清金化痰汤对慢性阻塞性肺疾病急性加重期的临床疗效、炎症反应和气道黏液高分泌的影响  

Effects of Qingjin Huatan Decoction in Treating acute Exacerbation of Chronic Obstructive Pulmonary Disease on the Clinical Efficacy,Inflammatory Response and Airway Mucus Hyper Secretion

作　　者：李探 张潇月 徐敏[1] 邵龙刚[1] 刘克琴[1] LI Tan;ZHANG Xiaoyue;XU Min;SHAO Longgang;LIU Keqin(The Second Affiliated Hospital of Nanjing University of Traditional Chinese Medicine,Jiangsu Nanjing 210017,China)

机构地区：[1]南京中医药大学第二附属医院急诊科,江苏南京210017

出　　处：《中医药临床杂志》2020年第4期781-786,共6页Clinical Journal of Traditional Chinese Medicine

基　　金：南京市科技项目(201611009)。

摘　　要：目的:探讨中药方剂清金化痰汤对慢性阻塞性肺疾病急性加重期(AECOPD)的临床疗效、炎症反应和气道黏液高分泌的影响。方法:符合AECOPD入选标准患者80例,随机分为清金化痰汤组(治疗组)和常规治疗组(对照组),每组40例。两组患者均常规给予低流量吸氧、抗感染、祛痰平喘等治疗,清金化痰汤治疗组在此基础上加用中药清金化痰汤口服或鼻饲,两组患者观察时间均为14d。通过评估两组患者抗菌药物使用时间的长短,治疗前后(入院当天和治疗14d)的血气分析及中医证候积分;入院第1d、7d、14d患者外周血中的白细胞计数、中性粒细胞百分比、C-反应蛋白(CRP)、降钙素原、肿瘤坏死因子-α(NF-α)、白介素1β(IL-1β)、白介素8(IL-8)、中性粒细胞弹性蛋白酶(NE)、基质金属蛋白酶-9(MMP-9);痰液中的黏蛋白5AC(MUC5AC)含量来探讨清金化痰汤对AECOPD的临床疗效、炎症反应及气道黏液高分泌的影响。结果:治疗组的抗生素使用时间显著低于对照组,治疗前后的中医证候积分、血气分析结果显著好于对照组,差异有统计学意义(P<0.05);两组患者的炎症指标及NE、MMP-9、MUC5AC的含量均低于入院时,但清金化痰汤组下降水平显著优于对照组,差异具有统计学意义(P<0.05)。结论:在常规西药治疗基础上,配合中药清金化痰汤治疗AECOPD,在改善患者临床症状、控制感染方面比单纯西医常规治疗效果更优,其作用机理可能与该方能够在一定程度上抑制炎症因子、减轻气道黏液高分泌有关。Objective:To explore the effect of Qingjin Huatan Decoction,a traditional Chinese medicine prescription,on the clinical efficacy,inflammation and high secretion of airway mucus in the acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:80 patients who met the AECOPD inclusion criteria were randomly divided into Qingjin Huatan Decoction group(treatment group)and conventional treatment group(control group),40 cases in each group.The two groups of patients were routinely given low-flow oxygen inhalation,anti-infection,expectorant and antiasthmatic treatments.The Qingjinhuatan Decoction treatment group added the traditional Chinese medicine Qingjinhuatan Decoction to oral or nasal feeding.For 14d.By evaluating the length of antimicrobial use of the two groups of patients,blood gas analysis before and after treatment(day of admission and 14d of treatment)and TCM syndrome scores;white blood cell count and percentage of neutrophils in the peripheral blood of patients on the 1st,7d,and 14d of admission,C-reactive protein(CRP),procalcitonin,tumor necrosis factor-α(NF-α),interleukin 1β(IL-1β),interleukin 8(IL-8),neutrophil elastase(NE),matrix Metalloproteinase-9(MMP-9);mucin 5AC(MUC5AC)content in sputum to explore the effect of Qingjinhuatan Decoction on the clinical efficacy,inflammation and high secretion of airway mucus in AECOPD.Results:The antibiotic use time of the treatment group was significantly lower than that of the control group,and the TCM syndrome score and blood gas analysis results before and after treatment were significantly better than the control group,the difference was statistically significant(P<0.05);inflammation indicators and NE of the two groups of patients,MMP-9 and MU C5AC were lower than those at admission,but the level of Qingjinhuatan Decoction group was significantly better than the control group,the difference was statistically significant(P<0.05).Conclusion:On the basis of conventional western medicine treatment,combined with the traditional Chinese medicine Qi

关 键 词：清金化痰汤 慢性阻塞性肺疾病急性加重期 炎症反应 气道黏液高分泌 

分 类 号：R[医药卫生]