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边哨, 沈珊, 吴安源, 王增玲.二陈汤合六君子汤化裁联合常规西医治疗慢性阻塞性肺疾病急性加重期疗效观察[J].湖南中医药大学学报,2025,45(5):904-909[点击复制] |
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| 二陈汤合六君子汤化裁联合常规西医治疗慢性阻塞性肺疾病急性加重期疗效观察 |
| 边哨,沈珊,吴安源,王增玲 |
| (合肥市第八人民医院中医科, 安徽 合肥 238000;吉林省中医药科学院(吉林省中医药科学院第一临床医院), 吉林 长春 130012) |
| 摘要: |
| 目的 探究二陈汤合六君子汤化裁联合常规西医治疗慢性阻塞性肺疾病急性加重期（AECOPD）痰浊阻肺证的疗效。方法 选取合肥市第八人民医院AECOPD痰浊阻肺证患者136例（2022年1月至2024年1月），随机分为观察组和对照组。对照组予常规西医治疗，观察组在对照组基础上加二陈汤合六君子汤化裁方汤剂内服。比较两组临床疗效及治疗前后中医证候积分、血气指标、肺功能指标、慢性阻塞性肺疾病肺评估测试（CAT）评分、6分钟步行距离（6MWD）、血清CX趋化因子配体10（CXCL10）、CX3趋化因子配体1（CX3CL1）水平，并分析用药安全性。结果 观察组总有效率明显高于对照组（P＜0.01）。与治疗前比较，治疗后两组中医证候积分、CAT评分、动脉二氧化碳分压（PaCO2）及血清CXCL10、CX3CL1水平明显降低（P＜0.01）；且观察组中的上述指标明显低于对照组（P＜0.01）。与治疗前相比，治疗后两组动脉血氧分压（PaO2）、第1秒用力呼气容积与用力肺活量比值（FEV1/FVC）、FEV1占预计值百分比（FEV1%pred）、6MWD明显升高（P＜0.01）；且观察组中的上述指标明显高于对照组（P＜0.01）。治疗期间，两组均未出现明显不良事件。结论 AECOPD痰浊阻肺证患者采用二陈汤合六君子汤化裁治疗，可缓解临床症状，改善肺通气功能，提高生活质量，降低血清CXCL10、CX3CL1水平，效果显著，且安全性高。 |
| 关键词: 二陈汤 六君子汤 慢性阻塞性肺疾病急性加重期 痰浊阻肺证 疗效 趋化因子 |
| DOI：10.3969/j.issn.1674-070X.2025.05.017 |
| 投稿时间：2024-11-29 |
| 基金项目:2022年中医药古籍文献和特色技术传承专项项目（GZY-KJS-2022-030）。 |
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| Efficacy observation of modified Erchen Decoction and Liujunzi Decoction combined with conventional western medicine therapy on acute exacerbation of chronic obstructive pulmonary disease |
| BIAN Shao, SHEN Shan, WU Anyuan, WANG Zengling |
| (Department of Chinese Medicine, the Eighth People's Hospital of Hefei, Hefei, Anhui 238000, China;Jilin Academy of Chinese Medicine Sciences (The First Clinical Hospital of Jilin Academy of Traditional Chinese Medicine), Changchun, Jilin 130012, China) |
| Abstract: |
| Objective To explore the efficacy of modified Erchen Decoction and Liujunzi Decoction combined with conventional western medicine therapy in treating acute exacerbation of chronic obstructive pulmonary disease (AECOPD) (phlegm dampness accumulating in the lung pattern). Methods A total of 136 AECOPD patients with phlegm dampness accumulating in the lung pattern admitted to the Eighth People's Hospital of Hefei from January 2022 to January 2024 were selected and randomly divided into observation group and control group. The control group received conventional western medicine therapy, while the observation group received oral administration of modified Erchen Decoction and Liujunzi Decoction in addition to the treatment provided to the control group. Clinical efficacy, TCM pattern scores, blood gas parameters, lung function indicators, COPD Assessment Test (CAT) scores, 6-minute walking distance (6MWD), serum levels of CX chemokine ligand 10 (CXCL10) and CX3 chemokine ligand 1 (CX3CL1) before and after treatment were compared between the two groups, and the safety of medication was analyzed as well. Results The total effective rate of the observation group was higher than that of the control group (P<0.01). Compared with before treatment, TCM pattern scores, CAT scores, arterial partial pressure of carbon dioxide （PaCO2）, and serum levels of CXCL10 and CX3CL1 decreased in both groups after treatment (P<0.01), and the above indicators in the observation group were lower than those in the control group (P<0.01). Compared with before treatment, both groups showed increased arterial partial pressure of oxygen （PaO2）, forced expiratory volume in one second to forced vital capacity (FEV1/FVC) ratio, FEV1to the predicted value (FEV1% pred), and 6MWD after treatment (P<0.01), and the above indicators in the observation group were higher than those in the control group (P<0.01). During treatment, no obvious adverse events occurred in either group. Conclusion For AECOPD patients with phlegm dampness accumulating in the lung pattern, the treatment with modified Erchen Decoction and Liujunzi Decoction can relieve clinical symptoms, improve pulmonary ventilation function, enhance the quality of life, and reduce the serum levels of CXCL10 and CX3CL1, exhibiting significant efficacy and high safety. |
| Key words: Erchen Decoction Liujunzi Decoction acute exacerbation of chronic obstructive pulmonary disease phlegm dampness accumulating in the lung pattern therapeutic effect chemokine |
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