牡丹江市第二人民医院 黑龙江 牡丹江 157011
摘要：目的：观察清气化痰汤联合西药治疗慢性阻塞性肺疾病急性期证属痰热壅肺型的临床疗效。方法：将60例慢性阻塞性肺疾病急性期患者随机分为2组。对照组采用西医常规疗法，给予茶碱缓释片每次0．2g，每12h1次，口服，盐酸氨溴索片每次30mg，每日3次，口服。治疗组30例在对照组治疗基础上加服清气化痰汤，每日1剂，每日2次。2组均以10 d为1个疗程，治疗1个疗程。结果：治疗组临床30例，显效25例，有效3例，无效2例。对照组30例，显效19例，有效8例，无效3例。结论：清气化痰汤联合西医常规疗法治疗慢性阻塞性肺疾病急性加重期能够明显减轻临床症状，且无不良反应，值得临床 推广应用。
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关键词：清气化痰汤联合西药；治疗慢性阻塞性肺疾病急性期；临床疗效
To explore the clinical curative effect of qingqi phlegm decoction combined with western medicine in the treatment of chronic obstructive pulmonary disease.
Abstract: objective: to observe the clinical curative effect of qingqi phlegm decoction combined with western medicine on chronic obstructive pulmonary disease syndrome. Methods: 60 patients with chronic obstructive pulmonary disease with chronic obstructive pulmonary disease were randomly divided into 2 groups. In the control group, 30 patients were treated with traditional western medicine, which gave continuous low flow oxygen uptake, and the corresponding antibiotics were selected according to the drug sensitivity results. At the same time, the tea base sustained release tablets 0. 2 g, 1 time per 12 h, oral, ambroxol hydrochloride tablets 30 mg every time, 3 times a day, orally. Treatment group of 30 patients in the control group on the basis of add clear phlegm decoction (by dried tangerine or orange peel, almonds, acid-insoluble ash, radix scutellariae, fructus kernel, poria cocos, bravery nanxing, method of pinellia tuber), daily 1 agent, by the mode is made, each agent 2 package, every package of 100 mL, 2 times a day. Both groups were treated with 10 d for 1 course of treatment and 1 course of treatment. Results: there were 30 cases in the treatment group and 25 in the treatment group, 3 cases were effective and 2 cases were invalid. In the control group, there were 30 cases, 19 cases, 8 effective cases and 3 invalid cases. There was no statistically significant difference between the two groups (P BBB 0.05). Conclusion: the treatment of acute exacerbation of chronic obstructive pulmonary disease in patients with chronic obstructive pulmonary disease can significantly reduce clinical symptoms and no adverse reactions, which is worthy of clinical application.
Key words: qingqi, phlegm soup, combined western medicine; To treat the acute phase of chronic obstructive pulmonary disease; Clinical curative effect
慢性阻塞性肺疾病属于中医学“肺胀”、“喘病”、“咳嗽”等范畴，因反复出现急性加重期可使病情不断进展，最终可引起呼吸衰竭和肺源性心脏病，是造成老年人致残和死亡的主要原因之一。目前常规西药治疗可取得较好疗效，但药物不良反应较大，且反复用药易产生耐药性。清气化痰汤针对痰热壅肺之病机，具有清热化痰、理气止咳和活血化瘀之功效。对清气化痰汤结合西医治疗AECOPD的临床疗效进行评价，为中西医结合治疗AECOPD提供依据。
1．资料与方法
1.1临床资料
选择2016年5月至2017年5月本院接受治疗的COPD患者60例，60例患者随机分为观察组与治疗组各30例，两组一般资料差异无统计学意义（P＞0.05）。症见：短期内咳嗽、喘息明显加重，痰量增加，呈脓性或粘液脓性，肺部听诊可闻及干罗音或干湿性罗音。
1.2治疗方法
对照组和治疗组患者均接受常规的综合治疗。给予对照组单纯的西医治疗，包括低流量 氧疗、抗生素治疗等。给予茶碱缓释片口服，硫酸沙丁胺醇雾化液（雾化吸入，治疗组在西药治疗的同时给予中医药的联合治疗，即清气化痰汤，治疗1个疗程后观察。
1.3疗效判定
痊愈：症状及体征完全消失；中医证候积分降低80％以上。显效：症状及体征明显改善；中医证候积分减低50％以上。有效：症状及体征好转；中医证候积分降低30％以上。无效：症状及体征无改善；中医证候积分降低小于30％。
2结果
两组总疗效比较：治疗组临床30例，显效25例，有效3例，无效2例。对照组30例，显效19例，有效8例，无效3例。2组疗效对比，差别无统计学意义(P＞0.05)。治疗组患者恢复率高于对照组，说明清气化痰汤联合西医常规疗法治疗慢性阻塞性肺疾病急性加重期能够明显减轻临床症状，且无不良反应，值得临床推广应用。
3讨论
慢性阻塞性肺疾病发生多因久病肺虚，进而影响脾肾心功能，脾失健运，酿湿生痰，肺朝百脉而助心行血，肺虚主气功能失常，无力推动血液正常运行致瘀血内阻，临床常又以痰热壅肺型为主, 故选清气化痰汤为主方，清热解毒，活血化瘀，有清热化痰，解毒化瘀扶正之效。现代医学研究表明热痰主要是一个炎症过程，且细菌性炎症是主要的，故中药清热化痰治疗实际即是抗炎治疗，中西合用，为治疗COPD最佳方法。
参考文献
[1]中华医学会呼吸病学分会，慢性阻塞性肺疾病(COPD)诊治规范(草案)，中华结核和呼吸杂志，1997，20(4):199～202
[2]曲松柏，李家庚，实用中医心血管病学，北京，科学技术文献出版社，1996:368～380
[3]陈炳，桃红枳实汤治疗肺原性心脏病39例临床观察，中医杂志，2000，41 (3):155～156
论文作者:姜贤德
论文发表刊物:《中国研究型医院》2018年5卷1期
论文发表时间:2018/6/22
标签：疗效论文; 西医论文; 疾病论文; 阻塞性肺论文; 对照组论文; 体征论文; 症状论文; 《中国研究型医院》2018年5卷1期论文;