摘要
目的研究麻杏二三汤化裁联合常规西药治疗慢性阻塞性肺疾病(COPD)急性加重期患者疗效及对气道炎症的影响。方法选取浙江省绍兴市中医院2021年1月至2024年1月收治的80例COPD急性加重期患者,按照不同的治疗方法将其分为西药组(33例,采用常规西药治疗)和中西药结合组(47例,在西药组基础上加用麻杏二三汤化裁治疗),2组疗程均为10 d,对比2组患者治疗前后的临床疗效、肺功能状态、气道炎症及不良反应。结果中西药结合组临床有效率为(98%)高于西药组(79%)(χ^(2)=4.727,P<0.05);中西药结合组患者治疗后咳嗽、咳痰、呼吸不畅、喘息等证候评分分别为[(1.94±0.36)分、(1.32±0.43)分、(1.87±0.48)分、(1.85±0.37)分]均低于西药组[(2.36±0.43)分、(1.94±0.56)分、(2.13±0.41)分、(2.21±0.45)分](t=4.739、5.599、2.529、3.916,P均<0.05);治疗后,中西药结合组患者的动脉血氧分压(PaO_(2))和血氧饱和度(SaO_(2))分别为[(80.6±7.7)mmHg、(95.2±2.7)%]均高于西药组[(76.3±7.2)mmHg、(93.7±2.4)%](t=2.524、2.497,P均<0.05),二氧化碳分压(PaCO_(2))为(50±5)mmHg,低于西药组的(54±5)mmHg(t=3.192,P<0.05);治疗后,中西药结合组患者的肺活量(VC)、第1秒用力呼吸容积(FEV_(1))和呼吸峰值流速(PEF)分别为[(2.08±0.43)L、(1.81±0.20)L、(367±36)L/min]均高于西药组[(1.73±0.32)L、(1.65±0.24)L、(335±36)L/min](t=3.965、3.242、2.846,P均<0.05);治疗后,中西药结合组患者的C反应蛋白(CRP)、几丁质酶-3样蛋白1(CHI3L1)、缺氧诱导因子-1α(HIF-1α)、白细胞介素6(IL-6)和白介素10(IL-10)分别为[(22.3±2.2)mg/L、(41±4)μg/L、(60±15)μg/L、(4.4±1.0)ng/L、(4.5±1.2)pg/ml]均低于西药组[(32.4±2.7)mg/L、(49±4)μg/L、(80±16)μg/L、(5.4±1.4)ng/L、(6.3±1.4)pg/ml](t=18.545、8.985、2.991、4.351、6.134,P均<0.05),中西药结合组患者用药不良反应发生率(9%)与西药组(6.06%)对比差异无统计学意义(χ^(2)=0.168,P>0.05)。结论麻杏二�
Objective To study the effects of modified maxing ersan decoction combined with conven-tional western medicine on patients with acute exacerbation of chronic obstructive pulmonary disease(COPD)and its influence on airway inflammation.Methods A total of 80 patients with acute exacerbation of COPD in the Shaoxing Hospital of Traditional Chinese Medicine from January 2021 to January 2024,According to the different treatment methods,they were divided into a western medicine group(n=33,conventional western medicine)and a Chinese-western medicine group(n=47,modified maxing ersan decoction on the basis of the western medicine group)according to the principles of non-randomized clinical concurrent control study and patient voluntarism.The courses of treatment for both groups were 10 days.The clinical efficacy,pulmonary function status,airway inflammation,and adverse reactions of the patients before and after treatment were compared between the two groups.Results The clinical effective rate of the Chinese-western medicine group was significantly higher than that of the western medicine group(98%vs 79%,χ^(2)=4.727,P<0.05).After treatment,the symptom scores of cough,expectoration,dyspnea,and wheezing in the Chinese-western medicine group were significantly lower than those in the western medicine group[(1.94±0.36),(1.32±0.43),(1.87±0.48),(1.85±0.37)vs(2.36±0.43),(1.94±0.56),(2.13±0.41),(2.21±0.45)],(t=4.739,5.599,2.529,3.916,all P<0.05).After treatment,the arterial partial pressure of oxygen(PaO_(2))and oxygen saturation(SaO_(2))in the Chinese-western medicine group were significantly higher than those in the western medicine group[(80.6±7.7)mmHg,(95.2±2.7)%vs(76.3±7.2)mmHg,(93.7±2.4)%](t=2.524,2.497,both P<0.05).The partial pressure of carbon dioxide(PaCO_(2))in the Chinese-western medicine group was significantly lower than that in the western medicine group[(50±5)mmHg vs(54±5)mmHg](t=3.192,P<0.05).After treatment,the vital capacity(VC),forced expiratory volume in 1 second(FEV1),and peak expiratory flow(PEF
作者
何薇
李慧娇
He Wei;Li Huijiao(Department of Pneumology,Shaoxing Hospital of Traditional Chinese Medicine,Shaoxin,Zhejiang 321000,China)
出处
《中国药物与临床》
CAS
2024年第17期1107-1112,共6页
Chinese Remedies & Clinics
关键词
麻杏二三汤
肺疾病
慢性阻塞性
血气分析:肺功能
治疗效果
炎症
Maxing Ersan decoction
Pulmonary disease,Chronic obstructive
Blood gas analysis
Pul-monary function
Treatment outcome
Inflammation
