翘芩清肺剂治疗慢性阻塞性肺疾病急性加重(痰热壅肺证)的疗效观察  

Clinical Effect of Qiao Qin Qingfei Decoction on Acute Exacerbation of Chronic Obstructive Pulmonary Disease(Phlegm-heat Obstructing Lung Syndrome)

作　　者：里自然 刘小虹[3] 叶焰[1] 熊艳云 梁仕勤 高婉玲 杜鹃 詹坤鹏 LI Ziran;LIU Xiaohong;YE Yan;XIONG Yanyun;LIANG Shiqin;GAO Wanling;DU Juan;ZHAN Kunpeng(The Affiliated TCM Hospital of Guangzhou Medical University,Guangzhou 510130 Guangdong,China;Guangzhou University of Chinese Medicine,Guangzhou 510120 Guangdong,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510120 Guangdong,China)

机构地区：[1]广州医科大学附属中医医院,广东广州510130 [2]广州中医药大学,广东广州510006 [3]广州中医药大学第一附属医院,广东广州510405

出　　处：《中药新药与临床药理》2022年第3期386-391,共6页Traditional Chinese Drug Research and Clinical Pharmacology

基　　金：广东省中医药局科研项目(20211295)。

摘　　要：目的评价翘芩清肺剂治疗慢性阻塞性肺疾病急性加重(AECOPD)痰热壅肺证的临床疗效及对炎症反应和氧化损伤的影响。方法将120例患者随机分为对照组(60例)和观察组(60例)。对照组给予西医综合治疗;观察组在对照组的基础上服用翘芩清肺剂。疗程均为10 d。评价治疗前后症状严重程度[慢性阻塞性肺疾病(COPD)自我评估测试(CAT)和咳嗽、咯痰、呼吸困难评分(BCSS)]、肺功能[第1秒用力呼气容积(FEV1),FEV1占预计值百分比(FEV1%)和FEV1占用力肺活量的百分比(FEV1/FVC)]、改良呼吸困难指数(mMRC)评分、痰热壅肺证积分、DECAF评分和COPD自我效能量表(CSES)评分;检测治疗前后降钙素原(PCT)、颗粒蛋白前体(PGRN)、白细胞介素8(IL-8)、8-羟基-2’-脱氧鸟苷(8-OHdG)和非对称二甲基精氨酸(ADMA)水平,并对其临床疗效和安全性进行评价。结果治疗后,两组患者CAT、BCSS、mMRC和痰热壅肺证积分均降低(P<0.01),且观察组各指标评分均低于对照组(P<0.01)。治疗后,两组患者FEV1、FEV1%和FEV1/FVC均升高(P<0.01),且观察组各指标均高于对照组(P<0.05)。治疗后,两组患者CSES评分升高(P<0.01),DECAF评分下降(P<0.01),且观察组CSES评分高于对照组,DECAF评分低于对照组(P<0.01)。治疗后,两组患者PCT、PGRN、IL-8、8-OHdG和ADMA水平均下降(P<0.01),且观察组各指标水平均低于对照组(P<0.01)。观察组临床总有效率为95.00%(57/60),高于对照组的80.00%(48/60)(χ^(2)=6.171,P<0.05)。治疗期间没有发现服用翘芩清肺剂引起的不良反应。结论翘芩清肺剂联合常规西医治疗可减轻AECOPD痰热壅肺证患者的临床症状,改善肺功能,提高自我效能,改善预后,并有抗炎和抗氧化作用,临床疗效优于单纯西医常规治疗,且使用安全。ObjectiveTo evaluate the clinical efficacy of Qiao Qin Qingfei Decoction in treating acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with phlegm-heat obstructing lung syndrome and its influence on inflammation and oxidative damage.MethodsThe 120 patients were randomly divided into a control group(60 cases)and an observation group(60 cases). Patients in the control group were given comprehensive western medicine treatment measures. In the observation group,Qiao Qin Qingfei Decoction was used on the basis of the therapy in the control group. Course of treatment for both groups were 10 days. The symptom severity included COPD selfassessment test(CAT) and cough, expectoration, dyspnea score(BCSS), pulmonary function included forced expiratory volume in the first second(FEV1), percentage of FEV1 to predicted value(FEV1%) and percentage of FEV1 occupancy of vital capacity(FEV1/FVC), modified dyspnea index(mMRC) score, phlegm-heat obstructing lung syndrome score,DECAF score and COPD self-efficacy energy scale(CSES)score before and after treatment were evaluated. The procalcitonin(PCT), granulin precursor(PGRN), interleukin-8(IL-8), 8-hydroxy-2’-deoxyguanosine(8-OHdG) and asymmetric dimethylarginine acid(ADMA) levels before and after therapy were detected. Safety evaluation was also carried out.ResultsAfter treatment,the scores of CAT,BCSS,mMRC and phlegm-heat obstructing lung syndrome of the two groups of patients all decreased(P<0.01),and the scores of all indicators in the observation group were lower than those of the control group(P<0.01). After treatment,the FEV1,FEV1%,and FEV1/FVC of the two groups of patients increased(P<0.01),and all the indicators of the observation group after treatment were higher than those of the control group(P<0.05). After treatment,the CSES scores of the two groups increased(P<0.01),while the DECAF scores decreased(P<0.01). After treatment,the CSES score of the observation group was higher than that of the control group,and the DECAF score was lower than that of the

关 键 词：慢性阻塞性肺疾病急性加重 痰热壅肺证 翘芩清肺剂 炎症因子 氧化损伤 预后 

分 类 号：R285.6[医药卫生—中药学]