金卫平喘汤治疗慢性阻塞性肺疾病急性加重期痰热瘀肺证患者的临床观察  

Clinical Efficacy of Jinwei Pingchuan Decoction in Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease with Phlegm-heat Obstruction in Lung Syndrome

作　　者：郑旭东 孔德钰 赵本璋 周慧敏 汪睿韬 吴建军 ZHENG Xudong;KONG Deyu;ZHAO Benzhang;ZHOU Huimin;WANG Ruitao;WU Jianjun(Beijing University of Chinese Medicine Third Affiliated Hospital,Beijing 100029,China)

机构地区：[1]北京中医药大学第三附属医院,北京100029

出　　处：《中国实验方剂学杂志》2025年第7期125-133,共9页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：第五批全国中医临床优秀人才研修项目(国中医药人教函[2022]1号);国家自然科学基金项目(82274462);北京市自然科学基金项目(7232284)。

摘　　要：目的:研究金卫平喘汤联合西医常规治疗对慢性阻塞性肺疾病(慢阻肺)急性加重期痰热瘀肺证患者急性加重次数、肺功能及临床症状的影响。方法:采用非随机对照研究的方法纳入60例慢阻肺急性加重期痰热瘀肺证的患者并按照是否服用金卫平喘汤分为治疗组、对照组,各30例。治疗组予金卫平喘汤联合西医常规疗法,对照组予西医常规疗法,两组疗程均为7 d,并对治疗前、后3个月的急性加重次数及肺功能指标进行随访记录,观察治疗前后患者急性加重次数、肺功能指标[第1秒用力呼气容积(FEV_(1))及占预计值百分比(FEV_(1)%)、用力肺活量(FVC)、第1秒用力呼气容积/用力肺活量(FEV_(1)/FVC)]、急性加重程度、中医证候评分、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、C反应蛋白(CRP)、白细胞(WBC)计数的变化。结果:对两组患者治疗后3个月内急性加重次数进行随访,与本组治疗前比较,治疗组急性加重次数减少(P<0.05),治疗后与对照组比较,治疗组急性加重次数减少(P<0.0.5);与本组治疗前比较,治疗组急性加重程度改善(P<0.05),治疗后与对照组比较,治疗组急性加重程度改善(P<0.05);与本组治疗前比较,治疗组肺功能指标中FEV_(1)、FEV_(1)%、FVC及FEV_(1)/FVC升高(P<0.05),对照组FEV_(1)、FEV_(1)%、FVC及FEV_(1)/FVC升高(P<0.05),治疗后与对照组比较,治疗组FEV_(1)、FVC升高(P<0.05);与本组治疗前比较,治疗组中医证候评分中喘息、咳嗽、咳痰、胸闷、气短、乏力单项症状积分及总积分下降(P<0.05),对照组咳嗽、咳痰、胸闷、乏力、心悸单项症状积分及总积分下降(P<0.05),治疗后与对照组比较,治疗组喘息、咳嗽、胸闷、气短单项症状积分及总积分下降(P<0.05);与本组治疗前比较,治疗组CAT评分咳嗽、咳痰、胸闷、爬楼、外出、活动、精力单项症状积分及�Objective:To study the effect of Jinwei Pingchuan decoction combined with conventional Western medicine on the number of acute exacerbations,lung function,and clinical symptoms in patients with acute exacerbation of chronic obstructive pulmonary disease(COPD)with phlegm-heat obstruction in lung syndrome.Methods:A non-randomized controlled trial was conducted to include 60 patients with acute exacerbation of COPD with phlegm-heat obstruction in lung syndrome.Patients were divided into a treatment group and a control group based on whether they received Jinwei Pingchuan decoction,with 30 patients in each group.The treatment group received Jinwei Pingchuan decoction combined with conventional Western medicine therapy,while the control group received conventional Western medicine therapy alone.Both groups received treatment for 7 days.The number of acute exacerbations and lung function indices were followed up and recorded before treatment and three months after treatment.The following outcomes were observed before and after treatment:the number of acute exacerbations,lung function indices(forced expiratory volume in one second[FEV_(1)],percentage of predicted value[FEV_(1)%pred],forced vital capacity[FVC],and FEV_(1)/FVC ratio),the degree of acute exacerbation,TCM syndrome score,COPD assessment test(CAT)score,modified British Medical Research Council Dyspnea Questionnaire(mMRC)score,C-reactive protein(CRP),and white blood cell(WBC)count.Results:After 3 months of follow-up,the treatment group showed a significant reduction in the number of acute exacerbations compared with the pre-treatment values(P<0.05).After treatment,the treatment group had fewer acute exacerbations than the control group(P<0.05).The degree of acute exacerbation in the treatment group improved significantly compared with the pre-treatment values(P<0.05).After treatment,the degree of acute exacerbation in the treatment group was improved compared to the control group(P<0.05).Regarding lung function,FEV_(1),FEV_(1)%pred,FVC,and FEV_(1)/FVC ratio in

关 键 词：慢性阻塞性肺疾病急性加重 金卫平喘汤 中医药 临床疗效 

分 类 号：R256[医药卫生—中医内科学] R287[医药卫生—中医学] R734.2