温胆汤联合西药治疗痰湿蕴肺型慢性阻塞性肺疾病急性加重期随机平行对照研究  

Wendantang Phlegm Retention in the Lung Combined with Western Medicine Treatment of Chronic Obstructive Pulmonary Disease with Acute Exacerbation of Randomized Controlled Study

作　　者：黄民华[1] 邱凯[1] 张海洋[1] 杨晓帆[1] 李旭红[1] 

机构地区：[1]福建中医药大学附属三明中西医结合医院呼吸内科,福建三明365000

出　　处：《实用中医内科杂志》2015年第11期136-138,共3页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：[目的]观察温胆汤联合西药治疗痰湿蕴肺型慢性阻塞性肺疾病急性加重期疗效。[方法]使用随机平行对照方法,将95例住院患者按抛硬币法简单随机分为两组。保证休息时间,做好保暖工作;合理、清淡饮食,忌生冷、辛辣、刺激食物,不可与过敏源接触。对照组45例2.5m L沙丁胺醇气雾剂雾化,6~8h/次;阿莫西林克拉维酸2.4g＋生理盐水100m L,12h/次,静滴;痰培结果阳性,抗生素、氨茶碱0.25g＋生理盐水250 m L,静滴;氨溴索30mg/次,2次/d;必要情况辅助呼吸,利尿剂、糖皮质激素等。治疗组50例温胆汤（杏仁、半夏各10g,枳壳12g,陈皮、茯苓各15g,甘草6g,僵蚕8g;严重气喘加地龙、麻黄炙各10g;咽喉干痒加蝉蜕、射干各10g;涕白且稀加辛夷10g;痰湿化热加大黄8g,胆南星10g,栀子12g,黄连6~10g）;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10d为1疗程。观测临床症状、FVC、Bu N、ALB、不良反应。治疗1疗程,判定疗效。[结果]治疗组临床控制36例,显效8例,有效5例,无效1例,总有效率98.00%。对照组临床控制6例,显效16例,有效16例,无效7例,总有效率4.44%。治疗组疗效优于对照组（P〈0.05）。肺功能指标大部分有改善（P〈0.01）,Bu N对照组无改善（P〉0.05）,治疗组改善优于对照组（P〈0.01）。[结论]温胆汤联合西药治疗痰湿蕴肺型慢性阻塞性肺疾病急性加重期疗效满意,无严重不良反应,值得推广。[Objective]To observe Wendantang phlegm retention in the lung combined with Western medicine treatment of chronic obstructive pulmonary disease with acute exacerbation of efficacy.[Method]randomized,parallel controlled method,95 cases of hospitalized patients by a coin toss method is simple randomized into two groups.Guaranteed rest time,make warm work;reasonable,light diet,avoid cold,spicy,stimulating food,not contact with allergens.45 cases in the control group 2.5m L salbutamol aerosol atomization,6~8 h/times;amoxicillin and clavulanic acid 2.4g＋100m L saline,12 h/times,infusion;sputum culture results positive,given antibiotics aminophylline 0.25g＋250 m L saline infusion;ambroxol,30 mg/times,2 times/d.If necessary,be taken given the ventilator assisted breathing therapy and diuretics and corticosteroids such as the implementation of comprehensive treatment.Treatment group of 50 patients Wendantang（Xingren,Banxia 10 g,Zhike 12 g,Chenpi,Fuling 15 g,Gancao 6g,Jiangchan 8g;severe asthma plus Dilong,Mahuang each 10g;dry throat oxygen plus Chantui,Shegan 10g;tears white and dilute Jia Xinyi 10g;phlegm heat syndrome increased Dahuang 8g,Dannanxing 10 g,Zhizi 12 g,Huanglian 6~10g）;1 ji/d,decoction 400 m L,sooner or later,oral,200 m L / times.Western medicine with the control group.10 d for a course of continuous treatment.Observation of clinical symptoms,FVC,Bu N,ALB,adverse reactions.One course of treatment,to determine efficacy.[Results]36 cases of the control treatment group,8 cases were markedly effective in 5 cases,one case,the total efficiency of 98.00%.6 cases of clinical control group,16 cases markedly effective in 16 cases,7 cases,the total efficiency of 4.44%.Treatment group than the control group（P〈0.05）.Most lung function improvement（P〈0.01）,Bu N no improvement in the control group（P〉0.05）,the treatment group than the control group improved（P〈0.01）.[Conclusion]Wendantang combined with Western treatment of acute exacerbation of the efficacy of phlegm retention in the lung dis

关 键 词：慢性阻塞性肺疾病急性加重期 肺胀 痰湿蕴肺 温胆汤 沙丁胺醇 阿莫西林克拉维酸 氨茶碱 盐酸氨溴索 FVC BUN ALB 中西医结合治疗 随机平行对照研究 

分 类 号：R563[医药卫生—呼吸系统]