清肺理痰方治疗稳定期支气管扩张症的临床疗效及其对患者肠道微生态的影响  

Clinical Efficacy of Qingfei Litan Prescription in the Treatment of Stable Bronchiectasis and Its Effect on Intestinal Microecology of Patients

作　　者：谢栩硕[1] 朱汉平[2] 张志敏[2] 温焕连[1] 卓超[1] 张浩 XIE Xushuo;ZHU Hanping;ZHANG Zhimin;WEN Huanlian;ZHUO Chao;ZHANG Hao(Department of Infectious Diseases,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120,China;Department of Traditional Chinese Medicine,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120,China)

机构地区：[1]广州医科大学附属第一医院感染内科,广东省广州市510120 [2]广州医科大学附属第一医院中医科,广东省广州市510120

出　　处：《实用心脑肺血管病杂志》2024年第12期92-97,共6页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：广东省中医药局中医药科研项目(20231243)。

摘　　要：目的探讨清肺理痰方对稳定期支气管扩张症的临床疗效及其对患者肠道微生态的影响。方法前瞻性选取2022年6月—2023年6月在广州医科大学附属第一医院就诊的稳定期支气管扩张症患者93例,采用随机数字表法将患者分为参照组47例和清肺理痰组46例。参照组采取常规治疗,包括采用体位引流、拍背等方法进行排痰,应用化痰药;清肺理痰组在参照组基础上接受清肺理痰方治疗,两组均连续用药12个月。比较两组临床疗效,治疗前后中医证候积分、支气管扩张严重度指数(BSI)评分,病情进展情况(急性加重次数、入院至首次急性加重的时间),治疗前后24 h痰量、铜绿假单胞菌(PA)分离率、肠道菌群数量,不良反应发生率。结果治疗期间,清肺理痰组失访1例,对照组失访2例。清肺理痰组临床疗效优于参照组(P<0.05)。治疗后,两组咳嗽、咯痰且色白、痞满、食少纳呆积分分别低于本组治疗前,且清肺理痰组低于参照组(P<0.05)。治疗后,两组BSI评分分别低于本组治疗前,且清肺理痰组低于参照组(P<0.05)。清肺理痰组急性加重次数少于参照组,入院至首次急性加重的时间长于参照组(P<0.05)。治疗后,两组24 h痰量分别少于本组治疗前,PA分离率分别低于本组治疗前,且清肺理痰组24 h痰量少于参照组,PA分离率低于参照组(P<0.05)。治疗后,两组双歧杆菌、乳酸杆菌数量分别多于本组治疗前,肠球菌、肠杆菌数量分别少于本组治疗前,且清肺理痰组双歧杆菌、乳酸杆菌数量多于参照组,肠球菌、肠杆菌数量少于参照组(P<0.05)。清肺理痰组不良反应发生率与参照组比较,差异无统计学意义(P>0.05)。结论清肺理痰方可提高稳定期支气管扩张症患者临床疗效,改善患者中医证候及支气管扩张程度,延缓病情进展,强效祛痰,减少痰液中的致病菌,同时能维持肠道微生态稳定,且用药安全性高。Objective To investigate the clinical efficacy of Qingfei Litan prescription in the treatment of stable bronchiectasis and its effect on intestinal microecology of patients.Methods A total of 93 patients with stable bronchiectasis admitted to the First Affiliated Hospital of Guangzhou Medical University from June 2022 to June 2023 were prospectively selected and divided into the control group(47 patients)and the Qingfei Litan group(46 patients)by random number table method.The control group was treated with conventional treatment,including using postural drainage,back patting,and other methods to expelling phlegm as well as applying phlegm-cleansing drugs;the Qingfei Litan group was treated with Qingfei Litan prescriptions on the basis of the control group,and both groups were treated for 12 months.Clinical efficacy,TCM syndrome score before and after treatment,Bronchiectasis Severity Index(BSI)score before and after treatment,disease progression(number of acute exacerbations,time from admission to the first acute exacerbation),24 h sputum volume before and after treatment,isolation rate of pseudomonas aeruginosa(PA)before and after treatment,intestinal flora quantity before and after treatment,and adverse reaction incidence were compared between the two groups.Results During treatment,there was 1 case of lost visits in the Qingfei Litan group and 2 cases of lost visits in the control group.The clinical efficacy of the Qingfei Litan group was better than that of the control group(P<0.05).After treatment,the scores of cough,phlegm with white color,plumpness and low food intake and dullness of the two groups were lower than those before treatment respectively,and those of the Qingfei Litan group were lower than those of the control group(P<0.05).After treatment,the BSI scores of the two groups were lower than those before treatment respectively,and those of the Qingfei Litan group were lower than those of the control group(P<0.05).The number of acute exacerbations in the Qingfei Litan group was less than that in th

关 键 词：支气管扩张症 清肺理痰方 胃肠道微生物组 治疗结果 

分 类 号：R562.22[医药卫生—呼吸系统]