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通腑降气汤在慢性阻塞性肺疾病急性加重期患者中的效果分析

Effect analysis of Tongfu Jiangqi Decoction in patients with acute exacerbation of chronic obstructive pulmonary disease

    摘要
  • 摘要:
    目的  观察通腑降气汤对慢性阻塞性肺疾病急性加重期（AECOPD）患者血气与肺功能指标的改善效果。
    方法  前瞻性选取2020年2月—2022年2月收治的160例AECOPD患者作为研究对象，采用随机掷硬币法将其分为A组、B组。最终纳入A组86例和B组74例，2组患者均给予西医常规治疗，A组患者在此基础上加用通腑降气汤。比较2组患者临床疗效，记录2组患者治疗前和治疗14 d后肺功能第1秒用力呼气容积（FEV1）、用力肺活量（FVC）、FEV1占预计值的百分比（FEV1% pred）、症状评分（喘息、咳嗽、咳痰）、凝血功能血清D-二聚体（D-D）、纤维蛋白原（Fib）、炎性因子白细胞（WBC）计数、C反应蛋白（CRP）、血气指标如pH值、动脉血氧分压pa（O2）、动脉血二氧化碳分压pa（CO2）的变化情况，观察2组不良反应发生情况。
    结果  A组患者临床总有效率为96.51%（83/86），高于B组的79.73%（59/74），差异有统计学意义（P < 0.05）；治疗14 d后，2组患者肺功能FVC、FEV1、FEV1% pred水平均上升，且A组以上指标高于B组，差异有统计学意义（P < 0.05）；治疗14 d后，2组患者症状评分中的喘息、咳嗽、咳痰评分均下降，且A组以上症状评分低于B组，差异有统计学意义（P < 0.05）。治疗14 d后，2组患者D-D、Fib水平均下降，且A组低于B组，差异有统计学意义（P < 0.05）。治疗14 d后，2组患者WBC、CRP水平均下降，且A组低于B组，差异有统计学意义（P < 0.05）。治疗14 d后，2组患者pH值、pa（O2）水平均提升，pa（CO2）水平均下降，且A组pH值、pa（O2）水平高于B组，pa（CO2）水平低于B组，差异有统计学意义（P < 0.05）。
    结论  AECOPD患者采用通腑降气汤联合西医治疗效果显著，其肺功能、临床症状、凝血功能、炎性反应及血气状况明显改善，且无明显不良反应。

     

    Abstract:
    Objective  To observe the improvement effect of Tongfu Jiangqi Decoction on blood gas and lung function in patients with acute obstructive pulmonary disease (AECOPD).
    Methods  A total of 160 patients with AECOPD admitted to our hospital from February 2020 to February 2022 were prospectively selected as research objects, and were divided into group A and group B by coin toss method. Finally, 86 patients in group A and 74 patients in group B were included. Both groups were given conventional western medicine treatment, and patients in group A were additionally given Tongfu Jiangqi Decoction. The clinical efficacy of the two groups was compared, and the pulmonary functionforced expiratory volume in one second (FEV1), forced vital capacity (FVC) and FEV1 percentage of predicted value (FEV1%pred), symptom score (wheezing, cough, expectoration), coagulation functionD-Dimer (D-D), fibrinogen (Fib), inflammatory factorswhite blood cell(WBC) count, and C-reactive protein (CRP), blood gas index including pH value, arterial partial pressure of oxygenpa(O2), and arterial partial pressure of carbon dioxidepa(CO2)before treatment and 14 days after treatment were recorded, and the incidence of adverse reactions was observed.
    Results  The total effective rate of group A was 96.51% (83/86), which was significantly higher than 79.73% (59/74) in the group B(P < 0.05); after 14 days of treatment, the levels of FVC, FEV1 and FEV1%pred in the two groups were significantly increased, and those in the group A were higher than those in the group B (P < 0.05); after 14 days of treatment, the scores of wheezing, cough and sputum production in the symptom scores of the two groups were significantly decreased, and the above scores of group A were lower than those of group B (P < 0.05). After 14 days of treatment, the levels of D-D and Fib in both groups were decreased, and group A was significantly lower than group B (P < 0.05). After 14 days of treatment, the levels of WBC and CRP in both groups were decreased, and group A was significantly lower than group B(P < 0.05); after 14 days of treatment, the levels of pH value and pa(O2) in both groups were increased, and pa(CO2) was reduced. The level of pa(O2) and pH value in group A were significantly higher than those in group B, and the level of pa(CO2) in group A was lower than that in group B(P < 0.05).
    Conclusion  The treatment effect of Tongfu Jiangqi Decoction combined with western medicine for patients with AECOPD is significant. The pulmonary function, clinical symptoms, coagulation function, inflammatory reaction and blood gas status of patients are significantly improved, and there is no obvious adverse reaction.

     

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