清肺十八味丸联合盐酸氯丙那林治疗老年咳嗽变异性哮喘并发阻塞性肺气肿临床研究  

Clinical effects of Qingfei Shibaweiwan combined with clorprenaline hydrochloride in the treatment of cough variant asthma with obstructive emphysema

作　　者：王成斌 王桂云 张青 任志超 Wang Chengbin;Wang Guiyun;Zhang Qing(Department of Respiratory Medicine,Central Hospital of Tongchuan Mining Bureau（Tongchuan 727000)

机构地区：[1]陕西省铜川矿务局中心医院呼吸内科,铜川727000 [2]陕西省咸阳市第一人民医院,咸阳712000

出　　处：《陕西中医》2018年第11期1536-1539,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：陕西省教育厅自然科学研究项目(2013JK0773)

摘　　要：目的:探讨清肺十八味丸联合盐酸氯丙那林对老年咳嗽变异性哮喘并发阻塞性肺气肿的临床治疗效果。方法:选取194例老年咳嗽变异性哮喘并发阻塞性肺气肿患者作为研究对象,采用随机数字表法将其分为观察组和对照组,每组97例。对照组给予盐酸氯丙那林治疗,而观察组则在此基础上另给予清肺十八味丸。治疗12周后,对两组疗效进行评价。治疗前及治疗12周后,检测两组患者肺功能指标(一氧化碳弥散量、一秒用力呼气容积、呼气峰流速值及呼气高峰流量),血气指标(二氧化碳分压、酸碱度及血氧张力),炎性因子(嗜酸性粒细胞趋化因子、巨噬细胞炎性蛋白-1α、嗜酸性阳离子蛋白及淀粉样蛋白A)。治疗期间,对患者的不良反应进行观察。结果:治疗12周后,观察组总有效率为91.7%,明显高于对照组(77.3%,P<0.05)。治疗12周后,观察组DLCO、FEV1、PEF及PEFR均明显高于对照组(P<0.05),PaCO2、pH及PaO2改善程度均明显优于对照组(P<0.05),且Eotaxin、MIP-1α、ECP及SAA均明显低于对照组(P<0.05)。治疗期间,患者均无严重不良反应,两组不良反应发生率基本一致(P>0.05)。结论:清肺十八味丸联合盐酸氯丙那林可有效改善老年咳嗽变异性哮喘并发阻塞性肺气肿患者肺功能及血气指标,降低患者血清炎性因子含量。Objective： To explore the clinical effect and safety of Qingfei Shibaweiwan combined with clorprenaline hydrochloride in the treatment of cough variant asthma with obstructive emphysema. Methods： 194 elderly patients of the cough variant asthma with obstructive emphysema were divided into observe group （97 cases） and control group （97 cases）. The control group was treated with clorprenaline hydrochloride while the treatment group with Qingfei Shibaweiwan on the base of control group. The treatment lasting 12 weeks in the 2 groups. 12 weeks after the treatment, the clinical effects were compared in patients. Before and 12 weeks after the treatment, the lung function index [carbon monoxide diffusion capacity （DLCO）, forced expiratory volume in one second （FEV1）, peak expiratory flow （PEF） and peak expiratory flow rate （PEFR）], blood gas index [CO 2 partial pressure （PaCO 2 ）, acidity （pH） and blood oxygen tension （PaO 2 ）], inflammatory factor [eosinophil chemotactic factor （Eotaxin）, macrophage inflammatory protein - 1 alpha （MIP-α）, eosinophilic cationic protein （ECP） and amyloid A （SAA）] were detected in the 2 groups. The adverse reactions were observed during the treatment. Results： 12 weeks after the treatment, the total effect rate in observe group was 91.7%（89/97）, significantly higher than control group [77.3%（75/97）] （ P 〈0.05）. 12 weeks after the treatment, the levels of DLCO, FEV1, PEF and PEFR in observe group were significantly higher than control group （ P 〈0.05）, PaCO 2 , pH and PaO 2 were significantly promoted than control group （ P 〈0.05）, while Eotaxin, MIP-1α, ECP and SAA were significantly lower than control group （ P 〈0.05）. There were no serious adverse actions in 2 groups during the treatment and the rates of adverse actions was similar in the 2 groups （ P 〉0.05）. Conclusions： Qingfei Shibaweiwan with clorprenaline hydrochloride in cough variant asthma with obstructive emphysema has a good eff

关 键 词：哮喘 肺气肿/中西医结合疗法 @清肺十八味丸 

分 类 号：R563.3[医药卫生—呼吸系统]