| BackgroundAcute exacerbation chronic obstructive pulmonary disease (AECOPD) is not only the direct cause of death of patients, but also the main factor of high medical costs.At present,modern medicine dominate the clinical treatment of AECOPD. From the analysis of the clinical curative effect of literature, it is imminent to seek new ways to further improve the clinical efficacy for about 30% of the patients with acute exacerbation of poor efficacy.Through the study of the etiology and pathogenesis and TCM syndrome of AECOPD,my professor summarize the TCM treatment of Qing Jin Hua Zhuo Fa in the practice of traditional Chinese medicine in the treatment of AECOPD. It uses in the early clinical course of AECOPD, shows good effect, helps to alleviate the symptoms, controls infection, shorten the course of disease, improves the efficacy of current western medicine treatment programs to a certain extent, and should be further validated and researched.Purpose and significanceThe subject of AECOPD (class Ⅱ) hospitalized patients gives Qing Jin Hua Zhuo Fa combined with western medicine treatment, and conducts perspective, randomized, parallel research by comparing with group of western medicine therapy. By observe serum inflammatory markers (white blood cell count (WBC), C-reactive protein (CRP),procalcitonin (PCT)), arterial blood gas analysis (arterial oxygen tension (PaO2), carbon dioxide partial pressure (PaCO2)), TCM syndrome scores (cough, expectoration, wheezing, chest tightness, fever, unconsciousness, etc.), grade control dyspnea (mMRC rates) and other objective indexes of comparison, discuss the influence of Qing Jin Hua Zhuo Fa on serum inflammatory markers, PaO2, PaCO2, traditional Chinese medicine syndrome, breathing difficulty rating,and evaluates the clinical efficacy and safety of Qing Jin Hua Zhuo Fa in the treatment of AECOPD, provide the basis for the clinical use of the drug.MethodBy perspective, randomized, parallel controlled study, randomly divides patients who meet the inclusion criteria that acute exacerbation duration is less than or equal to 1 week ofAECOPD (class Ⅱ) in hospitalized patients as the research object into two groups.Patients in control group were treated with the standard treatment for respiratory diseases from COPD group of respiratory disease branch of Chinese Medical Association "COPD diacritical and curative guidelines (2013 Revised Edition)" and AECOPD expert group for diagnosis and treatment "the diagnosis and treatment of AECOPD Chinese expert consensus (2014 Revised Edition) ", given the treatments as controlled oxygen therapy, bronchodilators, sugar cortical hormone, antibiotics, mechanical ventilation treatment according to the condition of patients; the experimental group was given Qing Jin Hua Zhuo Decoction of Chinese medicine oral or nasal feeding on the basis of the control group, treatment course 10 days. During the study period, two groups of patients were disabled to use other traditional Chinese medicine that in the treatment of the disease (including proprietary Chinese medicine, traditional Chinese medicine injection, etc.).The study observes the improvement of serum inflammatory markers,PaO2,PaCO2,TCM syndrome scores,dyspnea grad of before and after treatment in patients with acute exacerbation. A conclusion is drawn by using statistical software SPSS20.0.Results(1) There are no significant differences in age, sex, COPD duration, and acute exacerbation time in the two groups. The minimum age is 56 years old, the maximum age is 80 years old, of which 60-80 years of age accounts for 92.06%.The ratio of male to female is 2:1, which indicate that male COPD patients were more than female.(2) After the treatment, the serum inflammatory markers (white blood cell count (WBC), serum C-reactive protein (CRP), procalcitonin (PCT))was statistically significant in grading difference(P< 0.01); Test group WBC, CRP, PCT improvement is more than control group. Description Qing Jin Hua Zhuo Fa can significantly improve the chronic obstructive pulmonary disease with acute exacerbation of inflammatory serum markers of patients and improve clinical outcomes.(3) After treatment, there was a significant difference (P<0.01) groups were arterial oxygen tension (PaO2) levels of PaO2 experimental group improved significantly better than the control group. Description Qing Jin Hua Zhuo Fa can significantly improve the chronic obstructive pulmonary disease exacerbations PaO2 level of phlegm retention in the lung of patients and improve clinical outcomes.(4) Two groups of patients after treatment, chest tightness symptom scores were significantly different (P<0.01), chest tightness symptoms improved experimental group more than the control group. Description Qing Jin Hua Zhuo Fa can significantly improve the chronic obstructive pulmonary disease with acute exacerbation of phlegm retention in the lung of patients with clinical symptoms of chest tightness and wheezing.(5)Two groups of patients before and after clinical detection of blood, urine, alanine aminotransferase (ALT), serum creatinine (CRE) and other safety indicators showed no significant difference, and no significant adverse effects after treatment. Description The prescription drug safety, no significant side effects, patients are easy to accept.Conclusion and significanceProved by research, Qing Jin Hua Zhuo Fa combined with western medicine in treatment of chronic obstructive pulmonary disease with acute exacerbation, effectively improves AECOPD patients with serum inflammatory marker levels, arterial blood gas levels, traditional Chinese medicine syndrome,dyspnea grade,is a feasible clinical treatment. In the course of the study, there was no significant difference in the safety index, and no adverse reaction occurred. It can be considered that the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease is safe and feasible, no obvious toxic side effects. |
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