清热化痰联合低剂量激素治疗慢性阻塞性肺疾病急性加重期随机平行对照研究  

Randomized Parallel Group Study on Quality of Life and Safety:the Clearing Heat & Sputum Method with Low-dose Glucocorticoids for AECOPD

作　　者：蒋紫云 连乐燊 王婷 陈锦容 

机构地区：[1]东莞市中医院内五科 [2]东莞康华医院中医科,广东东莞523000

出　　处：《实用中医内科杂志》2016年第5期66-68,共3页Journal of Practical Traditional Chinese Internal Medicine

基　　金：2014年广东省东莞市科技局立项课题(No:20141051500025)~~

摘　　要：[目的]观察清热化痰法联合低剂量激素治疗慢性阻塞性肺疾病急性加重期疗效。[方法]使用多中心随机平行对照方法,将100例住院患者按随机数字表方法简单随机分为两组。对照组50例第1~3d,甲强龙,40mg+0.9%生理盐水20mL,1次/d,静推;第4~5d,甲强龙,20mg+0.9%生理盐水20mL,1次/d,静推;第6~7d,强的松,10mg,1次/d,口服。治疗组50例第1~7d,痰热清20mL+5%葡萄糖250mL,1次/d,静滴;第1~3d,甲强龙,20mg+0.9%生理盐水20mL,1次/d,静推;第4~5d,甲强龙,10mg+0.9%生理盐水20mL,1次/d,静推;第6~7d,强的松,5mg,1次/d,口服。连续治疗7d为1疗程。观测临床症状、CAT问卷评分、住院时间、血糖、不良反应。治疗1疗程,判定疗效。[结果]CAT问卷评分两组均有改善(P<0.01),治疗组改善优于对照组(P<0.01);住院时间治疗组短于对照组(P<0.05);血糖水平治疗组治疗组优于对照组(P<0.05)。[结论]清热化痰法联合低剂量激素治疗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 AECOPD patients, quality of life and safety-using the comprehensive therapy： the clearing heat＆ sputum method with low-dose glucocorticoids. [Method] 100 cases of inpatient and outpatient were randomly divided into two groups according to the treatment sequence number. In addition to basic therapy（the use of bronchodilators, antibiotics, expectorant drugs）, the control group of 50 cases with conventional doses of glucoeorticoid.The treatment group with the comprehensive therapy： the clearing heat ＆ sputum method with low-dose glucocorticoids.Both of grops with 7 days＇ continuous treatment. Control group （n=50）l^3d, methylprednisolone, 40mg＋0.9%physiological saline 20mL, 1 times/d,IV.The 4-Sdays, methylprednisolone, 20mg＋0.9% physiological saline 20mL, ltimes /d, IV; 6-7d, prednisone 10mg, QD, PO. Treatment group（n=50） 1-Td, Tanreqing Injection 20mL＋5% glucose 250mL, 1/d, VD; the 1 to 3 days, methylprednisolonc, 20mg＋0.9%physiological saline 20mL, 1 times/d, IV. The 4~5 days,methylprednisolone, 10mg＋0.9% physiological saline 20mL, 1 times/d,IV;6-7d, and prednisone 5rag, QD, PO.To observe the CAT questionnaire scores, hospitalization time, blood glucose and the rate of adverse reactions.[Results] The two groups can improve the CAT questionnaire scores （P〈0.01）.After treatment, the CAT questionnaire scores of the treatment group were better than the control group （P〈0.01）;the treatment group＇ s hospitalization time, blood glucose and the rate of adverse reactions were better than the control group （P〈0.05）.[Conclusion] The clearing heat ＆ sputum method with low-dose glucocorticoids improve the quality of life more significantly,and with more safety for AECOPD.

关 键 词：慢性阻塞性肺疾病急性加重期 清热化痰 低剂量激素 CAT问卷 住院时间 血糖 中西医结合治疗 多中心随机平行对照研究 

分 类 号：R563[医药卫生—呼吸系统]