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目的:观察中西医结合治疗慢性阻塞性肺疾病急性加重(AECOPD)患者的临床疗效。方法:采用随机对照、单盲的临床研究方法,将呼吸科及重症医学科入选的痰热壅肺证AECOPD患者120例随机分为4组,西医组(A组)、西医+清金化痰汤组(B组)、西医+支气管-肺泡灌洗组(C组)、西医+清金化痰汤+支气管-肺泡灌洗组(D组),每组30例,各组均按照既定治疗方案给予相应的干预措施。观察周期为7天,通过观察患者在治疗前后中医证候积分、痰液中黏蛋白MUC5AC含量等的变化,评估各组疗效。结果:中医证候积分方面:治疗后,D组治疗前后的差值明显少于其他3组,与其他3组比较,差异均有统计学意义(P<0.05)。临床疗效评价方面:D组的临床总有效率为93.33%,与A组、B组、C组比较,差异均有统计学意义(P<0.05)。MUC5AC含量方面:各组在治疗前后的差值比较,D组明显高于A组、B组、C组,差异均有统计学意义(P<0.05)。结论:在西医治疗基础上联合清金化痰汤和支气管-肺泡灌洗综合治疗,可以提高临床总有效率,同时能够降低AECOPD患者机体内黏蛋白的表达,改变痰液性状,从而改善患者气道黏液高分泌状态。
Objective: To observe the clinical efficacy of integrated traditional Chinese and western medicine in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: A randomized, single-blind clinical study was conducted in 120 patients with AECOPD who were admitted to the Department of Respiratory and Critical Care Medicine and divided into 4 groups: A group, Western medicine group, Qingjinhuatan group Western medicine + bronchoalveolar lavage group (C group), Western medicine + Qingjinhuatan decoction + bronchoalveolar lavage group (D group), 30 cases in each group. All groups were treated according to established treatment Program to give the appropriate interventions. The observation period was 7 days. The curative effect of each group was evaluated by observing the changes of TCM syndrome score and mucin MUC5AC content in sputum before and after treatment. Results: In the aspect of TCM syndrome score, after treatment, the difference between before and after treatment in group D was obviously less than that in the other three groups. There was significant difference between the three groups (P <0.05). Clinical evaluation: The total clinical effective rate in group D was 93.33%, which was significantly different from that in group A, B and C (P <0.05). MUC5AC content: the difference between before and after treatment in each group, D group was significantly higher than the A group, B group, C group, the difference was statistically significant (P <0.05). Conclusion: The combination of Qingjin Huatan Decoction and bronchoalveolar lavage combined therapy can improve the total clinical efficiency, reduce the expression of mucin in the body of AECOPD patients, change the properties of sputum, and improve the patient’s gas Road mucus hypersecretion state.