清热活血方佐治支气管扩张症急性加重期临床观察  

Clinical Observation on Qingre Huoxue Prescription in the Treatment of Acute Exacerbation of Bronchiectasis

作　　者：陈启庭 吴越[3] 蔡俊媛[2] CHEN Qiting;WU Yue;CAI Junyuan(The Second Clinical Medical College of Guangzhou University of Chinese Medicine,Guangzhou 510006,China;Department of Integrated Traditional Chinese and Western Medicine,Shenzhen Second People′s Hospital,Shenzhen 518000,China;Department of Pharmacy,Shenzhen Children′s Hospital,Shenzhen 518000,China)

机构地区：[1]广州中医药大学第二临床医学院,广州510006 [2]深圳市第二人民医院中西医结合科,深圳518000 [3]深圳市儿童医院药剂科,深圳518000

出　　处：《世界中医药》2020年第1期90-93,98,共5页World Chinese Medicine

基　　金：广州科技计划项目(201803010121);深圳市“三名工程”项目资助课题(SZSM201612049)

摘　　要：目的:探讨中药清热活血方佐治支气管扩张症急性加重期的临床疗效。方法:选取2016年10月至2018年10月广州中医药大学第二临床医学院收治的支气管扩张症急性加重期患者116例作为研究对象,按照随机数字表法随机分为对照组和观察组,每组58例。对照组给予排痰、抗感染等西医常规治疗;观察组在对照组治疗的基础上给予中药清热活血方治疗,疗程均为2周。比较2组治疗前后中医证候评分、动脉血气分析指标、血清基质金属蛋白酶-9(MMP-9)和基质金属蛋白酶抑制剂-1(TIMP-1)水平,并比较2组治疗总有效率。结果:治疗后观察组咳嗽痰多、痰中带血、发热口渴、胸闷气急、舌苔、脉象各项评分均低于对照组(P<0.01),血气分析指标中氧分压(PaO 2)、血氧饱和度(SaO 2)高于对照组(P<0.01),二氧化碳分压(PaCO 2)低于对照组(P<0.01),血清MMP-9水平低于对照组(P<0.01),TIMP-1水平高于对照组(P<0.01),治疗总有效率高于对照组(P<0.05)。结论:中药清热活血方佐治支气管扩张症急性加重期,可有效缓解症状,改善动脉血气指标,调节MMP-9、TIMP-1平衡,提高临床疗效。Objective:To explore the clinical effect of Qingre Huoxue Prescription in the treatment of acute exacerbation of bronchiectasis.Methods:A total of 116 patients with acute exacerbation of bronchiectasis treated in the Second Clinical Medical College of Guangzhou University of Chinese Medicine from October 2016 to October 2018 were selected as the research objects,who met the inclusion criteria were randomly divided into a control group and an observation group according to random number table method,with 58 cases in each group.The control group was given routine western medicine treatment such as expectoration and anti-infective,while the observation group was given Chinese medicine Qingre Huoxue Prescription based on the treatment of the control group for 2 weeks.The TCM syndrome score,arterial blood gas analysis index,serum Matrix Metalloproteinase-9(MMP-9)and Matrix Metalloproteinase Inhibitor-1(TIMP-1)levels were compared between the 2 groups before and after treatment,and the total effective rate was compared between the 2 groups.Results:After treatment,the scores of cough and phlegm,blood in sputum,fever and thirst,chest tightness,tongue coating and pulse of the observation group were lower than those of the control group(P<0.01).The partial pressure of oxygen(PaO 2)and oxygen saturation(SaO 2)in blood gas analysis indexes were higher than those of the control group(P<0.01).The partial pressure of carbon dioxide(PaCO 2)was lower than those of the control group(P<0.01),and the level of serum MMP-9 was lower than that of the control group(P<0.01).The level of TIMP-1 was higher than that of the control group(P<0.01),and the total effective rate of treatment was higher than that of the control group(P<0.05).The difference was statistically significant.Conclusion:Qingre Huoxue Prescription can effectively relieve symptoms,improve arterial blood gas index,regulate the balance of MMP-9 and TIMP-1,and improve clinical efficacy in the treatment of acute exacerbation of bronchiectasis.

关 键 词：支气管扩张症 急性加重 中药治疗 清热活血方 痰热瘀肺 中医证候 基质金属蛋白酶-9 基质金属蛋白酶抑制剂-1 

分 类 号：R285.6[医药卫生—中药学]