Efficacy of supplemented Cangma Pills in treatment of patients with acute exacerbation of bronchiectasis differentiated as syndrome of stagnation of phlegm-dampness in lung
-
摘要:目的 探讨苍麻丸加味治疗支气管扩张急性加重期痰湿阻肺证患者的临床疗效。方法 将68例支气管扩张急性加重期患者随机分为2组，对照组给予硫酸沙丁胺醇气雾剂和盐酸氨溴索片治疗，观察组在对照组基础上加用苍麻丸加味治疗。2组连续治疗2周。比较2组痰湿阻肺证症状评分、肺功能指标、临床疗效以及血清C反应蛋白(CRP)、白细胞计数(WBC)、中性粒细胞百分比(NEU%)水平。结果 治疗2周后，观察组痰湿阻肺证症状(咯痰色白、痰质稠、痞满、纳呆、周身沉重)评分以及血清CRP、WBC、NEU%水平低于对照组，第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、第1秒用力呼气容积与用力肺活量比值(FEV1/FVC)、治疗总有效率高于对照组，差异均有统计学意义(P < 0.05或P < 0.01)。结论 在常规治疗基础上加用苍麻丸加味治疗支气管扩张急性加重期痰湿阻肺证患者的疗效显著，能改善患者肺功能，降低感染性相关指标水平。Abstract:Objective To investigate the clinical efficacy of supplemented Cangma Pills in the treatment of patients with acute exacerbation of bronchiectasis differentiated as syndrome of stagnation of phlegm-dampness in lung.Methods Totally 68 patients with acute exacerbation of bronchiectasis were randomly divided into two groups. The control group was treated with salbutamol sulfate aerosol and ambroxol hydrochloride tablets, and the observation group was treated with supplemented Cangma Pills on the basis of the control group. Both groups were treated for 2 weeks. The score of syndrome of stagnation of phlegm-dampness in lung, pulmonary functions, clinical efficacy and levels of serum C reactive protein (CRP), white blood cell count (WBC) and neutrophil percentage (NEU%) were compared between the two groups.Results After 2 weeks of treatment, the scores of syndrome of stagnation of phlegm-dampness in lung (white expectoration, thick phlegm, fullness, poor appetite and digestion, heavy body) and the levels of serum CRP, WBC and NEU% in the observation group were significantly lower than those in the control group, while the forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), the ratio of forced expiratory volume in the first second to forced vital capacity (FEV1/FVC) and the total effective rate in the observation group were significantly higher than those in the control group (P < 0.05 or P < 0.01).Conclusion Application of supplemented Cangma Pills on the basis of conventional treatment is effective in the treatment of patients with acute exacerbation of bronchiectasis differentiated as syndrome of stagnation of phlegm-dampness in lung, which can improve the pulmonary functions of patients and reduce the levels of infectious related indicators.
-
-
表 1 2组痰湿阻肺证症状评分比较(x±s)
分 组别 时点 咯痰色白 痰质稠 痞满 纳呆 周身沉重 对照组(n=34) 治疗前 5.18±0.63 5.04±0.61 4.94±0.58 4.99±0.59 4.90±0.58 治疗后 2.37±0.29** 2.31±0.31** 2.22±0.29** 2.18±0.30** 2.03±0.26** 观察组(n=34) 治疗前 5.22±0.65 5.01±0.60 4.97±0.61 4.91±0.64 4.83±0.55 治疗后 1.15±0.18**## 1.13±0.16**## 1.04±0.15**## 1.09±0.14**## 1.06±0.16**## 与治疗前比较, **P＜0.01; 与对照组比较, ##P＜0.01。 
下载: 导出CSV
表 2 2组肺功能指标水平比较(x±s)
