化痰宁合剂治疗慢性支气管炎急性发作临床研究
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R562.2+1

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浙江丽水市科技计划项目(2012JYZB66)


Clinical Study on Huatanning Mixture for Acute Exacerbation of Chronic Bronchitis
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    摘要:

    目的:观察化痰宁合剂对慢性支气管炎急性发作期(AECB) 患者疾病控制及预后的影响。方法:将痰热壅肺证AECB患者100例按照随机数字表法分为2组,每组各50例;对照组在常规西医治疗的基础上加用盐酸氨溴索静脉滴注,治疗组在对照组的基础上加用化痰宁合剂治疗;观察比较2组治疗前后临床症状、肝肾功能、心电图检查、肺功能[肺活量(VC)、呼气流速峰值(PEF)、用力肺活量(FVC) 与第1 秒钟用力呼气容积(FEV1) 及其FEV1/FVC 比率]、炎症因子[白细胞介素-2(IL-2)、IL-4、IL-8、γ干扰素(IFN-γ)]、免疫功能[T淋巴细胞亚群CD3+细胞分数(CD3+)、CD4+、CD8+、CD4+/CD8+]、嗜酸性粒细胞(EOS)、补体C3、补体C4 以及并发症发生等情况。结果:总有效率治疗组为92.0%,对照组为76.0%,2 组比较,差异有统计学意义(P<0.05)。治疗后,2组患者的肺功能指标VC、PEF、FEV1、FEV1/FEV值均较治疗前明显升高(P<0.05);且治疗组各项指标均高于对照组(P<0.05)。治疗后,2组患者的免疫功能指标C3、C4、CD3+、CD4+以及CD4+/CD8+水平均较治疗前明显升高(P<0.05),CD8+水平明显降低(P<0.05);且治疗组C3、C4、CD3+、CD4+以及CD4+/CD8+高于对照组(P<0.05),CD8+水平低于对照组(P<0.05)。治疗后,2组血清炎症因子EOS、IL-2、IL-4及IL-10水平均较治疗前明显降低(P<0.05),IFN-γ水平明显升高(P<0.05);且治疗组EOS、IL-2、IL-4及IL-10水平低于对照组(P<0.05),IFN-γ水平高于对照组(P<0.05)。并发症发生率治疗组为6.0%,对照组为20.0%,2组比较,差异有统计学意义(P<0.05)。治疗期间,2组患者肝肾功能及心电图检查均无明显变化。结论:在西医治疗的基础上辅助化痰宁合剂治疗痰热壅肺证AECB疗效显著,能明显改善患者肺功能,增强机体免疫功能,抑制炎症反应,且安全性较高。

    Abstract:

    Abstract:Objective:To observe the effect of Huatanning mixture on disease control and prognosis in patients with acute exacerbation of chronic bronchitis(AECB). Methods:Divided 100 cases withAECB of phlegm-heat obstructing lung type into two groups according to random number table,50 cases in each group. The control group received ambroxol hydrochloride via intravenous drip based on routine western medicine treatment, while the treatment group additionally received Huatanning mixture. Observed and compared clinical symptoms, hepatic and renal function, electrocardiogram examination, pulmonary function[vital capacity(VC), peak expiratory flow(PEF), forced vital capacity(FVC) and forced expiratory volume in one second(FEV1), the ratios of FEV1 /FVC], inflammatory factors [interleukin-2(IL-2), IL-4, IL-8, γ interferon(IFN- γ)],immune function [cell fractions ofCD3+ (CD3+ ),CD4+,CD8+,CD4+/CD8+ in T-lymphocyte subsets], eosinophilic granulocytes(EOS)、complement C3、complement C4 and the occurrence of complications in both groups before and after treatment. Results: The total effective rate was 92.0% in the treatment group and 76.0% in the control group, difference being significant(P<0.05). After treatment,the indexes of pulmonary function including VC,PEF,FEV1 and FEV1/ FEV in both groups were higher than those before treatment(P<0.05), and each index above in the treatment group was higher than that in the control group(P<0.05). After treatment,the indexes of immune function including C3,C4,CD3 +, CD4+ and CD4+/CD8+ in both groups were significantly higher than those before treatment(P<0.05),and the levels of CD8+ were significantly decreased(P<0.05);the levels of C3,C4,CD3+,CD4+ and CD4+/CD8+ in the treatment group were higher than those in the control group(P<0.05), and the level of CD8 + was lower than that in the control group(P<0.05). After treatment,the levels of serum inflammatory factors including EOS,IL-2,IL-4 and IL-10 in both groups were significantly lower than those before treatment(P<0.05), and the levels of IFN- γ were significantly increased(P<0.05); the levels of EOS,IL- 2,IL- 4 and IL- 10 in the treatment group were lower than those in the control group(P<0.05),and the level of IFN-γ was higher than that in the control group(P<0.05). The incidence of complications was 6.0% in the treatment group and 20.0% in the control group,difference being significant(P<0.05). During treatment,no obvious changesoccurred in hepatic and renal function and electrocardiogram examination in both groups. Conclusion: The application of Huatanning mixture based on western medicine has significant therapeutic effect in treating AECB ofphlegm-heat obstructing lung type,which can obviously enhance renal function,improvebodily immune function and inhibit inflammatory response with high safety.

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孙涛,陈曦,刘笑静,李权.化痰宁合剂治疗慢性支气管炎急性发作临床研究[J].新中医,2020,52(9):59-62

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  • 在线发布日期: 2020-05-09
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