中药联合肺泡灌洗治疗慢性阻塞性肺疾病急性加重期的临床疗效观察  

Clinical Efficacy of Traditional Chinese Medicine Combined with Alveolar Lavage in Treatment of AECOPD Patients

作　　者：张秀莲[1] 李学良 马伟 刘芳英[1] 李莉[1] 危蕾[1] 钱叶长 ZHANG Xiulian;LI Xueliang;MA Wei;LIU Fangying;LI Li;WEI Lei;QIAN Yechang(Baoshan Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201999,China;Baoshan Branch,Renji Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200444,China)

机构地区：[1]上海中医药大学附属宝山医院,上海201999 [2]上海交通大学医学院附属仁济医院宝山分院,上海200444

出　　处：《中华中医药学刊》2023年第3期73-76,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81903977);上海市科学技术委员会“科技创新行动计划”医学引导类(中、西医)科技支撑项目(19401933200);上海市卫生健康委员会科研项目(2018LQ001,201940097);上海中医药大学后备卓越中医人才项目(上中医医管字〔2020〕10号)。

摘　　要：目的观察二陈汤合三子养亲汤联合肺泡灌洗治疗慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者的临床疗效及对肺功能和血气指标的影响。方法选取2019年10月—2021年9月医院呼吸科住院治疗的AECOPD且辨证为痰湿阻肺证患者,采用随机数字法分为治疗组40例,对照组39例。对照组在常规西药治疗联合肺泡灌洗基础上给予含10%中药安慰剂口服,治疗组在常规西药治疗联合肺泡灌洗基础上给予二陈汤合三子养亲汤颗粒剂。治疗1周后,评估两组患者治疗前后中医证候积分、肺功能及血气指标。结果治疗组患者咳嗽、咳痰、喘息、哮鸣、胸闷中医证候积分优于对照组,组间差异有统计学意义(P<0.05),治疗组有效率达97.5%(39/40),两组有效率比较,治疗组高于对照组(P<0.05)。两组患者肺功能FEV1和FEV1/Pre%比较,治疗组优于对照组(P<0.05)。治疗组患者血气指标pH、PaO_(2)、PaCO_(2)及SaO_(2)与对照组相比(P<0.05),治疗组在改善血气指标方面优于对照组。两组患者治疗前后肝肾功能均无异常表现,说明该治疗方法安全可靠。结论二陈汤合三子养亲汤联合肺泡灌洗治疗痰湿阻肺型AECOPD患者临床疗效显著,可促进机体痰液排出,改善患者肺功能及血气分析指标。且该治疗措施安全性较高,值得在临床中推广。Objective To observe the clinical efficacy of Erchen Decoction(二陈汤)and Sanzi Yangqin Decoction(三子养亲汤)combined with alveolar lavage in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and evaluate the effect on pulmonary function and blood gas indexes.Methods AECOPD patients hospitalized in the respiratory department of the hospital from October 2019 to September 2021 who were identified as phlegm-dampness blocking lung syndrome were randomly divided into the treatment group(40 cases)and the control group(39 cases).The control group was given placebo containing 10%traditional Chinese medicine on the basis of routine western medicine treatment combined with alveolar lavage.The treatment group was given granules containing Erchen Decoction and Sanzi Yangqin Decoction on the basis of routine western medicine treatment combined with alveolar lavage.After one week of treatment,the TCM syndrome scores,pulmonary function and blood gas indexes of the two groups were evaluated before and after treatment.Results The TCM syndrome scores of cough,expectoration,gasping,wheezing and chest tightness in the treatment group were better than those in the control group,and the differences between the groups were statistically significant(P<0.05).The effective rate of the treatment group was 97.5%(39/40),and the effective rate of the two groups was higher than that of the control group(P<0.05).The value of forced expiratory volume in the first second(FEV1)and the percentage of the expected value of FEV1(FEV1%/Pre)between the two groups had significant difference(P<0.05),and those of the treatment group were better than those of the control group.The blood gas indexes including(hydrogen ion concentration)pH,partial pressure of oxygen(PaO_(2)),carbon dioxide partial pressure(PaCO_(2))and blood oxygen saturation(SaO_(2))in the treatment group were better than those in the control group(P<0.05).There was no abnormal liver or kidney function in the two groups before and afte

关 键 词：慢性阻塞性肺疾病急性加重期 二陈汤 三子养亲汤 肺泡灌洗 痰湿 

分 类 号：R259.63[医药卫生—中西医结合]