瓜蒌薤白汤治疗中重度慢性阻塞性肺病(痰瘀型)患者急性发作期临床研究  

Clinical effect of gualouxiebai decoction treating acute patient with phlegm and blood stasis type on chronic obstructive pulmonary disease

作　　者：代君[1] 奚肇庆[2] 赵庆峰[1] 瞿媛[1] 方媛[1] 姚宏凤[1] 宋德胤[1] 

机构地区：[1]江苏省南京市中医院 [2]江苏省中医院

出　　处：《山西中医》2016年第2期19-21,32,共4页Shanxi Journal of Traditional Chinese Medicine

基　　金：2012第二批江苏省中医药管理局科技中标项目(编号YX1218)

摘　　要：目的：观察瓜蒌薤白汤在治疗中重度慢性阻塞性肺病（痰瘀型）急性发作期的疗效.方法：收集中重度慢性阻塞性肺病（痰瘀型）急性发作期患者共63例,随机分为治疗组32例,对照组31例.治疗组服用瓜蒌薤白汤加西医常规治疗,对照组西医常规治疗.疗程共2周.观察治疗前后两组综合疗效、中医症状积分、第一秒用力呼气容积占用力肺活量的百分比（FEV1/FVC％）、肿瘤坏死因子α（TNF-α）、白三烯B4（LTB4）、基质蛋白酶（MMP）的不同表达.结果：治疗组总有效率为96.88％（95％CI=83.68％～99.90％）,对照组为80.65％（95％CI =66.74％ ～ 94.56％）,两组综合疗效比较（u =3.886 0,P=0.000 1）,差异有显著性意义;与对照组比较,治疗组可降低中医证候积分参数（t=-12.305 5,P＜0.001）,改善FEV1/FVC％ （t＇=11.573 0,P＜0.05）,降低TNF-α（t＇=-13.916 6,P＜0.05）.结论：应用瓜蒌薤白汤合西药治疗中重度慢性阻塞性肺病（痰瘀型）急性发作期的疗效优于单纯应用西药的疗效的证据比较充分,其收益为OR =0.13（95％CI =0.02 ～ 1.18,但95％ CI跨过1）,NNT =6（95％CI =3.15 ～ 141.84）.Objective ： To observe effect of gualouxiebai decoction on acute exacerbation of moderate/severe chronic obstructive pulmonary disease （phlegm and blood stasis type）. Methods： 63 patients with acute exacerbation of moderate/severe chronic obstructive pulmonary disease （phlegm and blood stasis type） were collected, and were randomly divided into treatment group of 32 patients and control group of 31 patients. The treatment group was treated with gualouxiebai decoction combined with conventional western medicine. The control group was treated only with conventional western medicine. The course of treatment was two weeks. Before and after treatment , comprehensive effects, scores of TCM symptom, FEV1/FVC%, TNF-α, LTB4 and MMP different expressions in two groups were observed. Results ： The total effective rate of treatment group was 96.9% （95% CI = 83.68% 99.90% ） ,the control group was 80. 65% （95% CI = 66.74% - 94.56% ）. Compared the effects of two groups comprehensively（ u = 3. 886 0 ,P = 0. 000 1 ）, the difference had remarkable significance. Compared with the control group, the treatment group could reduce TCM syndrome score parameters （t = - 12. 305 5, P 〈0. 001 ）, improve FEV1 / FVC% （t＇ = 11. 5730, P 〈0. 05）, and reduce TNF - α（t＇ = - 13.9166, P 〈0. 05）. Conclusion ： The effect of gualouxiebai decoction combined with western medicine on acute exacerbation of moderate/severe chronic obstructive pulmonary disease （phlegm and blood stasis type） is better than simply with western medicine, which has obvious evidences. Its benefits is OR = 0. 13 （95% CI = 0. 02 - 1.18 ,but 95 % CI over 1 ） , NNT = 6（95%CI =3.15 -141.84）.

关 键 词：中重度慢性阻塞性肺病(痰瘀型) 急性发作期 瓜蒌薤白汤 临床研究 

分 类 号：R563.4[医药卫生—呼吸系统]