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目的:观察金水六君煎与三拗方合用辅助西药治疗慢性支气管炎急性加重期临床效果,并探讨其机制。方法:选取青海省中医院2012年5月—2014年5月收治的慢性支气管炎急性加重期患者160例,采用随机抽样方法分为对照组和治疗组,各80例。其中对照组患者采用常规西医干预治疗,治疗组患者则在此基础上加用金水六君煎合三拗方辅助治疗;比较两组患者临床疗效,临床症状体征持续时间,治疗前后中医证候积分、肺通气功能指标、炎性细胞因子水平及临床复发率等。结果:治疗组患者临床疗效明显优于对照组(P<0.05);与治疗前比较,两组患者治疗后中医证候积分明显降低(P<0.05),治疗后与对照组比较,治疗组患者中医证候积分明显降低(P<0.05),治疗组患者临床症状体征持续时间明显短于对照组(P<0.05)。与治疗前比较,两组患者治疗后肺通气功能指标水平明显增加(P<0.05);治疗后与对照组比较,治疗组患者肺通气功能指标水平明显增加(P<0.05)。与治疗前比较,两组患者治疗后炎性细胞因子水平明显降低(P<0.05);治疗后与对照组比较,治疗组患者炎性细胞因子水平明显降低(P<0.05)。治疗组患者临床复发率明显低于对照组(P<0.05)。结论:金水六君煎与三拗方合用治疗慢性支气管炎急性加重期可有效改善临床症状体征,缩短病程,提高肺部功能,并有助于降低远期复发率。
Objective: To observe the clinical effects of Jinshui Liujunjian and Sananfang combined with western medicine in the treatment of chronic exacerbation of chronic bronchitis, and to explore its mechanism. Methods: 160 cases of acute exacerbation of chronic bronchitis admitted to Qinghai Provincial Hospital of Traditional Chinese Medicine from May 2012 to May 2014 were selected and randomly divided into control group and treatment group (80 cases each). The control group of patients with conventional Western intervention, the treatment group was based on the addition of Jinshuiliujunjian Sangan formula adjuvant therapy; clinical efficacy, clinical symptoms and signs duration, before and after treatment of TCM Syndrome points , Pulmonary ventilation function indicators, levels of inflammatory cytokines and clinical relapse rate. Results: Compared with the control group, the clinical efficacy of the treatment group was significantly better than that of the control group (P <0.05). Compared with the pre-treatment, the TCM syndrome scores of the two groups were significantly decreased after treatment (P <0.05) TCM syndrome score was significantly lower (P <0.05), the duration of clinical symptoms and signs in the treatment group was significantly shorter than that in the control group (P <0.05). Compared with those before treatment, the levels of pulmonary function indexes increased significantly after treatment in both groups (P <0.05). Compared with the control group, the pulmonary function parameters in the two groups were significantly increased (P <0.05). The levels of inflammatory cytokines in both groups were significantly lower than those before treatment (P <0.05). Compared with the control group, the levels of inflammatory cytokines in the two groups were significantly decreased (P <0.05). The clinical relapse rate in the treatment group was significantly lower than that in the control group (P <0.05). Conclusion: The combination of Jinshuaijiangyunjian and Sananbo for the treatment of acute exacerbation of chronic bronchitis can effectively improve clinical symptoms and signs, shorten the course of disease, improve lung function and help to reduce the long-term recurrence rate.