清熱解毒扶正湯對AECOPD（痰熱壅肺兼氣陰兩虛）的臨床研究
發(fā)布時(shí)間：2018-10-26 15:59
【摘要】：目的:觀察清熱解毒扶正湯聯(lián)合西藥對慢性阻塞性肺疾病急性加重期(痰熱壅肺兼氣陰兩虛)的臨床療效、改善中醫(yī)臨床癥狀的作用以及對血清SAA的影響。方法:將符合納入標(biāo)準(zhǔn)的AECOPD患者72例按隨機(jī)數(shù)字表法分為對照組和治療組,兩組患者在年齡、性別、病程方面無顯著差異。最終入選患者62例,對照組31例,治療組31例。對照組采用常規(guī)西醫(yī)治療,治療組在常規(guī)西醫(yī)治療的基礎(chǔ)上,同時(shí)加服清熱解毒扶正湯,一日一劑,觀察療程14天。治療前后分別記錄臨床觀察指標(biāo),最后運(yùn)用統(tǒng)計(jì)學(xué)的方法進(jìn)行療效判定。結(jié)果:(1)對照組顯效率為35.48%,總有效率為83.87%,治療組顯效率為70.97%,總有效率90.32%,治療組的療效明顯優(yōu)于對照組。(2)治療組和對照組均能改善中醫(yī)證候總積分(P0.01),但治療組在改善中醫(yī)證候總積分方面明顯優(yōu)于對照組(P0.01)。(3)對照組在改善咳嗽、咯痰、喘息、氣短、肺部Up音、發(fā)熱、渴喜冷飲方面差異有統(tǒng)計(jì)學(xué)意義(P0.01);在改善自汗、倦怠乏力、盜汗、大便干結(jié)、手足心熱、口干治療前后差異無統(tǒng)計(jì)學(xué)意義(P0.05);治療組能有效改善咳嗽、咯痰、喘息、氣短、自汗、倦怠乏力、盜汗、肺部Up音、發(fā)熱、渴喜冷飲、大便干結(jié)、手足心熱、口干癥狀(P0.01),且效果均優(yōu)于對照組(P0.05)。(4)兩組均能有效改善血清CRP、SAA濃度(P0.01),治療組在降低血清CRP、SAA濃度方面優(yōu)于對照組(P0.05)。(5)兩組患者肺功能較治療前均有顯著改善(P0.01),治療后兩組患者FEV1、FVC、FEV1%差異均有統(tǒng)計(jì)學(xué)意義(P0.05),而FEV1/FVC(%)差異則無統(tǒng)計(jì)學(xué)意義(P0.05)。(6)兩組患者的白細(xì)胞計(jì)數(shù)、中性粒細(xì)胞(%)、淋巴細(xì)胞(%)較治療前均有改善(P0.01),治療后對照組與治療組白細(xì)胞計(jì)數(shù)、中性粒細(xì)胞(%)、淋巴細(xì)胞百分比差異不顯著(P0.05)。(7)兩組患者治療前后未見不良反應(yīng)。結(jié)論:清熱解毒扶正湯對慢性阻塞性肺疾病急性加重期(痰熱壅肺兼氣陰兩虛)具有良好的療效和安全性,能有效降低患者血清SAA及CRP濃度水平,尤其對于改善患者咳嗽、喘息、自汗、倦怠乏力、盜汗等癥狀具有顯著作用,能提高臨床治療的有效率,具有較高的臨床應(yīng)用價(jià)值。
[Abstract]:Objective: to observe the clinical effect of Qingre jiedu Fuzheng decoction combined with western medicine on acute exacerbation of chronic obstructive pulmonary disease (COPD), improve the clinical symptoms of TCM and influence on serum SAA. Methods: 72 AECOPD patients who met the inclusion criteria were divided into control group and treatment group according to random digital table method. There was no significant difference in age, sex and course of disease between the two groups. Finally, 62 cases were selected, 31 cases in control group and 31 cases in treatment group. The control group was treated with routine western medicine, and the treatment group was treated with Qingre jiedu Fuzheng decoction on the basis of routine western medicine treatment. The clinical observation indexes were recorded before and after treatment, and the curative effect was determined by statistical method. Results: (1) in the control group, the effective rate was 35.48 and the total effective rate was 83.87. In the treatment group, the effective rate was 70.97 and the total effective rate was 90.32. The therapeutic effect of the treatment group was significantly better than that of the control group. (2) both the treatment group and the control group could improve the total score of TCM syndromes (P0.01). However, the treatment group was superior to the control group in improving the total score of TCM syndromes (P0.01). (3). The control group improved cough, sputum, wheezing, shortness of breath, lung Up sound, fever. The difference of thirst and cold drink was statistically significant (P0.01). In the improvement of self-sweat, fatigue, night sweat, stool dry knot, heart heat, dry mouth before and after treatment had no statistical significance (P0.05); In the treatment group, cough, sputum, wheezing, shortness of breath, self-sweating, fatigue, night sweat, lung Up sound, fever, thirst, cold drink, stool dry knot, heart and foot fever, dry mouth symptoms were improved (P0.01). The effect was better than that of the control group (P0.05). (4). Both groups could improve the serum CRP,SAA concentration (P0.01). The treatment group was reducing the serum CRP,. The concentration of SAA was better than that of the control group (P0.05). (5). The pulmonary function of the two groups was significantly improved than that before treatment (P0.01), and the difference of FEV1,FVC,FEV1% between the two groups after treatment was statistically significant (P0.05). However, there was no significant difference in FEV1/FVC (%) between the two groups (P0.05). (6). The leukocyte count, neutrophils (%) and lymphocytes (%) in the two groups were improved compared with those before treatment (P0.01). After treatment, there was no significant difference in leukocyte count, neutrophils (%) and lymphocyte percentage between control group and treatment group (P0.05). (7). Conclusion: Qingre jiedu Fuzheng decoction has good curative effect and safety in acute exacerbation of chronic obstructive pulmonary disease (phlegm and heat obstruction of lung and deficiency of qi and yin). It can effectively reduce serum SAA and CRP levels, especially in improving cough. Wheezing, self-sweating, fatigue, night sweating and other symptoms have a significant effect, can improve the effective rate of clinical treatment, has a higher clinical application value.
