清肺化痰汤联合西药治疗老年慢性支气管炎合并肺气肿随机平行对照研究

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[目的]观察清肺化痰汤联合西药治疗老年慢性支气管炎疗效。[方法]使用随机平行对照方法,将74例住院及门诊患者按就诊顺序编号方法简单随机分为两组。对照组37例控制感染、镇咳祛痰、平喘等,左氧氟沙星,0.1g/次,3次/d,口服;复方甘草口服溶液15m L/次,3次/d,口服;气喘加氨茶碱0.1~0.2g/次,1~2次/d,口服;锻炼做腹式呼吸,缩唇深慢呼气,加强呼吸肌活动,增加膈的活动能力;适当运动,太极拳、呼吸操,定量行走或登梯练习。治疗组37例清肺化痰汤(西洋参、蛤蚧、诃子、延胡索、紫河车、沉香各10g),水煎400m L,早晚温服,咳嗽咳痰加川贝粉;西药治疗同对照组。连续治疗4周为1疗程。观测临床症状、残气容积(RV)、肺总量(TLC)、不良反应。治疗1疗程,判定疗效。[结果]治疗组显效17例,有效18例,无效2例,总有效率94.59%。对照组显效14例,有效13例,无效10例,总有效率72.97%。治疗组疗效优于对照组(P<0.01)。咳嗽、咳痰、喘息治疗组优于对照组(P<0.05)。[结论]清肺化痰汤联合西药治疗老年慢性支气管炎合并肺气肿,疗效满意,无严重不良反应,值得推广。 [Objective] To observe the curative effect of Qingfei Huatan Decoction combined with western medicine on senile chronic bronchitis. [Methods] Using randomized parallel control method, 74 inpatients and outpatients were randomly divided into two groups randomly according to the sequence number of visiting doctor. Control group of 37 cases of infection control, antitussive expectorant, asthma, levofloxacin, 0.1g / times, 3 times / d, oral; compound licorice oral solution 15m L / times, 3 times / d, orally; Alkali 0.1 ~ 0.2g / time, 1 ~ 2 times / d, orally; Exercise do abdominal respiration, deflated lips deep breath, strengthen respiratory activity, increase the activity of the diaphragm; appropriate exercise, tai chi, breathing exercises, Quantitative walking or boarding exercises. In the treatment group, 37 cases of Qingfei Huatan Decoction (American ginseng, Gecko, Myrobalan, Corydalis, Placenta, Agarwood each 10g), decoction 400m L, morning and evening warm clothes, cough and expectoration plus Chuanbei powder; Western medicine treatment with the control group. Continuous treatment for 4 weeks for a course of treatment. Clinical symptoms, residual volume (RV), total lung volume (TLC) and adverse reactions were observed. Treatment of a course of treatment to determine the efficacy. [Result] In the treatment group, 17 cases were markedly effective, 18 cases were effective and 2 cases were ineffective. The total effective rate was 94.59%. In the control group, 14 cases were markedly effective, 13 cases were effective, 10 cases were ineffective, and the total effective rate was 72.97%. The treatment group than the control group (P <0.01). Cough, sputum, wheeze treatment group than the control group (P <0.05). [Conclusion] Qingfei Huatan Decoction combined with western medicine in the treatment of senile chronic bronchitis complicated with emphysema has satisfactory curative effect and no serious adverse reactions and is worth popularizing.
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