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目的:探讨化痰活血降气方治疗慢性阻塞性肺疾病急性加重期(AECOPD)的临床疗效及其部分作用机制。方法:将86例AECOPD患者随机分为治疗组和对照组,两组均给予西医治疗方法,治疗组加用化痰活血降气方治疗,比较两组治疗后的证候疗效,评价两组治疗前后的临床症状评分、慢阻肺患者自我评估测试(CAT)评分、改良版英国医学研究委员会呼吸问卷(m MRC)分级及血清纤维蛋白原(FIB)、C-反应蛋白(CRP)水平,对比两组治疗前后肺功能水平(包括FEV1、FEV1占预计值的百分比、FEV1/FVC)的变化。结果:治疗后治疗组的证候疗效(包括总有效率及总显效率)明显优于对照组,治疗组治疗后的临床症状评分、CAT评分、m MRC分级较治疗前明显改善,且与对照组相比,临床症状评分、CAT评分有显著差异;治疗组治疗后肺功能(包括FEV1、FEV1占预计值的百分比、FEV1/FVC)明显提高,与对照组相比有显著差异;治疗组治疗后血清FIB及CRP水平明显下降,与对照组相比有显著差异。结论:化痰活血降气方药治疗AECOPD临床疗效确切,能提高AECOPD患者肺功能水平,其机制可能与改善患者炎症水平及血液流变学有关。
Objective: To investigate the clinical curative effect and its partial mechanism of Huatan Huoxue Jiangqi Decoction on acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: Eighty-six patients with AECOPD were randomly divided into treatment group and control group. Western medicine treatment was given to both groups. The treatment group was treated with Huatan Huoxue Jiangqi Decoction. The curative effect of the two groups was compared and the two groups were evaluated Clinical symptom scores, CAT scores of patients with COPD, m MRC grading, serum fibrinogen (FIB) and C-reactive protein (CRP) levels were compared between the two groups Changes in lung function (including FEV1, percentage of predicted FEV1, FEV1 / FVC) before and after treatment in both groups. Results: The curative effect (including total effective rate and total effective rate) in the treatment group was significantly better than that in the control group. The clinical symptom score, CAT score and m-MRC grade in the treatment group were significantly improved after treatment compared with the control group The scores of clinical symptom and CAT were significantly different. The pulmonary function (including FEV1, the percentage of predicted FEV1, FEV1 / FVC) of the treatment group after treatment was significantly higher than that of the control group After the serum FIB and CRP levels decreased significantly compared with the control group. Conclusion: The therapeutic effect of Huatan Huoxue Jiangqi Recipe on AECOPD is definite. It can improve pulmonary function in patients with AECOPD. The mechanism may be related to the improvement of inflammation level and hemorheology.