加味千金苇茎汤对慢性阻塞性肺病急性加重期患者气道清除功能的影响

观察加味千金苇茎汤对慢性阻塞性肺疾病急性加重期(AECOPD)属中医痰热郁肺证候的患者临床疗效及对患者气道清除功能的影响。【方法】以中医辨证为痰热郁肺证候的AECOPD患者为研究对象,采用前瞻性对照研究方案,随机分为对照组和试验组各30例。对照组采用常规西药治疗,试验组在此基础上加用加味千金苇茎汤治疗。观察两组临床疗效以及治疗前后1s用力呼气量(FEV1)、用力肺活量(FVC)、FEV1与FVC比值、呼吸总阻抗(Zrs)、气道总粘性阻力 (R5)等肺功能指标的变化,并重点观察两组治疗前后气道清除率(Ct)的变化。【结果】试验组显效率为70．00％,优于对照组的23．33％(P<0．01)。两组治疗后的肺功能指标FEV1、FEV1／FVC、Zrs、R5较治疗前均有不程度的改善(P<0．05或 P<0．01),且试验组较对照组改善更为明显(P<0．05或P<0．01)。气道清除率Ct值两组各时段治疗后较治疗前均有改善 (P<0．05);在30min时两组比较无显著性差异(P>0．05),在60min和90min时试验组较对照组改善更为明显(P<0．05 或P<0．01)。【结论】加味千金苇茎汤治疗AECOPD,疗效确切,并有改善患者肺功能和气道粘液-纤毛清除功能的作用。

Influence of Modified Qianjin Weijing Decoction on Airway Clearance in Patients with Acutely Exacerbated Chronic Obstructive Pulmonary Disease

Objective] To observe the influence of Modified Qianjin Weijing Decoction (MQWD) on airway clearance in patients with acutely exacerbated chronic obstructive pulmonary disease (AECOPD) , which was differentiated as the syndrome of phlegm-heat congesting lung. Methods] A prospective control trial was carried out in 60 AECOPD patients with phlegm-heat congesting lung. The patients were equally randomized into two groups: the treatment group (group A) was treated with MQWD and routine western medicine, and the control group (group B) with routine western medicine only. The therapeutic effect, indexes of lung function including FEV1 (forced expiratory volume in one second), FVC (forced vital capacity), FEV1/FVC, Zrs (total respiratory impedance) and R5 (total airway resistance), and in particular, the airway clearance rate (Ct) were observed and compared in the two groups. Results] In the treatment group, the markedly effective rate was 70.00 % , higher than that (23.33 % ) in the control group ( P < 0.01) . The lung function indexes of FEV1, FEV1/FVC, Zrs and R5 were both improved in two groups after treatment (P<0.05 or P < 0.01 compared with those before treatment), and the improvement being obvious in the treatment group as compared with that in the control group (P<0.05 or P<0.01). Ct was also improved in the two groups (P<0.05 compared with that before treatment) , the difference of Ct in 30-minute treatment was insignificant between the two groups ( P > 0.05) but Ct in 60-minute and 90-minute treatment was much improved in the treatment group than that in the control group (P<0.05 or P<0.01) . Conclusion] MQWD exerts a certain effect in the treatment of AECOPD patients with phlegm-heat congesting lung, and can improve the lung function and airway pili-phlegm clearance.