补肺阿胶汤合百合固金汤加减联合西药治疗老年支气管扩张症临床研究  

Clinical Study on Modified Bufei Ejiao Decoction and Baihe Gujin Decoction Combined with Western Medicine for Bronchiectasis in Senile Patients

作　　者：徐国龙 王婷婷 王媛 XU Guoong;WANG Tingting;WANG Yuan(Emergency Department of Internal Medicine,Jiashan County Hospital of Chinese Medicine,Jiashan Zhejiang 314100,China)

机构地区：[1]嘉善县中医医院急诊内科,浙江嘉善314100

出　　处：《新中医》2024年第16期16-21,共6页New Chinese Medicine

摘　　要：目的:观察补肺阿胶汤合百合固金汤加减联合西药治疗老年支气管扩张症的效果。方法:纳入206例阴虚痰热型老年支气管扩张症患者,随机分为联合组和西药组。2组均采用常规西药治疗,联合组加用补肺阿胶汤合百合固金汤加减治疗,2组均治疗2周。比较治疗前、治疗2周后的中医证候评分、呼吸困难程度[改良呼吸困难指数(mMRC)评分、支气管扩张严重度指数(BSI)评分]、肺通气功能指标[第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、FEV_(1)与FVC的比值(FEV_(1)/FVC)、最大自主分钟通气量(MVV)]及炎症标志物[降钙素原(PCT)、白细胞介素-17 (IL-17)、红细胞沉降率],记录肺部啰音减少的时间、咳痰气喘减轻的时间与不良反应发生情况,比较2组的临床疗效。结果:治疗2周后,联合组总有效率高于西药组(P<0.05)。2组治疗效果比较,差异有统计学意义(P<0.05)。2组各项中医主症评分、次症评分均较治疗前降低(P<0.05)。联合组各项中医主症评分、次症评分均低于西药组(P<0.05)。联合组肺部啰音减少时间、咳痰气喘减轻时间均短于西药组(P<0.05)。2组mMRC评分、BSI评分均较治疗前降低(P<0.05),联合组mMRC评分、BSI评分均低于西药组(P<0.05)。2组FEV_(1)、FVC、FEV_(1)/FVC及MVV值均较治疗前升高(P<0.05),联合组4项指标值均高于西药组(P<0.05)。2组PCT、IL-17水平及红细胞沉降率均较治疗前下降(P<0.05),联合组3项指标值均低于西药组(P<0.05)。结论:补肺阿胶汤合百合固金汤加减联合西药可有效缓解阴虚痰热型老年支气管扩张症患者的临床症状,改善肺通气功能,减轻炎症反应,安全性好。Objective:To observe the effect of modified Bufei Ejiao Decoction and Baihe Gujin Decoction combined with western medicine on bronchiectasis in senile patients.Methods:A total of 206 cases of senile patients who had bronchiectasis with yin deficiency and phlegm-heat syndrome were randomly divided into the combination group and the western medicine group.Both groups were treated with conventional western medicine,and the combination group was additionally treated with modified Bufei Ejiao Decoction and Baihe Gujin Decoction.Both groups were treated for two weeks.Traditional Chinese medicine(TCM)syndrome scores,degree of dyspnea[scores of modified Medical Research Council(mMRC)and Bronchiectasia Severity Index(BSI)],pulmonary ventilation function indicators[the forced expiratory volume in one second(FEV_(1)),forced vital capacity(FVC),the ratio of FEV_(1)to FVC(FEV_(1)/FVC),and maximal voluntary ventilation(MVV)],inflammatory markers[procalcitonin(PCT),interleukin-17(IL-17),and erythrocyte sedimentation rates]before and after two weeks of treatment were compared.The time for lung rale reduction,relief of expectoration and panting,and incidence of adverse reactions were recorded.Clinical effects were compared between the two groups.Results:After two weeks of treatment,the total effective rate in the combination group was higher than that in the western medicine group(P<0.05).The comparison of curative effects between the two groups showed significance in the difference(P<0.05).The scores of the main symptoms and secondary symptoms of TCM syndrome in the two groups were decreased when compared with those before treatment(P<0.05).The scores of the main symptoms and secondary symptoms of TCM syndrome in the combination group were lower than those in the western medicine group(P<0.05).The time for lung rale reduction and relief of expectoration and panting in the combination group were earlier than those in the western medicine group(P<0.05).The scores of mMRC and BSI in the two groups were declined when compared with t

关 键 词：支气管扩张症 阴虚痰热证 补肺阿胶汤 百合固金汤 肺通气功能 老年人 

分 类 号：R562.22[医药卫生—呼吸系统] R259[医药卫生—内科学]