摘要
目的观察中医定向透药疗法联合常规西药治疗重度慢性阻塞性肺疾病急性加重(AECOPD)阴虚内热证的临床效果。方法将重度AECOPD阴虚内热证患者72例采用随机数字表法分为对照组与观察组各36例。对照组予常规西药治疗,观察组在此基础上予中医定向透药疗法,2组均连续治疗10 d。观察2组中医证候疗效,比较2组治疗前后中医证候评分、炎症指标、血气分析、肺功能、改良版英国医学研究委员会呼吸困难评级问卷(mMRC)、慢性阻塞性肺疾病自我评估测试量表(CAT)评分。对2组进行安全性监测。结果2组各脱落1例。观察组中医证候疗效显效率为85.71%(30/35),对照组为62.86%(22/35),2组比较差异有统计学意义(P<0.01)。与本组治疗前比较,2组治疗后中医证候积分下降(P<0.01);观察组治疗前后中医证候积分差值高于对照组(P<0.05),观察组治疗后胸闷喘息、苔少、咽干口干、盗汗、大便干结评分低于对照组(P<0.05,P<0.01)。与本组治疗前比较,2组治疗后炎症指标[白细胞计数、中性粒细胞%(NE%)、C-反应蛋白、降钙素原(PCT)]、血气分析[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、肺功能[第1秒用力呼气容积占用力肺活量比例、第1秒用力呼气容积占预计值百分比(FEV1%pred)]、mMRC评分、CAT评分均明显改善(P<0.01);观察组治疗后NE%、PCT、PaO_(2)、PaCO_(2)、FEV1%pred、mMRC评分、CAT评分改善程度优于对照组(P<0.05,P<0.01)。2组治疗前后各项安全性指标均未出现明显异常,未见严重不良反应。结论中医定向透药疗法联合常规西药治疗能够明显改善重度AECOPD阴虚内热证患者的临床症状,可有效控制炎症、改善肺功能、提高生活质量。
Objective To observe the clinical efficacy of the directional drug penetration therapy of TCM combined with Western medicine treatment of severe acute exacerbation of chronic obstructive pulmonary disease(severe AECOPD)with yin-deficiency-heat syndrome.Methods Totally 72 patients with severe AECOPD(yindeficiency-heat syndrome)were involved and divided into control group and observation group according to random number table method,with 36 cases in each group.The control group was given regular Western medication,while the observation group received TCM directional drug penetration therapy based on the Western medication.The course lasted 10 days.The TCM symptom efficacy of both groups was observed.TCM symptom score,inflammatory indexes,blood gas analysis,lung function,mMRC and CAT score of both groups before and after treatment were compared.The safety of both groups were monitored.Results There were 1 case of detachment in each groups.The effective rate of TCM syndromes in the observation group was 85.71%(30/35),and that in the control group was 62.86%(22/35),with statistical significance(P<0.01).Compared with before treatment,the total score of TCM syndrome decreased in both groups after treatment(P<0.01);the difference in the total score of TCM syndromes in the observation group before and after treatment was higher than that in the control group(P<0.05).After treatment,the scores of chest tightness,wheezing,less coating,dry throat,dry mouth,night sweats and dry stool in the observation group were lower than those in the control group(P<0.05,P<0.01).Compared with before treatment,inflammatory indexes[white blood cell count,neutrophil%(NE%),C-reactive protein(CRP),procalcitonin(PCT)],blood gas analysis[arterial oxygen partial pressure(PaO_(2)),arterial blood carbon dioxide partial pressure(PaCO_(2))],pulmonary function(FEV1/FVC,FEV1%pred),mMRC,CAT scores were significantly improved(P<0.01);after treatment,the improvement of NE%,PCT,PaO_(2),PaCO_(2),FEV1%pred,mMRC scores and CAT scores in the observation group was better than that in the control group(P<0.05,P<0.01).There were no obvious abnormalities in the safety indicators before and after treatment in the two groups,and no serious adverse reactions were found.Conclusion The directional drug penetration therapy of TCM combined with Western medicine can significantly improve the clinical symptoms in patients with severe AECOPD(yin-deficiency-heat syndrome),which can effectively control inflammation,improve lung function and quality of life.
作者
范旋飞
汤玲玲
唐继红
FAN Xuanfei;TANG Lingling;TANG Jihong(Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200062,China)
出处
《中国中医药信息杂志》
CAS
CSCD
2023年第1期142-147,共6页
Chinese Journal of Information on Traditional Chinese Medicine
基金
国家自然科学基金青年基金(82004265)
上海市普陀区卫生健康系统临床特色专科建设计划(2020tszk02)。
关键词
重度慢性阻塞性肺疾病急性加重
阴虚内热
中医定向透药疗法
临床研究
severe acute exacerbation of chronic obstructive pulmonary disease
yin-deficiency-heat syndrome
TCM directional drug penetration therapy
clinical study
