| Bronchiectasis is a common chronic respiratory disease,which is characterized by infection,inflammation and permanent and irreversible expansion of bronchial wall.The interaction of chronic infection,deterioration and inflammation drives a vicious cycle,leading to lung injury in the bronchus and lung parenchyma.The etiology of this disease is not completely clear,and the etiology of about 50% ～ 70% of bronchiectasis is unknown.It is clinically called "idiopathic bronchiectasis".The main clinical symptoms are chronic cough,expectoration,occasional hemoptysis,and some symptoms such as chest tightness,shortness of breath and shortness of breath.Bronchiectasis is divided into acute exacerbation stage and stable stage,and frequent exacerbation will damage pulmonary function and affect the prognosis of patients.High resolution CT can detect abnormal bronchiectasis and bronchial wall thickening,and then diagnose the disease.At present,the focus of the treatment of bronchiectasis is airway clearance technology(ACT)and the synergistic effect of mucus active drugs to achieve the purpose of promoting expectoration and resolving phlegm,thereby reducing the accumulation of sputum in the airway and reducing the probability of bacterial colonization.Break the vicious circle of bronchiectasis.This study is based on the theory of traditional Chinese medicine and based on the theoretical basis of "the spleen is the source of phlegm,and the lung is the device of phlegm storage",it is believed that in stable bronchiectasis,both lung and spleen deficiency,phlegm-dampness accumulation in the lung syndrome are the main syndrome types,and the lung is the main syndrome type.Deficiency of the spleen and phlegm and obstruction of the lung are the basic pathogenesis of acute exacerbation of bronchiectasis in the stable stage,and the accumulation of phlegm and heat is the main pathological manifestation of acute exacerbation of bronchiectasis.On the basis of Liujunzi Decoction and Erchen Decoction,a basic formula for invigorating the lungs,invigorating the spleen and resolving phlegm was established.Objective: To explore the effect of Bufei Jianpi Huatan basic formula on 24-hour sputum volume and acute exacerbation rate in patients with bronchiectasis,so as to provide clinical basis for the treatment of bronchiectasis with traditional Chinese medicine.Methods: the study type was a randomized controlled study.50 patients with bronchiectasis(phlegm dampness accumulating lung type)were randomly divided into control group and treatment group.The control group took acetylcysteine tablets,one tablet at a time(600mg),twice a day;On the basis of the control group,the experimental group was added with the basic formula of Tonifying the lung,strengthening the spleen and resolving phlegm.The course of treatment was 4 weeks.The changes of acute exacerbation,24-hour sputum volume,clinical symptoms,TCM symptoms and quality of life of the two groups before and after treatment were observed,analyzed and discussed,and objectively evaluated the effect of Bufei Jianpi Huatan basic formula in the treatment of bronchiectasis.Result:1 24-hour sputum volumeThe sputum volume at 24 hours before and after treatment was significantly reduced in the two groups,and there was a statistical difference(P<0.05);there was no statistical difference in the sputum volume at 24 hours after treatment(P>0.05);There was a statistically significant difference in the difference between the two groups(P<0.05).That is to say,both the experimental group and the control group can reduce the daily expectoration volume of the subjects,and the curative effect of reducing the sputum volume of the experimental group is significantly better than that of the control group.2 acute exacerbationsAfter treatment,there was a statistically significant difference between the experimental group and the control group in the number of acute exacerbations(P<0.05),and there was a statistically significant difference in the frequency of acute exacerbation between the groups(P<0.05).That is,during the follow-up period,the number of acute exacerbations in the experimental group was significantly less than that in the control group,and the frequency of acute exacerbations was lower.3 TCM symptom scoreThe total effective rate of the experimental group was 95.83%,and the total effective rate of the control group was 82.60%.The effective rate of the experimental group was higher than that of the control group,but there was no statistical difference between the two groups(P>0.05).Comparison of symptom scores in the two groups before and after treatment have decreased significantly.For single symptom comparison,after treatment,the experimental group had statistical significance in cough,expectoration,chest tightness,lack of appetite and fatigue(P<0.05),but no statistical significance in abdominal distension symptoms(P>0.05);control group Before and after treatment,there were statistical significance in cough,expectoration,chest tightness and fatigue(P<0.05),but no statistical significance in abdominal distension and lack of appetite(P>0.05).Compared with the two groups,the effective rate of the experimental group in treating symptoms of cough,expectoration and fatigue was higher than that in the control group,the effective rate in treating symptoms of chest tightness and abdominal distension was not as good as that in the control group,and the effective rate in treating lack of food was similar to that in the control group.4 No deterioration rateDuring the 12-week follow-up period,there was a statistical difference between the experimental group and the control group(P<0.05).That is,the improvement and no deterioration rate of the experimental group was better than that of the control group.There was a statistically significant difference in the non-deterioration rate before and after treatment in the experimental group(P value far less than 0.001);there was no statistical difference in the non-deterioration rate in the control group before and after treatment(P>0.05).That is,the experimental group can significantly increase the rate of no deterioration after treatment.5 Time to the first aggravationThe first exacerbation time of the experimental group was 13.042±0.883(weeks),and the first exacerbation time of the control group was 12.826 ± 0.755(weeks).learning differences.6 CAT ScoreBefore and after treatment,the CAT scores of the two groups were significantly decreased;before and after the study,the CAT scores of the two groups were significantly decreased;compared between the two groups,on the 28 th day of the treatment period,the two groups had the same effect of improving the CAT score,and on the 12 th week of the follow-up period,the improvement of CAT score in the experimental group was significantly better than that in the control group.Conclusion:1.The basic formula of nourishing lung,strengthening spleen and resolving phlegm can significantly reduce the 24-hour phlegm volume in patients with stable bronchiectasis.2.The basic formula of nourishing lung,strengthening spleen and resolving phlegm can significantly reduce the frequency and frequency of acute exacerbations in patients with stable bronchiectasis.3.The basic formula of nourishing lung,strengthening spleen and resolving phlegm can significantly improve the symptoms of cough,expectoration and fatigue in patients with stable bronchiectasis.4.The basic formula of nourishing lung,strengthening spleen and resolving phlegm can significantly increase the non-exacerbation rate of patients with stable bronchiectasis.5.The basic formula of nourishing lung,strengthening spleen and resolving phlegm can significantly improve the quality of life of patients with stable bronchiectasis. |
PDF Full Text Request