经方序贯疗法治疗嗜酸性粒细胞增高型慢性阻塞性肺疾病急性加重期外寒内饮证的中医证候疗效及对炎症指标和凝血指标的影响  

Effect of sequential treatment of classical prescription on acute exacerbation of chronic obstructive pulmonary disease with external cold and internal drinking of peripheral blood eosinophils increased and its influence on inflammatory and coagulation index

作　　者：刘宏祥[1] 赵永辰[1] 周胜男 孙艳敏 张彦广[4] 高宏伟 史曼[5] LIU Hongxiang;ZHAO Yongchen;ZHOU Shengnan;SUN Yanmin;ZHANG Yanguang;GAO Hongwei;SHI Man(Department of Integrated Traditional Chinese and Western Medicine,Affiliated Hospital of Hebei University,Baoding,Heibei 071000;不详)

机构地区：[1]河北大学附属医院中西医结合科,河北保定071000 [2]河北省荣军医院综合内科,河北保定071000 [3]河北省容城县中医医院内科,河北容城071700 [4]河北省保定市第七医院中西医结合科,河北保定072150 [5]河北大学附属医院心内科,河北保定071000

出　　处：《河北中医》2021年第4期566-570,652,共6页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省科学技术厅科技计划项目(编号:162777223);河北省财政厅2018年政府资助专科能力建设和专科带头人培养项目(编号:361007)。

摘　　要：目的观察经方序贯疗法治疗嗜酸性粒细胞(EOS)增高型慢性阻塞性肺疾病急性加重期(AECOPD)外寒内饮证的中医证候疗效及对炎症指标和凝血指标的影响。方法将72例EOS增高型AECOPD外寒内饮证患者按照随机数字表法分为2组,治疗组36例予经方序贯疗法治疗,对照组36例予西医常规治疗。治疗组小青龙加石膏汤服用3 d,序贯以加味苓桂术甘汤服用7 d,序贯以加减金匮肾气丸服用12周;对照组注射用甲泼尼龙琥珀酸钠静脉滴注连续治疗5 d,布地奈德福莫特罗粉吸入剂连用12周。比较2组中医证候疗效;比较2组治疗前及治疗1、2、12周炎症指标和凝血指标变化;比较2组治疗前后中医证候评分变化。结果最终治疗组34例、对照组32例完成研究。治疗组显效率50.0%(17/34),对照组显效率12.5%(4/32),治疗组疗效优于对照组(P<0.05)。2组治疗后外周血EOS、血清C反应蛋白(CRP)、降钙素原(PCT)、淀粉样蛋白A(SAA)均较本组治疗前降低(P<0.05);经重复测量方差分析,治疗组治疗12周SAA水平低于对照组同期(P<0.05);2组治疗1、2周SAA比较差异无统计学意义(P>0.05);2组治疗各时间点EOS、CRP、PCT比较差异均无统计学意义(P>0.05)。2组治疗后D-二聚体(D-D)、纤维蛋白原(FIB)均较本组治疗前降低(P<0.05);经重复测量方差分析,治疗组治疗12周FIB水平低于对照组(P<0.05);2组治疗1、2周FIB比较差异均无统计学意义(P>0.05);2组治疗各时间点D-D比较差异均无统计学意(P>0.05)。2组治疗后中医证候咳嗽、咯痰、气促评分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。结论经方序贯疗法治疗外周血EOS增高型AECOPD外寒内饮证,能明显改善炎症指标、凝血指标,疗效优于西医常规治疗。Objective To explore the effect on sequential treatment of classical prescription of acute exacerbation of chronic obstructive pulmonary disease(AECOPD) with external cold and internal drinking of peripheral blood eosinophils(EOS)increased and its influence on inflammatory index and coagulation index.Methods Totally 72 AECOPD patients with external cold and internal drinking of peripheral blood EOS increased were randomly divided into 2 groups,36 cases in treatment group received sequential treatment of classical prescription(Xiaoqinglong plus Shigao Decoction for 3 days,followed by Modified Linggui Zhugan Decoction for 7 days,and followed by Modified Jinkui Shenqi Pills for 12 weeks);36 cases in control group received conventional treatment of western medicine(injection of methylprednisolone sodium succinate for 5 days,and inhalation of budesonide formoterol powder for 12 weeks).TCM curative effect,inflammatory and coagulation index TCM syndrome scores were compared between groups before treatment and after 1-,2-,12 week of treatment.Results There were 34 cases in treatment group and 32 cases in control group completed the study.The curative effect in treatment group were better than those in control group [50.0%(17/34) vs 12.5%(4/32),(P < 0.05),respectively].Compared with before treatment,peripheral blood EOS,serum C-reactive protein(CRP),procalcitonin(PCT),serum amyloid A(SAA) after treatment in groups were significantly decreased(P < 0.05).Repeated measures analysis of variance showed SAA level in 12-week of treatment group was lower than that of in control group(P < 0.05),with no statistically significant difference in SAA in 1-,2-week between groups(P > 0.05);the difference was no statistically significant in EOS,CRP,and PCT between groups at each time point(P > 0.05);d-dimer(D-D) and fibrinogen(FIB) in groups were significantly decreased after treatment(P < 0.05) with no statistically significant difference in DD between groups at each time point(P > 0.05).FIB level in 12-week was lower in treatment group

关 键 词：肺疾病 慢性阻塞性 经方 炎症 

分 类 号：R563.05[医药卫生—呼吸系统]