组别 时点 FEV1/L FVC/L FEV1/FVC 对照组(n=34) 治疗前 1.73±0.31 2.41±0.34 65.64±8.74 治疗后 2.47±0.37** 3.03±0.41** 75.11±9.91** 观察组(n=34) 治疗前 1.81±0.33 2.49±0.37 66.03±8.91 治疗后 3.14±0.43**## 3.37±0.47**## 82.03±9.94**## FEV1: 第1秒用力呼气容积; FVC: 用力肺活量; FEV1/FVC: 第1秒用力呼气容积与用力肺活量比值。与治疗前比较, * * P＜0.01; 与对照组比较, ##P＜0.01。
下载: 导出CSV
表 3 2组疗效比较[n(%)]
组别 n 临床治愈 有效 未愈 总有效 对照组 34 19(55.88) 5(17.41) 10(29.41) 24(70.59) 观察组 34 27(79.41) 5(17.41) 2(5.88) 32(94.12)* 与对照组比较, * P＜0.05。
下载: 导出CSV
表 4 2组血清CRP、WBC、NEU%水平比较(x±s)
组别 时点 CRP/(mg/L) WBC/(×109/L) NEU%/% 对照组(n=34) 治疗前 68.44±8.30 12.38±1.81 87.09±10.03 治疗后 20.04±3.63** 6.93±0.77** 66.04±8.21** 观察组(n=34) 治疗前 68.63±8.44 12.22±1.75 87.63±10.15 治疗后 14.34±2.95**## 4.99±0.57**## 63.51±7.94**## CRP: C反应蛋白; WBC: 白细胞计数; NEU%: 中性粒细胞百分比。与治疗前比较, * * P＜0.01; 与对照组比较, ##P＜0.01。
下载: 导出CSV
-
[1] 徐金富, 林洁璐, 瞿介明. 中国支气管扩张症诊治现状及面临的挑战[J]. 中华结核和呼吸杂志, 2017, 40(1): 8-10. doi: 10.3760/cma.j.issn.1001-0939.2017.01.003 [2] 汤葳, 周俊, 高习文, 等. 联合清肺抑火胶囊治疗支气管扩张症急性加重的多中心随机对照研究[J]. 中国呼吸与危重监护杂志, 2019, 18(4): 352-356. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGHW201904016.htm [3] 李志成, 王丽彦, 刘瑶, 等. 清金化痰汤联合西医常规疗法治疗支气管扩张症急性加重期临床研究[J]. 国际中医中药杂志, 2020, 42(6): 547-551. doi: 10.3760/cma.j.cn115398-20190816-00110 [4] 晏海飞, 陈玲, 周红英, 等. 疏风解毒胶囊治疗支气管扩张症的疗效观察[J]. 中国中医急症, 2020, 29(5): 884-886. doi: 10.3969/j.issn.1004-745X.2020.05.038 [5] 马家驹, 陈明, 王玉光. 小剂量苍麻丸对支气管扩张症稳定期气道黏液高分泌状态的影响[J]. 中国临床医生杂志, 2019, 47(6): 742-745. doi: 10.3969/j.issn.2095-8552.2019.06.040 [6] 成人支气管扩张症诊治专家共识编写组. 成人支气管扩张症诊治专家共识[J]. 中华结核和呼吸杂志, 2012, 35(7): 485-492. doi: 10.3760/cma.j.issn.1001-0939.2012.07.003 [7] 中华中医药学会肺系病分会. 支气管扩张症中医证候诊断标准(2019版)[J]. 中医杂志, 2020, 61(15): 1377-1380. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ202015024.htm [8] 中华人民共和国卫生部. 中药新药临床研究指导原则[M]. 北京: 中国医药科技出版社, 2002: 54-58. [9] 肺痈的诊断依据、证候分类、疗效评定——中华人民共和国中医药行业标准《中医内科病证诊断疗效标准》(ZY/T001. 1-94)[J]. 辽宁中医药大学学报, 2013, 15(1): 162-162. https://www.cnki.com.cn/Article/CJFDTOTAL-XYSY201505010.htm [10] 吴坚, 蒋熙, 姜丹, 等. 国医大师朱良春支气管扩张症辨治实录及经验撷菁[J]. 江苏中医药, 2014, 46(3): 1-3. https://www.cnki.com.cn/Article/CJFDTOTAL-JSZY201403003.htm [11] 张召杨, 孙增涛, 刘南飞, 等. 肺脾相关理论及临床应用研究[J]. 陕西中医, 2020, 41(11): 1623-1626, 1631. doi: 10.3969/j.issn.1000-7369.2020.11.028 [12] 黄琼珍, 裴远丽, 李洁莲, 等. 六君子汤加减治疗支气管扩张稳定期脾胃气虚兼痰湿证35例[J]. 中国民族民间医药, 2017, 26(23): 93-94. https://www.cnki.com.cn/Article/CJFDTOTAL-MZMJ201723031.htm [13] 徐琳, 路苹, 姚红梅, 等. 支气管扩张症合并感染患者血清人分泌型磷脂酶A2-X表达情况及其与炎性指标的相关性研究[J]. 中国全科医学, 2020, 23(24): 3034-3039. doi: 10.12114/j.issn.1007-9572.2020.00.352 [14] 杨丽青, 杨小东, 杨凌婧, 等. 支气管扩张患者急性加重危险因素分析[J]. 中国呼吸与危重监护杂志, 2020, 19(6): 543-547. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGHW202006004.htm [15] 王月平, 尹飞飞, 赵国厚, 等. 血清CRP、IL-6、PCT在支气管扩张症合并肺部感染中的表达水平及意义[J]. 中华医院感染学杂志, 2020, 30(9): 1350-1354. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHYY202009016.htm
表(4)
计量
- 文章访问数: 310
- HTML全文浏览量: 223
- PDF下载量: 22
苏公网安备 32100302010246号