【學(xué)位授予單位】：云南中醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259
[Abstract]:Objective: to observe the clinical effect of Qingre jiedu Fuzheng decoction combined with western medicine on acute exacerbation of chronic obstructive pulmonary disease (COPD), improve the clinical symptoms of TCM and influence on serum SAA. Methods: 72 AECOPD patients who met the inclusion criteria were divided into control group and treatment group according to random digital table method. There was no significant difference in age, sex and course of disease between the two groups. Finally, 62 cases were selected, 31 cases in control group and 31 cases in treatment group. The control group was treated with routine western medicine, and the treatment group was treated with Qingre jiedu Fuzheng decoction on the basis of routine western medicine treatment. The clinical observation indexes were recorded before and after treatment, and the curative effect was determined by statistical method. Results: (1) in the control group, the effective rate was 35.48 and the total effective rate was 83.87. In the treatment group, the effective rate was 70.97 and the total effective rate was 90.32. The therapeutic effect of the treatment group was significantly better than that of the control group. (2) both the treatment group and the control group could improve the total score of TCM syndromes (P0.01). However, the treatment group was superior to the control group in improving the total score of TCM syndromes (P0.01). (3). The control group improved cough, sputum, wheezing, shortness of breath, lung Up sound, fever. The difference of thirst and cold drink was statistically significant (P0.01). In the improvement of self-sweat, fatigue, night sweat, stool dry knot, heart heat, dry mouth before and after treatment had no statistical significance (P0.05); In the treatment group, cough, sputum, wheezing, shortness of breath, self-sweating, fatigue, night sweat, lung Up sound, fever, thirst, cold drink, stool dry knot, heart and foot fever, dry mouth symptoms were improved (P0.01). The effect was better than that of the control group (P0.05). (4). Both groups could improve the serum CRP,SAA concentration (P0.01). The treatment group was reducing the serum CRP,. The concentration of SAA was better than that of the control group (P0.05). (5). The pulmonary function of the two groups was significantly improved than that before treatment (P0.01), and the difference of FEV1,FVC,FEV1% between the two groups after treatment was statistically significant (P0.05). However, there was no significant difference in FEV1/FVC (%) between the two groups (P0.05). (6). The leukocyte count, neutrophils (%) and lymphocytes (%) in the two groups were improved compared with those before treatment (P0.01). After treatment, there was no significant difference in leukocyte count, neutrophils (%) and lymphocyte percentage between control group and treatment group (P0.05). (7). Conclusion: Qingre jiedu Fuzheng decoction has good curative effect and safety in acute exacerbation of chronic obstructive pulmonary disease (phlegm and heat obstruction of lung and deficiency of qi and yin). It can effectively reduce serum SAA and CRP levels, especially in improving cough. Wheezing, self-sweating, fatigue, night sweating and other symptoms have a significant effect, can improve the effective rate of clinical treatment, has a higher clinical application value.
【學(xué)位授予單位】：云南中醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259
【參考文獻(xiàn)】
相關(guān)期刊論文 前10條
1 唐文芳;劉日輝;于雅琴;劉晶;高鵬;王珂;;2000—2014年中國40歲以上成人慢性阻塞性肺疾病患病率的Meta分析[J];吉林大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2015年05期
2 萬穎蕾;李文靜;項(xiàng)明潔;;血清淀粉樣蛋白A在感染性疾病中的診斷價(jià)值[J];診斷學(xué)理論與實(shí)踐;2015年02期
3 孫雪松;許國磊;;麻杏石甘湯加減治療慢性阻塞性肺疾病急性發(fā)作臨床觀察[J];世界中醫(yī)藥;2015年02期
4 張維珍;吳姍姍;閆兆;;中西醫(yī)結(jié)合治療老年慢性阻塞性肺疾病急性加重期臨床觀察[J];中國中醫(yī)急癥;2014年11期
5 邵娜;;加味大承氣湯改善慢性阻塞性肺疾病急性加重期肺熱腑實(shí)證患者炎性反應(yīng)的研究[J];遼寧中醫(yī)雜志;2014年09期
6 楊學(xué);馮喜英;張Z，
本文編號：2296252
本文鏈接：http://sikaile.net/zhongyixuelunwen/2296252.html
最近更新
教材專著
