运用经方序贯治疗外寒内饮型急性加重期慢性阻塞性肺疾病  

Sequential Therapy of Acute Exacerbation of Chronic Obstructive Pulmonary Disease with Syndrome of External Cold and Internal Fluid with Classical Prescriptions

作　　者：刘宏祥 赵永辰[2] 王涛[2] 史曼[2] 李轶璠[1] 张新文 田蜜[3] LIU Hongxiang;ZHAO Yongchen;WANG Tao;SHI Man;LI Yifan;Zhang Xinwen;Tian Mi(Tianjin University of Chinese Medicine,Tianjin China 300193;Affiliated Hospital of Hebei University,BaodingHebei China 071000;Baoding First Central Hospital,Baoding Hebei China 071000)

机构地区：[1]天津中医药大学,天津300193 [2]河北大学附属医院,河北保定071000 [3]保定市第一中心医院,河北保定071000

出　　处：《中医学报》2019年第7期1506-1510,共5页Acta Chinese Medicine

基　　金：河北省科技厅科技支撑项目(162777223)

摘　　要：目的:探讨运用经方干预治疗外寒内饮型慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者的临床疗效。方法:69例AECOPD患者随机分为经方组35例,常规组34例。两组患者均给予常规基础治疗,常规组在基础治疗基础上给予甲泼尼龙注射液;经方组在基础治疗基础上给予小青龙汤加石膏汤(3 d),加味苓桂术甘汤(4 d)。治疗后,比较两组患者临床疗效、住院时间,超敏C-反应蛋白(h-C-reaction protein,hCRP)、白细胞、降钙素原(procalcitonin,PCT)水平,肺功能,BODE评分。结果: (1)炎症指标:治疗前,经方组与常规组白细胞、h-CRP、PCT水平比较,差异无统计学意义(P> 0. 05);治疗后,两组患者白细胞、h-CRP、PCT水平均明显下降,且经方组优于常规组,差异均有统计学意义(P <0. 05)。(2)BODE评分:治疗前,经方组与常规组呼吸困难分级及6分钟步行距离比较,差异无统计学意义(P> 0. 05);治疗后,经方组以上指标明显优于常规组(P <0. 01)。(3)肺功能:治疗前,两组患者第1秒用力呼气量(forced expiratory volume 1 second,FEV1)、用力肺活量(forced vital capacity,FVC)、FEV1/FVC比较,差异均无统计学意义(P <0. 05);治疗后,经方组FEV1、FVC、FEV1/FVC均优于常规组,差异均有统计学意义(P <0. 01)。(4)住院时间及费用:经方组住院时间及住院费用均明显低于常规组,差异均有统计学意义(P <0. 05)。结论:温阳化饮经方治疗AECOPD疗效显著,可显著降低患者炎症因子水平,改善患者肺功能。Objective: To observe the clinical efficacy of sequential therapy of acute exacerbation of chronic obstructive pulmonary disease with syndrome of external cold and internal fluid with classical prescriptions. Methods: 69 patients with AECOPD were randomly divided into classical prescription group( 35 cases) and routine group( 34 cases). Both groups were given routine basic treatment,while the routine group was given methylprednisolone injection on the basis of basic treatment;the classical prescription group was given Xiaoqinglong Decoction,Shigao Decoction( 3d) and Linggui Zhugan Decoction( 4d) on the basis of basic treatment. After treatment,the clinical efficacy,hospitalization time,the levels of h-C-reactive protein( h-CRP),white blood cells,procalcitonin( PCT),lung function and BODE scores were compared between the two groups. Results: ①Inflammation indicators: before treatment,there was no significant difference in leucocyte,h-CRP and PCT levels between the classical prescription group and the routine group( P > 0. 05);after treatment,the leucocyte,h-CRP and PCT levels of the two groups were significantly decreased,and the classical prescription group was better than the routine group,the difference was statistically significant( P < 0. 05). ②BODE score: before treatment,there was no significant difference in dyspnea grade and 6-minute walking distance between the prescription group and the routine group( P > 0. 05);after treatment,the above indexes in the prescription group were significantly better than those in the routine group( P < 0. 01). ③Pulmonary function: before treatment,there was no significant difference in forced expiratory volume 1 second( FEV1),forced vital capacity( FVC),FEV1/FVC between the two groups( P < 0. 05). After treatment,FEV1,FVC and FEV1/FVC in the classical prescription group were better than those in the routine group. The difference was statistically significant( P < 0. 01). ④Hospitalization time and expenses: the hospitalization time and hospitalization expenses of cl

关 键 词：经方 小青龙汤 石膏汤 苓桂术甘汤 序贯治疗 慢性阻塞性肺疾病 

分 类 号：R256.1[医药卫生—中医内科学]