清咳平喘颗粒治疗慢阻肺急性加重期痰热郁肺证的临床观察  

Clinical Observation on Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease(Syndrome of Phlegm-heat Obstructing Lung)with Qingke Pingchuan Granules

作　　者：张志杰 崔红生 黄贵锐 张诗瑜 王妍妍 李佳琦[1,2] ZHANG Zhijie;CUI Hongsheng;HUANG Guirui;ZHANG Shiyu;WANG Yanyan;LI Jiaqi(The Third Affiliated Hospital of Beijing University of Chinese Medicine,Beijing 100029,China;Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学第三附属医院,北京100029 [2]北京中医药大学,北京100029

出　　处：《中国实验方剂学杂志》2024年第16期85-91,共7页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金项目(82274462)。

摘　　要：目的:观察清咳平喘颗粒治疗慢性阻塞性肺疾病(慢阻肺)急性加重期痰热郁肺证的临床疗效及安全性。方法:选取慢阻肺急性加重期痰热郁肺证患者100例,按照随机数字表分为治疗组和对照组,各50例。治疗组予清咳平喘颗粒联合西医常规治疗,对照组予西医常规治疗。两组疗程均为14 d,随访1个月。于治疗前、治疗后观察记录患者中医证候量表积分,慢阻肺患者自我评估测试问卷(CAT)评分、改良版英国医学研究委员会呼吸困难问卷(mMRC)评分、6 min步行距离、C反应蛋白(CRP)变化水平,在随访1月时观察记录患者中医证候量表评分、CAT、mMRC。结果:与对照组比较,治疗组患者一般资料分布差异无统计学意义,治疗组患者治疗后综合疗效较高,治疗后咳嗽、喘息、气短、痰量、痰色、痰质、烦躁、舌苔、脉象及中医证候总积分均有明显改善(P<0.05);CAT问卷总积分及咳嗽、咳痰、胸闷等各项症状积分较对照组均明显改善(P<0.05);mMRC问卷评分明显降低(P<0.05);6 min步行距离及CRP水平差异无统计学意义。随访1月时,与对照组比较,治疗组咳嗽、喘息、痰量、胸闷及中医证候总积分均明显降低(P<0.05);CAT问卷总积分及咳嗽、咳痰、胸闷等各项症状积分均降低(P<0.05);mMRC问卷评分明显降低(P<0.05)。同时,在治疗过程中,治疗组与对照组均未出现严重不良反应,安全性较高。结论:清咳平喘颗粒可以明显改善慢阻肺急性加重期痰热郁肺证患者咳嗽、咳痰、胸闷等症状,提高患者生活质量,药效作用时间较长,药物安全性高,临床值得推广使用。Objective:To observe the clinical efficacy and safety of Qingke Pingchuan granules in the treatment of acute exacerbation of chronic obstructive pulmonary disease(COPD)due to phlegm-heat obstructing lung.Method:One hundred patients with the syndrome of phlegm-heat obstructing lung during acute exacerbation of COPD were selected and assigned into a treatment group(50 cases)and a control group(50 cases)according to the random number table.The treatment group was treated with Qingke Pingchuan granules combined with conventional western medicine,and the control group was treated with conventional western medicine.The treatment course was 14 days in both groups,and the follow-up lasted for 1 month.Before and after the treatment,the traditional Chinese medicine(TCM)symptom score,COPD assessment test(CAT)score,modified Medical Research Council(mMRC)scale core,6-minute walk distance(6MWD),and C-reactive protein(CRP)level were determined.In addition,the TCM symptom score,CAT score,and mMRC score were recorded one month after treatment in the follow-up.Result:The general information of the patients showed no significant difference between the two groups.The treatment group had higher comprehensive treatment efficacy than the control group,as demonstrated by the lower scores of cough,wheezing,shortness of breath,sputum volume,sputum color,sputum texture,irritability,tongue coating,and pulse manifestation and lower total TCM symptom score(P<0.05).The treatment group outperformed the control group in terms of the total CAT score and scores of symptoms,such as cough,expectoration,and chest tightness(P<0.05).The treatment group had lower mMRC scale score than the control group(P<0.05),and there was no significant difference in 6MWD or CRP level between the two groups.The follow-up results showed that compared with the control group,the treatment group showcased reductions in cough,wheezing,sputum volume,chest tightness,and total TCM symptom scores(P<0.05),total CAT score and the scores of cough,expectoration,and chest tightness

关 键 词：慢性阻塞性肺疾病急性加重期 痰热郁肺证 清咳平喘颗粒 临床疗效 临床随机对照研究 

分 类 号：R2-0[医药卫生—中医学] R22R242R285.5R563