中药穴位贴敷联合痰热清雾化治疗慢性阻塞性肺疾病伴重症肺炎临床研究  

Clinical Study on Chinese Medicine Point Application Combined with Phlegm-Heat Clearing Atomization for Chronic Obstructive Pulmonary Disease Complicated with Severe Pneumonia

作　　者：包秋丽 BAO Qiuli(Department of Intensive Care Unit,Lanxi People's Hospital,Lanxi Zhejiang 321100,China)

机构地区：[1]兰溪市人民医院重症医学科,浙江兰溪321100

出　　处：《新中医》2024年第20期141-145,共5页New Chinese Medicine

摘　　要：目的:观察中药穴位贴敷联合痰热清雾化治疗慢性阻塞性肺疾病(COPD)伴重症肺炎的临床疗效及对Toll样受体4 (TLR4) mRNA、黏蛋白5AC (MUC5AC)的影响。方法:采用随机数字表法将98例COPD伴重症肺炎患者分为对照组、观察组各49例。对照组给予常规对症治疗,观察组在对照组基础上加用中药穴位贴敷联合痰热清雾化治疗。比较2组治疗前后急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)评分、中医证候积分、肺通气功能指标及TLR4 mRNA、MUC5AC水平,评估2组临床疗效及不良反应发生情况。结果:观察组总有效率95.92%,高于对照组79.59%(P<0.05)。治疗后,2组最大通气量(MVV)、最大呼气峰流速(PEF)水平、第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC均较治疗前升高(P<0.05),APACHEⅡ评分、中医证候积分及TLR4 mRNA、MUC5AC水平均较治疗前降低(P<0.05),且观察组APACHEⅡ评分、中医证候积分及TLR4 mRNA、MUC5AC水平低于对照组(P<0.05),肺通气功能指标水平均高于对照组(P<0.05)。2组均未见严重不良反应。结论:中药穴位贴敷联合痰热清雾化治疗COPD伴重症肺炎疗效显著,能够调节患者TLR4 mRNA、MUC5AC水平,改善肺通气功能,安全性较高。Objective:To observe the clinical effect of Chinese medicine point application combined with phlegm-heat clearing atomization on chronic obstructive pulmonary disease(COPD)complicated with severe pneumonia and its effect on toll-like receptor 4(TLR4)mRNA and mucins 5AC(MUC5AC).Methods:A total of 98 cases of COPD patients complicated with severe pneumonia were divided into the control group and the observation group,with 49 cases in each group,using a random number table method.The control group received routine symptomatic treatment,and the observation group received additional treatment with Chinese medicine point application combined with phlegm-heat clearing atomization in addition to the treatment of the control group.The acute physiology and chronic health evaluationⅡ(APACHEⅡ)scores,traditional Chinese medicine(TCM)syndrome scores,lung ventilation function indicators,and TLR4 mRNA and MUC5AC levels were compared before and after treatment between the two groups.The clinical effects and incidence of adverse reactions were evaluated in both groups.Results:The total effective rate was 95.92%in the observation group,which was higher than that of 79.59%in the control group(P<0.05).After treatment,the maximum ventilation volume(MVV),peak expiratory flow rate(PEF)levels,first second forced expiratory volume(FEV1),forced vital capacity(FVC),and FEV1/FVC in both groups were increased when compared with those before treatment(P<0.05),and APACHEⅡscores,TCM syndrome scores,TLR4 mRNA,and MUC5AC levels were decreased when compared with those before treatment(P<0.05);the observation group had lower APACHEⅡscores,TCM syndrome score,and TLR4 mRNA and MUC5AC levels than the control group(P<0.05),and higher lung ventilation function indicators levels(P<0.05).No serious adverse reactions were observed in the two groups.Conclusion:Chinese medicine point application combined with phlegm-heat clearing atomization has a significant curative effect in treating COPD complicated with severe pneumonia,which can regulate TLR4 mR

关 键 词：慢性阻塞性肺疾病 重症肺炎 中药穴位贴敷 痰热清雾化 

分 类 号：R563[医药卫生—呼吸系统]