辨证分型联合西药治疗慢性阻塞性肺病急性加重期随机平行对照研究  

Chronic Obstructive Pulmonary Disease Randomized Controlled Study in Parallel with Acute Exacerbation of Syndrome Differentiation Combined Western Medicine

作　　者：陈昌胜 

机构地区：[1]湖南省临澧县中医医院内科,湖南临澧415200

出　　处：《实用中医内科杂志》2015年第11期115-117,共3页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：[目的]观察辨证分型联合西药治疗慢性阻塞性肺病急性加重期疗效。[方法]使用随机平行对照方法,将160例住院及门诊患者按病志号抽签法简单随机分为两组。对照组80例卧床,持续低流量吸氧,营养支持,维持水、电解质平衡、吸痰、支气管舒张剂、祛痰药、茶碱类,常规抗感染。治疗组80例辨证分型。外寒内饮-小青龙汤(麻黄、桂枝各15g,白芍10g,细辛3g,干姜15g,五味子6g,法半夏10g,杏仁5g);痰热郁肺-越婢加半夏汤(麻黄15g,生石膏10g,生姜、法半夏各12g,大枣8颗,黄芩10g,甘草5g);痰热夹瘀-清金畅肺饮(瓜蒌皮15g,黄芩、桔梗各10g,杏仁5g,浙贝母、葶苈子各12g,虎杖、红景天各8g,陈皮6g,甘草5g);痰蒙神窍-涤痰汤(法半夏10g,陈皮15g,茯苓10g,胆南星8g,竹茹10g,枳实、石菖蒲、党参各15g,甘草5g);1剂/d,水煎400m L,早晚口服,200m L/次;西药治疗同对照组。连续治疗14d为1疗程。观测临床症状、FEV1/FVC、FEV1、不良反应。治疗1疗程,判定疗效。[结果]治疗组临床控制24例,显效30例,有效24例,无效2例,总有效率97.50%。对照组临床控制9例,显效21例,有效38例,无效12例,总有效率85.00%。治疗组疗效优于对照组(P<0.01)。肺功能指标两组均有改善(P<0.01),治疗组改善优于对照组(P<0.01)。[结论]辨证分型联合西药治疗慢性阻塞性肺病急性加重期疗效满意,无严重不良反应,值得推广。[Objective]To observe Syndromes Combined with Western treatment acute exacerbation of chronic obstructive pulmonary disease effect.[Methods]Randomized parallel controlled method,160 inpatients and outpatients by disease Zhi No.lottery method is simple and randomly divided into two groups.The control group of 80 patients ambulatory,continuous low flow oxygen,essential nutritional support,maintain water and electrolyte balance;inability periodic suctioning sputum and other treatment,I bronchodilators,expectorant drug,theophylline relieve bronchial spasm,conventional anti- infection.The treatment group 80 cases Syndromes.The outer cold drink-XQLD（Mahuang,Guizhi 15 g,Baishao 10 g,Xixin 3g,Ganjiang 15 g,Wuweizi 6g,Fabanxia 10 g,Xingren5g）;phlegm Yu Lung- plus more servant Banxia soup（Mahaung 15 g,Shengshigao 10 g,Shengjiang,Fabanxia12 g,Dazao 8,Huangqin 10 g,Gancao 5g）;phlegm stasis- Qing Jin Chang Lung drink（Gualoupi15g,Huangqin,Jiegeng 10 g,Xingren 5g,Zhebeimu,Tinglizi each 12 g,Huzhang,Hongjingtian each 8g,Chenpi6 g,Gancao 5g）;sputum awakened by God- Ditan soup（Fabanxia 10 g,Chenpi 15 g,Fuling 10 g,Dannanxing 8g,Zhuru10 g,Zhishi,Shichangpu,Dangshen 15 g,Gancao 5g）;l/ d,decoction 400 mL,sooner or later,oral,200mL/times.Western medicine with the control group.14 d for a course of continuous treatment.Observation of clinical symptoms,FEV_1/FVC,FEV_1,adverse reactions.One course of treatment,to determine efficacy.[Results]Control treatment group 24 cases,30 cases markedly effective in 24 cases,2 cases,the total efficiency of 97.50%.9 cases of clinical control group,21 cases markedly effective in 38 cases,12 cases,the total efficiency of 85.00%.Treatment group than the control group（P〈0.01）.Lung function improved in both groups（P〈0.01）,the treatment group than the control group improved（P〈0.01）.[Conclusion]Syndromes Combined with Western treatment of pulmonary acute exacerbation of chronic obstructive sexual satisfaction,no serious adverse reactions,is worth promoting.

关 键 词：慢性阻塞性肺病急性加重期 肺胀 辨证分型 外寒内饮-小青龙汤 痰热郁肺-越婢加半夏汤 痰热夹瘀-清金畅肺饮 痰蒙神窍-涤痰汤 FEV1/FVC FEV1 中医药治疗 随机平行对照研究 

分 类 号：R563[医药卫生—呼吸系统]