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目的:探讨苇金消痈汤加减辅助治疗痰热壅肺型支气管扩张急性加重期的疗效以及对痰液和血清中基质金属蛋白酶-9(MMP-9)和基质金属蛋白酶抑制剂-1(TIMP-1)的影响。方法:收集支气管扩张急性加重期患者98例,参照随机按数字表法平均分为对照组和治疗组各49例;两组患者参照《成人支气管扩张症诊治专家共识》给予非药物干预。对照组抗感染采取盐酸左旋氧氟沙星注射液,0.4 g加入生理盐水400 m L,200 m L/次,2次/d;对铜绿假单胞菌感染者,0.6 g加入生理盐水600 m L,300 m L/次,2次/d。化痰采取氨溴索注射液,30 mg加入生理盐水100 m L,1次/d。治疗组在对照组治疗的基础上给予苇金消痈汤,1剂/d,常规水煎煮2次,分早晚2次内服。两组疗程均为2周。比较两组第1秒最大呼气量(FEV1),FEV1/用力肺活量(FVC),血氧分压(Pa O2),二氧化碳分压(Pa CO2),血氧饱和度(Sa O2)及临床症状评分;分析两组患者临床疗效;测定两组患者痰液和血清中MMP-9,TIMP-1水平。结果:治疗后治疗组FEV1,FEV1/FVC,Pa O2和Sa O2均明显高于对照组,而Pa CO2和咳嗽等临床积分均明显低于对照组(P<0.01);治疗组和对照组临床治疗总有效率分别为95.92%和79.59%,治疗组明显优于对照组(P<0.05);治疗后治疗组痰液和血清中MMP-9水平均明显低于对照组,而TIMP-1高于对照组(P<0.01)。结论:在常规西医治疗的基础上,苇金消痈汤辅助治疗痰热壅肺型支气管扩张急性加重期疗效确切,抑制痰液和血清中MMP-9水平及上调TIMP-1水平可能在其中发挥重要作用。
Objective: To investigate the curative effect of reed Jinxiao Decoction on adjuvant treatment of acute exacerbation of bronchiectasis of phlegm-dampness lung and to evaluate the effect of MMP-9 and TIMP-1 in sputum and serum -1). Methods: A total of 98 patients with acute exacerbation of bronchiectasis were enrolled in this study. The patients were divided into control group and treatment group with 49 cases in each group according to the random number table. The two groups were given non-drug intervention according to the expert consensus of diagnosis and treatment of adult bronchiectasis. Anti-infection in the control group was levofloxacin hydrochloride injection, 0.4 g normal saline 400 m L, 200 m L / times, 2 times / d; Pseudomonas aeruginosa infection, 0.6 g added saline 600 m L, 300 m L / time, 2 times / d. Huatan take ambroxol injection, 30 mg saline 100 m L, 1 time / d. Treatment group in the control group given on the basis of the reed Jinxiao Decoction, 1 / d, conventional boiling water twice, points in the morning and evening 2 times orally. Two groups of treatment are 2 weeks. The FEV1, FVC, Pa O2, PaCO2, Sa O2 and clinical symptoms were compared between the two groups The clinical efficacy of the two groups was analyzed. The levels of MMP-9 and TIMP-1 in sputum and serum of the two groups were measured. Results: After treatment, the FEV1, FEV1 / FVC, Pa O2 and Sa O2 in the treatment group were significantly higher than those in the control group, while the clinical scores of Pa CO2 and cough were significantly lower than those in the control group (P <0.01) The total effective rate was 95.92% and 79.59% respectively, which was significantly better than that of the control group (P <0.05). After treatment, the levels of MMP-9 in sputum and serum of the treatment group were significantly lower than those in the control group, while the high level of TIMP-1 In the control group (P <0.01). Conclusion: On the basis of routine western medicine treatment, reed Jinxiao Decoction can effectively treat the acute exacerbation of bronchiectasis of phlegm-dampness lung, and it may play an important role in inhibiting the level of MMP-9 in sputum and serum and up-regulating the level of TIMP-1 Important role.