透热转气法治疗急性加重期慢性阻塞性肺疾病
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摘要
目的:观察透热转气法治疗急性加重期慢性阻塞性肺病(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)痰热壅肺证患者的临床疗效。方法:150例患者随机分为观察组75例和对照组75例。对照组给予西医常规治疗,观察组在对照组治疗基础上给予透热转气中药治疗。比较两组患者临床疗效、第1秒用力呼气量(forced expiratory volume in the first second,FEV1)、FEV1%、FEV1/用力肺活量(forced vital capacity,FVC)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、中医证候积分、生存质量评分等指标变化。结果:与治疗前比较,两组患者治疗后肺功能(FEV1、FEV1%、FEV1/FVC)、中医证候积分、生存质量评分均明显改善(P <0. 01),炎症因子水平(IL-6、TNF-α)明显降低(P <0. 01);且观察组以上各指标改善情况优于对照组(P <0. 01)。观察组有效率为88. 0%,对照组为74. 7%,两组比较,差异有统计学意义(P <0. 05)。结论:透热转气法治疗AECOPD痰热壅肺证患者疗效显著,可降低炎症因子水平,改善肺功能,提高患者生存质量。
Objective: To observe the clinical efficacy of clearing heat of yingfen to qifen method in the treatment of acute exacerbation of chronic obstructive pulmonary disease with phlegm-heat stagnation of lung syndrome. Methods: 150 patients were randomly divided into observation group( 75 cases) and control group( 75 cases). The control group was treated with routine western medicine,while the observation group was treated with Chinese medicine of clearing heat of yingfen to qifen based on the treatment of the control group. The clinical efficacy,forced expiratory volume in the first second( FEV1),FEV1%,FEV1/forced vital capacity( FVC),interleukin-6( IL-6),tumor necrosis factor-α( TNF-α),TCM syndrome score and quality of life score were compared between the two groups. Results: Compared with before treatment,the lung function( FEV1,FEV1%,FEV1/FVC),TCM syndrome score and quality of life score of the two groups were significantly improved after treatment( P < 0. 01),and the levels of inflammatory factors( IL-6,TNF-α) were significantly decreased( P < 0. 01),and the improvement of the above indexes in the observation group was better than that in the control group( P < 0. 01). The effective rate was 88. 0% in the observation group and 74. 7% in the control group. There was significant difference between the two groups( P < 0. 05). Conclusion: Therapeutic effect of clearing heat of yingfen to qifen method on AECOPD patients with phlegm-heat stagnation of lung syndrome is remarkable. It can reduce the level of inflammatory factors,improve lung function and improve the quality of life of patients.
Objective: To observe the clinical efficacy of clearing heat of yingfen to qifen method in the treatment of acute exacerbation of chronic obstructive pulmonary disease with phlegm-heat stagnation of lung syndrome. Methods: 150 patients were randomly divided into observation group( 75 cases) and control group( 75 cases). The control group was treated with routine western medicine,while the observation group was treated with Chinese medicine of clearing heat of yingfen to qifen based on the treatment of the control group. The clinical efficacy,forced expiratory volume in the first second( FEV1),FEV1%,FEV1/forced vital capacity( FVC),interleukin-6( IL-6),tumor necrosis factor-α( TNF-α),TCM syndrome score and quality of life score were compared between the two groups. Results: Compared with before treatment,the lung function( FEV1,FEV1%,FEV1/FVC),TCM syndrome score and quality of life score of the two groups were significantly improved after treatment( P < 0. 01),and the levels of inflammatory factors( IL-6,TNF-α) were significantly decreased( P < 0. 01),and the improvement of the above indexes in the observation group was better than that in the control group( P < 0. 01). The effective rate was 88. 0% in the observation group and 74. 7% in the control group. There was significant difference between the two groups( P < 0. 05). Conclusion: Therapeutic effect of clearing heat of yingfen to qifen method on AECOPD patients with phlegm-heat stagnation of lung syndrome is remarkable. It can reduce the level of inflammatory factors,improve lung function and improve the quality of life of patients.
引文
[1]刘佳玉,石克华.中医药治疗慢性阻塞性肺疾病急性加重期研究进展[J].河北中医,2018,40(1):146-151.
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[3]朱立成,朱文娟,尚云飞.中西医结合治疗慢性阻塞性肺疾病并呼吸衰竭疗效及安全性的Meta分析[J].现代中西医结合杂志,2009,18(31):3789-3791,3794.
[4]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版)[J].中华结核和呼吸杂志,2013,25(8):453-460.
[5]中华中医药学会内科分会肺系病专业委员会.慢性阻塞性肺疾病中医诊疗指南(2011版)[J].中医杂志,2012,53(1):80-84.
[6]齐莹.慢性阻塞性肺疾病稳定期综合评估与中医证素的相关性研究[D].北京:北京中医药大学,2014.
[7]韩健,张伟.从气道炎症因子研究肺舒颗粒对慢性阻塞性肺疾病急性加重期的疗效机制[J].中华中医药杂志,2013,28(7):2202-2204.
