2018 年第 7 期 第 13 卷

清金化痰汤联合西药治疗慢性阻塞性肺疾病急性加重期患者的临床效果

Clinical effect of Qingjin Huatan decoction combined with western medicine on acute exacerbation of chronic obstructive pulmonary disease

作者：李国生许光兰李娇赵媚邓庆文

英文作者：

单位：530001南宁，广西中医药大学研究生学院（李国生、邓庆文）；530001南宁，广西中医药大学第一附属医院呼吸内科（许光兰、李娇、赵媚）

英文单位：

关键词：慢性阻塞性肺疾病；清金化痰汤

英文关键词：

• 摘要：

• 【摘要】目的    观察清金化痰汤治疗慢性阻塞性肺疾病急性加重期（AECOPD）（痰热郁肺证）患者的临床效果。方法    选取2017年6—12月广西中医药大学第一附属医院呼吸内科收治的64例AECOPD患者，采用随机数字表法分为观察组和对照组，每组32例。对照组给予常规西医治疗；观察组在对照组基础上服用清金化痰汤，均治疗14 d。比较2组患者治疗前后血气指标、肺功能、血常规和炎性因子指标，记录中医证候积分和临床肺部感染评分（CPIS），记录患者抗菌药物使用时间。结果    治疗后观察组动脉血氧分压、第1秒用力呼气容积占预计值百分比明显高于对照组［（75±9）mmHg（1 mmHg=0.133 kPa）比（69±9）mmHg、（52±6）%比（49±5）%］，动脉血二氧化碳分压、白细胞计数、中性粒细胞百分比、C反应蛋白和降钙素原水平、中医证候积分和CIPS总分明显低于对照组［（55±7）mmHg比（59±8）mmHg、（6.0±2.5）×109比（7.2±2.7）×109、（66±8）%比（69±8）%、（6±4）mg/L比（9±4）mg/L、（0.36±0.25）μg/L比（0.75±0.34）μg/L、（6.0±2.5）分比（8.0±3.2）分、（1.5±1.4）分比（2.6±2.2）分］，差异均有统计学意义（均P＜0.05）。观察组抗菌药物使用时间短于对照组［（8.1±2.0）d比（10.3±2.4）d］，差异有统计学意义（P＜0.05）。结论    清金化痰汤联合常规西医治疗AECOPD（痰热郁肺证）患者可以较好地控制肺部感染，改善肺功能，减少抗菌药物使用，提高临床疗效。

• 【Abstract】Objective    To observe the clinical effect of Qingjin Huatan decoction combined with western medicine on acute exacerbation of chronic obstructive pulmonary disease（AECOPD）. Methods    Sixty-four AECOPD patients were enrolled from June to December 2017 in the First Affiliated Hospital of Guangxi University of Chinese Medicine and divided into observation group and control group, with 32 cases in each group. The control group was treated with western medicine and the observation group was treated with Qingjin Huatan decoction additionally for 14 d. Blood gas, pulmonary function, blood routine and inflammatory indexes, Chinese medical syndrome score, clinical pulmonary infection score（CPIS） and antimicrobial use time were analyzed. Results    After treatment, arterial partial pressure of oxygen and forced expiratory volume in 1 second percentage in observation group were significantly higher than those in control group［（75±9）mmHg vs （69±9）mmHg, （52±6）% vs （49±5）%］; arterial partial pressure of carbon dioxide, leucocyte count, neutrophil percentage, serum levels of C-reactive protein and procalcitonin, Chinese medical syndrome score and CPIS in observation group were significantly lower than those in control group［（55±7）mmHg vs （59±8）mmHg, （6.0±2.5）×109 vs （7.2±2.7）×109, （66±8）% vs （69±8）%, （6±4）mg/L vs （9±4）mg/L, （0.36±0.25）μg/L vs （0.75±0.34）μg/L, （6.0±2.5） vs （8.0±3.2）, （1.5±1.4） vs （2.6±2.2）］（P＜0.05）. Antimicrobial use time in observation group was significantly shorter than that in control group［（8.1±2.0）d vs （10.3±2.4）d］（P＜0.05）. Conclusion    Qingjin Huatan decoction combined with western medicine decoction treating AECOPD can effectively control lung infection, improve lung function and reduce antimicrobial use.

  【Key words】Chronic obstructive pulmonary disease;Qingjin Huatan decoction

  【Fund program】National Natural Science Foundation of China（81760848）; Postgraduate Research and Innovation Project of Guangxi University of Chinese Medicine（YJSP201723）