Clinical Observation Of Modified Wendan Decoction Combined With Herbal Fumigation Treatment For Acute Exacerbation Of Chronic Obstructive Pulmonary Disease With Phlegm Obstructing The Lungs

ObjectiveThe purpose of this study was to observe the clinical effect of modified Wendan decoction combined with herbal fumigation treatment for acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with phlegm obstructing the lungs from the changes of inflammatory index,the improvement of clinical symptoms and signs,the comprehensive prognostic index of BODE and so on,and to investigate the advantages of traditional Chinese medicine combined with herbal fumigation in the treatment of AECOPD.It was to provide new ideas and new directions for the combination of Chinese and western treatment of AECOPD.MethodsA total of 60 AECOPD patients with phlegm obstructing the lungs,which met the inclusion criteria,were randomly divided into two groups with 30 patients in each group according to the design of a randomized controlled trial.The patients in the control group were given conventional western medicine treatment,and those in the control group were given oral modified Wendan decoction combined with herbal fumigation in addition to the conventional western medicine treatment.The course of treatment was 10 days for both groups.The serum levels of C-reactive protein(CRP)and procalcitonin(PCT),clinical symptoms and signs score,the comprehensive prognostic index of BODE and clinical outcome were compared between the two groups before and after treatment.Results1.The difference in the two groups in age,gender,the course of disease,the serum levels of CRP and PCT,clinical symptoms and signs score and the comprehensive prognostic index of BODE before treatment was no significant difference(P>0.05),it was of comparative.2.The inflammation index:The serum levels of CRP and PCT comparison within the groups are statistically significant(P<0.05)before and after treatment of the two groups.Combined with the levels of CRP and PCT after treatment are lower than before treatment,the treatment for both groups can reduce the level of inflammation.The reduction extent of CRP and PCT comparison between the treatment group and the control group are statistically significant(P<0.05).Compared with the control group,the reduction extent of CRP and PCT in the treatment group is higher than that in the control group.It can be concluded that the effect of the treatment group in controlling inflammation is higher than that of the control group.3.The clinical symptoms and signs score and efficacy evaluation:The clinical symptoms and signs score comparison within the groups are statistically significant(P<0.05)before and after treatment of the two groups.Combined with the clinical symptoms and signs score after treatment are lower than before treatment,the treatment for both groups can reduce the clinical symptoms and signs score.The reduction extent of clinical symptoms and signs score comparison between the treatment group and the control group are statistically significant(P<0.05).Compared with the control group,the reduction extent of clinical symptoms and signs score in the treatment group is higher than that in the control group.It can be concluded that the effect of the treatment group in improving clinical symptoms and signs is higher than that of the control group.The treatment group is markedly effective in 20 cases,effective in 9 cases,ineffective in 1 cases.The control group is markedly effective in 11 cases,effective in 16 cases,ineffective in 3 cases.The difference between two grops in the clinical efficacy was statistically significant(P<0.05).Combined with the average rank,the clinical efficacy of the treatment group is better than that of the control group.4.The comprehensive prognostic index of BODE:The levels of BODE,FEV1%,MRC score and 6MWT comparison within the groups are statistically significant(P<0.05)before and after treatment of the two groups,while the levels of BMI is not statistically significant(P>0.05).Combined with the levels of BODE,FEV1%,MRC score and 6MWT after treatment are better than before treatment,the treatment for both groups can improve the level of BODE,FEV,%,MRC score and 6MWT,but not BMI.The improvement extent of MRC score and 6MWT comparison between the treatment group and the control group are statistically significant(P<0.05),while the levels of BODE and FEV1%is not statistically significant(P>0.05).It can be concluded that the effect of the treatment group in improving the levels of MRC score and 6MWT is higher than that of the control group,but not in improving the levels of BODE and FEV1%.Conclusion1.Modified Wendan decoction combined with herbal fumigation can effectively reduce the level of CRP and PCT,and the curative effect is significantly superior to conventional western medicine treatment.2.Modified Wendan decoction combined with herbal fumigation can effectively improve clinical symptoms and signs and the clinical efficacy.3.Modified Wendan decoction combined with herbal fumigation can effectively improve the level of MRC score and 6MWT,and the curative effect is significantly superior to conventional western medicine treatment.However,there was no statistically significant difference between the two groups in improving the levels of pulmonary function and the comprehensive prognostic index of BODE.