【摘要】：目的:通過觀察清肺化濁湯對慢性阻塞性肺疾病急性加重期痰熱郁肺證患者的臨床證候療效、血清TNF-α、肺功能及CAT評分的影響,探討清肺化濁湯對AECOPD的療效及可能的作用機(jī)制,為AECOPD臨床治療提供理論依據(jù)。方法:將符合納入標(biāo)準(zhǔn)的60例AECOPD患者,采用隨機(jī)數(shù)字表法分為兩組,治療組和對照組各30例。對照組采用西醫(yī)常規(guī)治療,予氧療,長效抗膽堿能藥物噴入、霧化化痰藥及支氣管舒張劑,靜滴抗生素、化痰藥物;治療組在對照組的基礎(chǔ)上,加服用清肺化濁湯(每日一劑,早晚分服),療程為14天。以了解兩組患者用藥前后及兩組組間臨床癥狀體征改變、血清TNF-α、肺通氣功能、血?dú)夥治�、CAT評分的變化。結(jié)果:1.臨床證候療效:癥狀和體征的證候總積分,治療組和對照組分別自身前后比較,治療后組間比較,差異具有統(tǒng)計學(xué)意義(P0.05)。治療后,兩組組間證候積分比較,差異具有統(tǒng)計學(xué)意義(P0.05)。2.血清TNF-α:治療后,治療組與對照組患者血清TNF-α水平分別與治療前相比,差異具有統(tǒng)計學(xué)意義(P0.05)。治療后,治療組患者血清TNF-α水平與對照組相比,差異具有統(tǒng)計學(xué)意義(P0.05)。3.肺功能:治療后治療組和對照組肺功能FEV1占預(yù)計值百分比分別與治療前相比,差異具有統(tǒng)計學(xué)意義(P0.05),治療后治療組與對照組組間比較肺功能FEV1占預(yù)計值%差異無統(tǒng)計學(xué)意義(P0.05)。4.CAT評分:治療后,治療組與對照組患者CAT評分分別與治療前相比,差異具有統(tǒng)計學(xué)意義(P0.05)。治療后,治療組患者CAT評分與對照組相比,差異具有統(tǒng)計學(xué)意義(P0.05)。5.血?dú)夥治?PO2、PCO2):治療后對照組和治療組分別與治療前相比,P0.05,具有統(tǒng)計學(xué)意義,說明兩組均能改善患者血?dú)馑?對照組和治療組組間比較,P0.05,無統(tǒng)計學(xué)意義,說明治療組對患者血?dú)獾母纳苾?yōu)于對照組。結(jié)論:1.清肺化濁湯聯(lián)合西醫(yī)常規(guī)治療可改善AECOPD患者總的臨床癥狀和體征,提高總有效率,且在改善咳痰、Up音方面有一定優(yōu)勢。2.清肺化濁湯聯(lián)合西醫(yī)常規(guī)治療可改善AECOPD患者血清TNF-α水平,提示清肺化濁湯可能有減輕氣道炎癥作用。3.清肺化濁湯聯(lián)合西醫(yī)常規(guī)治療可以改善AECOPD患者CAT評分,提高患者生活質(zhì)量。4.清肺化濁湯聯(lián)合西醫(yī)常規(guī)治療短期改善AECOPD患者肺功能FEV1占預(yù)計值%水平,改善情況與西藥常規(guī)治療相同。5.清肺化濁湯聯(lián)合西醫(yī)常規(guī)治療可以改善AECOPD患者血?dú)夥治?改善情況優(yōu)于西藥常規(guī)治療。
[Abstract]:Objective: to observe the effect of Qingfei Huazhuo decoction on the clinical syndrome, serum TNF- 偽, pulmonary function and CAT score in patients with acute exacerbation of chronic obstructive pulmonary disease. To explore the therapeutic effect and possible mechanism of Qingfei Huazhuo decoction on AECOPD, and to provide theoretical basis for clinical treatment of AECOPD. Methods: 60 patients with AECOPD were randomly divided into two groups: treatment group (n = 30) and control group (n = 30). The control group was treated with routine western medicine, oxygen therapy, injection of long-term anticholinergic drugs, atomization of phlegm and bronchodiastolic agents, intravenous drip of antibiotics, phlegm drugs. Treatment group on the basis of the control group, plus Qingfei Huazhuo decoction (one dose per day, morning and evening divided), the course of treatment is 14 days. To investigate the changes of clinical symptoms and signs, serum TNF- 偽, pulmonary ventilation function, blood gas analysis and CAT score before and after treatment. Results: 1. Clinical syndromes efficacy: symptoms and signs of the syndrome of the total score, treatment group and control group before and after comparison, after treatment, the difference was statistically significant (P0.05). After treatment, the two groups between the syndromes score comparison, the difference was statistically significant (P0.05). Serum TNF- 偽: after treatment, the level of serum TNF- 偽 in treatment group and control group was significantly higher than that before treatment (P0.05). After treatment, the serum TNF- 偽 level in the treatment group was significantly higher than that in the control group (P0.05). Pulmonary function: after treatment, the percentage of FEV1 in predicted value in treatment group and control group was significantly higher than that before treatment (P0.05). There was no significant difference in pulmonary function FEV1% between the treatment group and the control group after treatment (P0.05). 4.CAT score: after treatment, the CAT score of the treatment group and the control group were compared with those before treatment, respectively. The difference was statistically significant (P0.05). After treatment, the CAT score of the patients in the treatment group was significantly different from that in the control group (P0.05). Blood gas analysis (PO2,PCO2): control group and treatment group after treatment compared with before treatment, P0.05, with statistical significance, indicating that both groups can improve the blood gas level of patients; There was no significant difference between the control group and the treatment group (P 0.05), indicating that the improvement of blood gas in the treatment group was better than that in the control group. Conclusion: 1. Qingfei Huazhuo decoction combined with routine western medicine treatment can improve the total clinical symptoms and signs of AECOPD patients, improve the total effective rate, and improve sputum, Up sound has a certain advantage. 2. Qingfei Huazhuo decoction combined with routine western medicine treatment can improve the level of serum TNF- 偽 in patients with AECOPD, suggesting that Qingfei Huazhuo decoction may reduce airway inflammation. 3. Qingfei Huazhuo decoction combined with routine western medicine treatment can improve the CAT score of patients with AECOPD, improve the quality of life of patients. 4. Qingfei Huazhuo decoction combined with routine western medicine treatment for short-term improvement of pulmonary function of AECOPD patients with FEV1 accounted for% of the predicted level, the improvement of the situation is the same as the routine treatment of western medicine. 5. 5. Qingfei Huazhuo decoction combined with conventional western medicine can improve blood gas analysis of patients with AECOPD.
【學(xué)位授予單位】：湖南中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259

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