清肺降逆汤联合西药治疗慢性阻塞性肺疾病急性发作(痰热壅肺)随机平行对照研究  

Treatment of Acute Attack of Chronic Obstructive Pulmonary Disease(Phlegm-heat Obstructing Lung/痰热壅肺) with Qingfei Jiangni Decoction/清肺降逆汤 and Western Medicine

作　　者：夏莉 XIA Li(Department of Respiration,Tongxiang Second People's Hospital,Tongxiang 314511,Zhejiang,China)

机构地区：[1]桐乡市第二人民医院呼吸科

出　　处：《实用中医内科杂志》2019年第4期36-39,共4页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：[目的]观察清肺降逆汤联合西药治疗慢性阻塞性肺疾病(痰热壅肺)急性发作疗效。[方法]使用随机平行对照方法,将95例住院患者按病志号抽签方法随机分为两组。对照组47例控制性吸氧,氧流量2L/min,12h/d。异丙托溴铵500μg/次,3次/d,雾化吸入;多索茶碱100mL+氨溴索30mg,静滴;甲泼尼龙40mg/次,1次/d,连续7d,静滴;莫西沙星400mg/次,1次/d,静滴。治疗组48例清肺降逆汤(桑白皮、半夏、紫苏子、杏仁、贝母、栀子、黄芩各15g,黄连、姜生各6g),水煎400mL,1剂/d,早晚温服。热甚加知母、石膏;痰多黏稠加蛤蚧粉、瓜蒌;口渴咽干加天花粉、玄参、芦根、麦冬等;西药治疗同对照组。连续治疗14d为1疗程。观测临床表现、第一秒用力呼气容积占用力肺活量百分比(FEV1/FVC)、FEV1、中医证候积分、不良反应。治疗1疗程(14d),判定疗效。[结果]治疗组临床控制显效31例,有效37例,无效7例,总有效率90.67%;对照组显效20例,有效36例,无效19例,总有效率74.67%;治疗组疗效优于对照组(P<0.05)。FEV1/FVC、FEV1、中医证候积分两组均有改善(P<0.01),治疗组改善优于对照组(P<0.01)。[结论]清肺降逆汤联合西药治疗慢性阻塞性肺疾病(痰热壅肺)急性发作,疗效满意,无严重不良反应,值得推广。[Objective] To observe the curative effect of Qingfei Jiangni decoction combined with western medicine on chronic obstructive pulmonary disease(COPD). [Method] 95 hospitalized patients were randomly divided into two groups by drawing lots according to the disease sign by random parallel control method. 47 patients in the control group received controlled oxygen inhalation with oxygen flow rate of 2 L/min and 12 h/d. Ipratropium bromide aerosol inhalation solution 500μg/time, 3 times/d, aerosol inhalation;doxofylline injection 100 mL + ambroxol 30 mg, intravenous drip;methylprednisolone 40 mg/time, once a day, continuous 7 days, intravenous drip;moxifloxacin injection 400 mg/time, once a day, intravenous drip. In the treatment group, 48 cases of Qingfei Jiangni decoction(Sangbaipi, Banxia, Zisuzi, Xingren, Beimu, Zhizi, Huangqin each 15 g, Huanglian, Shengjiang each 6 g) were decocted with water 400 mL, 1 dose per day, and taken warm in the morning and evening. Hot and viscous phlegm with Zhimu, Shigao, The phlegm is thick with Gejiefen,Gualu;thirsty and dry pharynx with Tianhuafen, Xuanshen, Maidong, western medicine treatment with the control group. Continuous treatment for 14 days is a course of treatment. Clinical manifestations, FEV1/FVC,FEV1, TCM syndrome score and adverse reactions were observed. One course of treatment(14 days) was used to determine the curative effect. [Result] 31 cases were markedly effective in the treatment group, 37 cases were effective, 7 cases were ineffective, and the total effective rate was 90.67%. 20 cases were markedly effective in the control group, 36 cases were effective, 19 cases were ineffective, the total effective rate was 74.67%. The curative effect of the treatment group was better than that of the control group(P<0.05). FEV1/FVC, FEV1 and TCM syndrome scores were improved in both groups(P<0.01), and the improvement in treatment group was better than that in control group(P<0.01). [Conclusion] Qingfei Jiangni decoction combined with western medicine for chronic obstru

关 键 词：慢性阻塞性肺疾病 喘证 清肺降逆汤 低流量吸氧 异丙托溴铵 雾化吸入 多索茶碱 培垛普利 氨溴索 甲泼尼龙 FEV1/FVC FEV1 中医证候积分 中药复方 随机平行对照研究 

分 类 号：R563.9[医药卫生—呼吸系统]