清金化浊方联合西医常规疗法治疗感染性慢性阻塞性肺疾病急性加重疗效及抑制气道黏液高分泌机制研究  

Study on Efficacy of Qingjin Huazhuo Decoction Combined with Western Medicine Conventional Therapy in the Treatment of Acute Exacerbation of Infectious Chronic Obstructive Pulmonary Disease and Mechanism of Inhibiting Airway Mucus Hypersecretion

作　　者：王彬[1] 吴蔚[1] 高峰[1] 汪伟[1] 冯雪梅[1] 张晶 WANG Bin;WU Wei;GAO Feng;WANG Wei;FENG Xuemei;ZHANG Jing(Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing 100102,China)

机构地区：[1]中国中医科学院望京医院,北京100102

出　　处：《中国中医药信息杂志》2022年第1期124-129,共6页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：北京市科技计划项目(Z181100001718114);中国中医科学院自主选题项目(ZZ11-081)。

摘　　要：目的观察清金化浊方联合西医常规疗法治疗感染性慢性阻塞性肺疾病急性加重(AECOPD)痰热蕴肺证患者的疗效,探讨其抑制气道黏液高分泌可能的作用机制。方法采用区组随机方法将102例住院患者分为观察组与对照组各51例。对照组予支气管舒张剂、控制性氧疗、抗生素、糖皮质激素、机械通气等措施,观察组在此基础上予清金化浊方,每日1剂,每日2次,口服。2组均连续治疗7d,全程住院观察。观察2组治疗前后中医症状评分、痰液性状评分、呼吸困难严重程度、血常规感染指标及气道黏液高分泌指标,并监测不良反应。结果与本组治疗前比较,2组治疗后咳嗽、喘息气短、咯痰、发热、便秘评分降低(P<0.05,P<0.01),观察组治疗后口渴评分降低(P<0.01);2组治疗前后差值比较,观察组改善咳嗽、喘息气短、咯痰、口渴、便秘评分优于对照组(P<0.01,P<0.05)。与本组治疗前比较,2组治疗后痰液性状评分、呼吸困难严重程度评分下降(P<0.01);2组治疗前后差值比较,观察组改善痰液性状评分及呼吸困难严重程度评分优于对照组(P<0.01)。与本组治疗前比较,2组治疗后血常规感染指标(外周血白细胞计数、中性粒细胞百分比)、气道黏液高分泌指标(痰液黏蛋白5AC含量、痰液黏蛋白5AC mRNA表达)降低(P<0.05,P<0.01);2组治疗前后差值比较,观察组降低血常规感染指标、气道黏液高分泌指标优于对照组(P<0.05)。观察组腹泻3例,对照组腹泻2例,2组不良反应发生率比较差异无统计学意义(P>0.05)。结论清金化浊方联合西医常规疗法治疗感染性AECOPD痰热蕴肺证可明显改善患者症状、痰液性状及呼吸困难严重程度,降低血常规感染指标。其抑制气道黏液高分泌机制可能为下调痰液黏蛋白5AC含量及其m RNA的表达。Objective To observe the efficacy of Qingjin Huazhuo Decoction combined with western medicine conventional therapy in the treatment of infectious acute exacerbation of chronic obstructive pulmonary disease(AECOPD);To analyze its possible mechanism of inhibiting airway mucus hypersecretion.Methods Totally 102 hospitalized patients were randomly divided into observation group and control group using block randomization method,with 51 cases in each group.The control group was given bronchodilator,controlled oxygen therapy,antibiotics,glucocorticoids,mechanical ventilation and other treatment measures according to the condition,and the observation group was given Qingjin Huazhuo Decoction on this basis,one dosage per day,twice a day,orally.The course of treatment for both groups was 7 days,under whole hospitalization observation.The changes of TCM symptom score,sputum traits score,severity of dyspnea,blood routine infection indexes and airway mucus hypersecretion indexes were observed before and after treatment in two groups,and monitored adverse reaction.Results Compared with before treatment,the scores of cough,wheezing and shortness of breath,expectoration,fever,and constipation in the two groups decreased after treatment(P<0.05,P<0.01),and the thirst score of the observation group decreased after treatment(P<0.01);comparing the difference between the two groups before and after treatment,the scores of cough,wheezing and shortness of breath,expectoration,thirst,and constipation in the observation group were better than those in the control group(P<0.01,P<0.05).Compared with before treatment,the scores of sputum traits and the severity of dyspnea in the two groups decreased after treatment(P<0.01);comparing the difference between the two groups before and after treatment,the scores of sputum traits and the severity of dyspnea in the observation group were better than those of the control group(P<0.01).Compared with before treatment,blood routine infection indicators(peripheral blood white blood cell count,neutrophi

关 键 词：清金化浊方 慢阻肺急性加重期 感染性 痰热蕴肺证 气道黏液高分泌 临床研究 

分 类 号：R259.63[医药卫生—中西医结合]