Clinical Study On Long Dan Li Fei Decoction In Treating Acute Exacerbation Of Chronic Obstructive Pulmonary Disease (Lung Phlegm Heat Stasis Syndrome)

Chronic obstructive pulmonary disease(COPD)has attacked a large number of people in China.Its main feature is the incomplete reversible airflow limitation.Clinically,it is recurrent and increasingly become severe.Patients has to be hospitalized and treated with antibiotics and corticosteroids over and over again,and may developed with adverse reactions such as bacterial resistance and hormone dependence,accompanied with a decline of life quality and heavy economic burden,also resulted in a waste of social medical resources.Professor Shen Chun-ti has worked for more than 40 years,and she often used traditional Chinese medicine(TCM)combining with Western medicine(WM)to treat COPD,achieved better therapeutic effect.Shen found that patients in acute exacerbated COPD(AECOPD)D group the Lung phlegm heat stasis syndrome is the most common type.She often used Long Dan Li Fei decoction to treat this syndrome and have good results.In order to further prove the clinical efficacy of the prescription,based on western medicine treatment combined with Long Dan Li Fei decoction.,we conducted a randomized,controlled clinical study based on western medicine treatment combining with Long Dan Li Fei decoction.Objective:To observe the clinical efficacy of Long Dan Li Fei decoction in the treatment of AECOPD(group D),and further clarify whether it can improve the symptoms of Chinese medicine,lung function,blood viscosity and the synergistic anti-infective effects.Method:This study was based on a loaded clinical trial.Patients with Lung phlegm heat stasis syndrome of AECOPD(group D)were selected in the project.A total of 42 hospitalized patients of pulmonary department of Nanjing University of Traditional Chinese Medicine Affiliated Wujin Traditional Chinese Medicine hospital were selected,and were randomized into control group(21 cases)and treatment group(21 cases)according to the odd number of the date of admission.The control group were treated with conventional western medicine:Anti-infection(piperazepam tazobactam sodium),Phlegm(ambroxol hydrochloride),Antispasmodic asthma(Doxofylline,budesonide and terbutaline sulfate),and using prednisone 3-5 days in condition that the condition become severe.Meanwhile,Oxygen therapy,water-electrolyte balancing procedure were adopted.The treatment group were treated with Long Dan Li Fei decoction on the basis of control group(1 piece perday,7 days a course,14 days observation).The clinical efficacy,blood routine,blood viscosity,pulmonary function,blood gas analysis and other related indexes of the two groups were recorded before and 1 week.The data were analyzed and analyzed using SPSS 19.0.Result:1.The curative effect of the two groups was different.The treatment group:significant efficiency(57.14%),effective rate(38.10%).The control group:significant efficiency(19.05%),effective rate(76.19%).After analysis,the total effective rate of the two groups was statistically different by χ2 test,the therapeutic effect is better(P<0.05).2.There were differences in clinical main symptom between the two groups.After treated for the first week,both groups were received a good efficacy(P<0.01),but there was little difference between the two groups.However,when the following-up continued to the second week,the treatment group showed better result in expectoration and wheeze than in control group(P<0.05).3.Before and after treatment,there were differences in infectious indicators between the two groups.The number of WBC,the number of neutrophils and the changes of hCRP in both groups were statistically significant(P<0.05),and hCRP declined more in treatment group.(P=0.027<0.05).4.Before and after treatment,there were differences in blood gas index between the two group.After treatment,both PaO2 and SaO2 in the two groups were significantly higher than before treatment(P<0.05),and PaO2 of treatment group increased more obvious(P=0.020<0.05).5.Before and after treatment,there were differences in the pulmonary function between the two groups.After treatment,both FVC and FEV1 in the two groups were significantly higher than before treatment(P<0.05),and the treatment group increased more obvious(P<0.05).6.There was no difference in the hemorheology between the two groups before and after treatment.The value of whole blood viscosity(low cut,middle shear,High cut),plasma viscosity and erythrocyte sedimentation rate in two groups did not change significantly after treatment(P>0.05)Conclusion:In the course of the routine treatment of Lung phlegm heat stasis syndrome of AECOPD(group D),Long Dan Li Fei Decoction can assist in anti-infection,improve hypoxia and carbon dioxide retention,which can improve the clinical treatment effect.Long-term use of the herb,can also reduce the respiratory symptoms of patients.