目的 观察清金化浊方治疗慢性阻塞性肺疾病急性加重(AECOPD)患者临床疗效及对急性炎性反应的影响.方法 纳入急性加重病程≤1周的AECOPD(Ⅱ级)住院患者60例,随机分为观察组和对照组各30例.2组均采用AECOPD常规西医治疗,观察组并予清金化浊方,每日1剂,口服.连续治疗10 d.观察2组患者治疗前后中医症状评分、呼吸困难严重程度(mMRC分级)、全血白细胞计数(WBC)、血清C反应蛋白(CRP)、血清降钙素原(PCT)及动脉血氧分压(PaO2)、二氧化碳分压(PaCO2).结果 2组治疗后中医症状总分及咳嗽、咯痰、喘息胸闷、发热、紫绀评分较治疗前均明显降低(P<0.05),治疗后观察组咳嗽、咯痰改善程度优于对照组(P<0.05).2组患者治疗后mMRC分级较治疗前均有改善(P<0.05).与本组治疗前比较,2组患者治疗后WBC、CRP、PaCO2下降,PaO2上升(P<0.05).治疗后观察组CRP、PaCO2下降程度优于对照组(P<0.05,P<0.01).结论 清金化浊方联合西药治疗可有效缓解AECOPD患者的临床症状,降低急性炎性反应,改善通气.%Objective To observe the efficacy and acute inflammatory reactionof Qingjin Huazhuo Prescription combined with Western medicine therapy for treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Totally 60 hospitalized patients with AECOPD (Grade Ⅱ) and acute exacerbation course≤1 week were enrolled in this study. The patients were randomly divided into two groups, with 30 cases in each group. The control group was treated with conventional Western medicine. The observation group was treated with conventional Western medicine and oral administration of Qingjin Huazhuo Prescription for 10 days, once a day. TCM syndrome and dyspnea grading (mMRC score), white blood cell (WBC), C-reactive protein (CRP), procalcitonin (PCT) and partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2), were measured before and after the treatment. Results The total scores of TCM syndromes and cough, expectoration, wheezing, fever, and cyanosis in the two groups decreased significantly (P<0.05). The improving degrees of cough and expectoration were better in the observation group than in the control group (P<0.05). The scores of mMRC in the two groups were better than before treatment (P<0.05). The levels of WBC, CRP and PaCO2 in the two groups were lower than those before treatment (P<0.05). The decreased degrees of CRP and PaCO2 in the observation group were better than those in the control group (P<0.05, P<0.01). Conclusion Qingjin Huazhuo Prescription combined with Western medicine therapy can relieve clinical symptoms, reduce the acute inflammatory reaction of AECOPD patients and improve respiration.
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