the observation group, 41 cases were clinically controlled, 19 cases were markedly improved, 17 cases were improved, 3 cases were ineffective and the total effective rate was 96.25%. In the control group, 23 cases were clinically controlled, 20 cases markedly improved, 26 cases improved and 11 ineffective, with a total effective rate of 86.25%. The total effective rate in observation group was higher than that in control group (P <0.05). Conclusion: Based on the routine treatment of Western medicine, combined with Qingke Pingchuan Granule in treating AECOPD phlegm and heat lungs card, it can effectively relieve the symptoms of dyspnea during the acute phase, improve the pulmonary function and blood gas indexes and achieve better clinical curative effect, which is better than Western medicine treatment.