[8]李建生,张海龙,王海峰,等.慢性阻塞性肺疾病证候演变特点临床调查[J].中医杂志,2017,58(9):772-776.
[9]朱为坤,纪立金,李芹.从营气与营阴探讨“入营犹可透热转气”[J].中华中医药杂志,2018,33(2):453-455.
[10]孙晓光,彭建中.透热转气在杂病中的拓展运用[J].中华中医药杂志,2014,29(11):3528-3530.
[11]周博文.糖尿病热伏营分证与透热转气法探析[J].中国中医药信息杂志,2016,23(12):107-108.
[12]白弘.运用透热转气思想从毒论治急性冠脉综合征[D].沈阳:辽宁中医药大学,2016.
[13]刘枭,刘涛.吴鞠通配伍应用金银花、连翘的经验[J].中医药导报,2016,22(3):24-25,38.
[14]吴嘉瑞,金燕萍,王凯欢,等.基于网络药理学的“金银花-连翘”药对作用机制研究[J].中国实验方剂学杂志,2017,23(5):179-183.
[15]袁岸,李燕,罗林,等.连翘提取物对酵母和脂多糖所致大鼠发热模型的影响研究[J].辽宁中医杂志,2017,44(2):402-405.
[16]陈燕文,胡晶红,李佳,等.金银花多糖提取精制方法和药理活性综述[J].辽宁中医药大学学报,2017,19(1):155-159.
[17]宋亚林,倪付勇,赵玮武,等.金银花化学成分研究进展[J].中草药,2014,45(24):3656-3664.
[18]梁炜,陈斯宁,李瑞祥.痰热清注射液对慢性阻塞性肺疾病急性加重期hs-CRP、IL-6、IL-10的影响[J].广西中医药大学学报,2017,20(1):11-13.
[19]都勇,揭志军,何炜,等.痰热清注射液对慢性阻塞性肺疾病急性加重期患者血清超敏C-反应蛋白及降钙素原的影响研究[J].中华医院感染学杂志,2015,25(6):1233-1235.
[2]李建生,王至婉,余学庆,等.中药治疗COPD急性加重期的系统评价[J].天津中医药,2008,25(5):428-432.
[3]朱立成,朱文娟,尚云飞.中西医结合治疗慢性阻塞性肺疾病并呼吸衰竭疗效及安全性的Meta分析[J].现代中西医结合杂志,2009,18(31):3789-3791,3794.
[4]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版)[J].中华结核和呼吸杂志,2013,25(8):453-460.
[5]中华中医药学会内科分会肺系病专业委员会.慢性阻塞性肺疾病中医诊疗指南(2011版)[J].中医杂志,2012,53(1):80-84.
[6]齐莹.慢性阻塞性肺疾病稳定期综合评估与中医证素的相关性研究[D].北京:北京中医药大学,2014.
[7]韩健,张伟.从气道炎症因子研究肺舒颗粒对慢性阻塞性肺疾病急性加重期的疗效机制[J].中华中医药杂志,2013,28(7):2202-2204.
[8]李建生,张海龙,王海峰,等.慢性阻塞性肺疾病证候演变特点临床调查[J].中医杂志,2017,58(9):772-776.
[9]朱为坤,纪立金,李芹.从营气与营阴探讨“入营犹可透热转气”[J].中华中医药杂志,2018,33(2):453-455.
[10]孙晓光,彭建中.透热转气在杂病中的拓展运用[J].中华中医药杂志,2014,29(11):3528-3530.
[11]周博文.糖尿病热伏营分证与透热转气法探析[J].中国中医药信息杂志,2016,23(12):107-108.
[12]白弘.运用透热转气思想从毒论治急性冠脉综合征[D].沈阳:辽宁中医药大学,2016.
[13]刘枭,刘涛.吴鞠通配伍应用金银花、连翘的经验[J].中医药导报,2016,22(3):24-25,38.
[14]吴嘉瑞,金燕萍,王凯欢,等.基于网络药理学的“金银花-连翘”药对作用机制研究[J].中国实验方剂学杂志,2017,23(5):179-183.
[15]袁岸,李燕,罗林,等.连翘提取物对酵母和脂多糖所致大鼠发热模型的影响研究[J].辽宁中医杂志,2017,44(2):402-405.
[16]陈燕文,胡晶红,李佳,等.金银花多糖提取精制方法和药理活性综述[J].辽宁中医药大学学报,2017,19(1):155-159.
[17]宋亚林,倪付勇,赵玮武,等.金银花化学成分研究进展[J].中草药,2014,45(24):3656-3664.
[18]梁炜,陈斯宁,李瑞祥.痰热清注射液对慢性阻塞性肺疾病急性加重期hs-CRP、IL-6、IL-10的影响[J].广西中医药大学学报,2017,20(1):11-13.
[19]都勇,揭志军,何炜,等.痰热清注射液对慢性阻塞性肺疾病急性加重期患者血清超敏C-反应蛋白及降钙素原的影响研究[J].中华医院感染学杂志,2015,25(6):1233-1235.