苇金消痈汤加减辅助治疗支气管扩张急性加重期痰热壅肺证的临床分析  

Clinical Analysis of Weijin Xiaoyong Decoction in Adjuvant Therapy of Bronchiectasis at Acute Exacerbation Stage with Syndrome of Phlegm-heat Obstructing Lung

作　　者：房波[1] 赵刚[2] 

机构地区：[1]即墨市中医医院,山东即墨266200 [2]青岛大学医学院附属医院,山东青岛266000

出　　处：《中国实验方剂学杂志》2016年第15期194-198,共5页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：山东省自然科学基金项目(ZR2009CL018)

摘　　要：目的:探讨苇金消痈汤加减辅助治疗痰热壅肺型支气管扩张急性加重期的疗效以及对痰液和血清中基质金属蛋白酶-9(MMP-9)和基质金属蛋白酶抑制剂-1(TIMP-1)的影响。方法:收集支气管扩张急性加重期患者98例,参照随机按数字表法平均分为对照组和治疗组各49例;两组患者参照《成人支气管扩张症诊治专家共识》给予非药物干预。对照组抗感染采取盐酸左旋氧氟沙星注射液,0.4 g加入生理盐水400 m L,200 m L/次,2次/d;对铜绿假单胞菌感染者,0.6 g加入生理盐水600 m L,300 m L/次,2次/d。化痰采取氨溴索注射液,30 mg加入生理盐水100 m L,1次/d。治疗组在对照组治疗的基础上给予苇金消痈汤,1剂/d,常规水煎煮2次,分早晚2次内服。两组疗程均为2周。比较两组第1秒最大呼气量(FEV1),FEV1/用力肺活量(FVC),血氧分压(Pa O2),二氧化碳分压(Pa CO2),血氧饱和度(Sa O2)及临床症状评分;分析两组患者临床疗效;测定两组患者痰液和血清中MMP-9,TIMP-1水平。结果:治疗后治疗组FEV1,FEV1/FVC,Pa O2和Sa O2均明显高于对照组,而Pa CO2和咳嗽等临床积分均明显低于对照组(P<0.01);治疗组和对照组临床治疗总有效率分别为95.92%和79.59%,治疗组明显优于对照组(P<0.05);治疗后治疗组痰液和血清中MMP-9水平均明显低于对照组,而TIMP-1高于对照组(P<0.01)。结论:在常规西医治疗的基础上,苇金消痈汤辅助治疗痰热壅肺型支气管扩张急性加重期疗效确切,抑制痰液和血清中MMP-9水平及上调TIMP-1水平可能在其中发挥重要作用。Objective： To observe the efficacy of Weijin Xiaoyong decoction in the adjuvant therapy of bronchiectasis at acute exacerbation stage with syndrome of phlegm-heat obstructing lung,and investigate its effects on levels of matrix metalloproteinase-9（ MMP-9） and tissue inhibitor of metalloproteinase-1（ TIMP-1） in serum and sputum. Method： Ninty-eight patients with acute exacerbation stage bronchiectasis were randomly divided into treatment group（ 49 cases） and control group（ 49 cases） according to random number table. Non-pharmaceutical interventions were given according to ‘Expert Consensus on Diagnosis and Treatment of Adult Bronchiectasis Disease＇in both groups. In the control group,0. 4 g ofloxacin hydrochloride injection was added to 400 m L normal saline for anti-infection（ 200 m L / time,bid）,0. 6 g ofloxacin hydrochloride injection was added to 600 m L normal saline for pseudomonas aeruginosa infection（ 300 m L / time,bid）,30 mg ambroxol injection was added to 100 m L normal saline for dissipating phlegm,qd. The patients in treatment group also received Weijin Xiaoyong decoction（ one dose / day,boiled and taken orally twice） based on the treatment in control group. The treatment course was 2weeks for both groups. Forced expiratory volume in one second（ FEV1）,FEV1/ forced vital capacity（ FVC）,blood oxygen partial pressure（ Pa O2）,CO2 partial pressure（ Pa CO2）,blood oxygen saturation（ Sa O2） and clinical symptom scores were compared between two groups. The clinical efficacy was analyzed in two groups. The levels of MMP-9 and TIMP-1 in serum and sputum were detected in both groups. Result： After treatment,FEV1,FEV1/ FVC,Pa O2 and Sa O2 levels in treatment group were significantly higher than those in control group,while clinical scores such as Pa CO2 and cough were significantly lower than those in control one（ P 〈0. 01）. The total effective rate was 95. 92% in treatment group,significantly higher than 79. 59% in control group（ P 〈0. 05）. Aft

关 键 词：苇金消痈汤 支气管扩张 痰热壅肺证 基质金属蛋白酶-9 基质金属蛋白酶抑制剂-1 

分 类 号：R287[医药卫生—中药学]