Clinical Study On The Effect Of Xiaoqinglong Decoction On Acute Exacerbation Of Chronic Obstructive Pulmonary Disease(AECOPD)Airway Inflammation

Chronic obstructive pulmonary disease(COPD)is a common respiratory disease in China,characterized by high disability rates and prevalence,calling for huge medical consumption.Its main pathogenesis includes airway inflammation,oxidative-antioxidative imbalance,abnormal neurological function and enzymology,and apoptosis and immune mechanism abnormalities etc.TCM treatment of COPD has a long history and rich connotation.Xiaoqinglong Decoction features exogenous cold dispersing and internalization of interior stagnant fluid,coupled with set prescription that combines dispersing and internalization,and treat both the lung and the spleen,serving as a famous prescription for treating stagnant fluid-relevant symptoms.Modern pharmacological studies have confirmed that it has pharmacological effects such as anti-inflammation,relieving cough and asthma,immunoregulation and bacteriostasis.It is an effective prescription for clinical treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD).This study took AECOPD patients with symptoms of exogenous cold and interior stagnant fluid hospitalized in Guangzhou City Panyu District TCM Hospital Section One as research subjects to evaluate the efficacy of Xiaoqinglong Decoction in treating AECOPD airway inflammation.ObjectiveTo study the clinical efficacy of Xiaoqinglong Decoction combined with western medicine in treating acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with symptoms of exogenous cold and interior stagnant fluid,and to evaluate the improvement and therapeutic effect of Xiaoqinglong Decoction on AECOPD airway inflammation.MethodsThis research was a prospective randomized controlled clinical research.The research subjects were the patients with AECOPD and lower respiratory infection hospitalized in an internal medicine department of the Hospital of Traditional Chinese Medicine in Panyu District,Guangzhou.65 patients meeting all the inclusion criteria and no exclusion criteria were randomly grouped into the observation group and control group.Both groups were treated with standard western medicine therapeutic regimen.On such basis,the treatment group was additionally treated with Xiaoqinglong Decoction for 7 days.Monitoring indexes were collected before treatment(24 hours after admission)and on the 7th day after enrollment.Four aspects covering the scores and efficacy of TCM syndrome before and after treatment,serum inflammation indexes(including white blood cells(WBC),C-reactive protein(CRP),interleukin-6(IL-6),and procalcitonin(PCT)),pulmonary function(including ventilation function FEVlpred%and pulmonary diffuse function arterial blood gas analysis),and survival status assessment(including COPD assessment test(CAT score)and 6 minutes walking test(6MWT)for activity endurance)were compared between the two groups;The cost-effectiveness of health economic indexes was compared between the two groups.SPSS 19.0 was used for data statistics.As to normal distributed data with equal variance,independent sample t-test was used for comparison among groups,and paired sample t-test was used for before-and-after comparison.Independent sample Mann-Whitney U rank sum test was used among abnormal distribution data,whileWilcoxon signedrank test was used for before-and-after comparison.Chi-squared test was used between two enumeration data groups.Independent sample Mann-Whitney U rank sum test was used for ordinal categorical variables.Results1.TCM syndrome scores:TCM syndrome scores in the treatment group were significantly lowered after treatment as compared with the control group(P<0.01).2.Airway inflammation:WBC,CRP,IL-6,and PCT in both groups were significantly decreased after treatment(P<0.01);Compared with the control group,CRP,IL-6,and PCT in the treatment group after treatment were significantly reduced(P<0.05).3.Pulmonary ventilation and diffusion function:FEVlpred%in both groups was markedly increased after treatment(P<0.01);Compared with the control group,the treatment group showed no significant difference in FEVlpred%after treatment(P>0.05).There was no significant difference in arterial PO2 and PCO2 between the two groups before and after treatment(P>0.05);Compared with the control group,the treatment group displayed no significant difference in PO2 and PCO2 after treatment(P>0.05).4.Quality of life and activity endurance:CAT scores in both groups were significantly improved after treatment(P<0.01);Compared with the control group,the CAT scores of the treatment group were significantly improved after treatment(P<0.05).6MWT in both groups were significantly increased after treatment(P<0.01).Compared with the control group,6MWT was significantly increased in the treatment group after treatment(P<0.05).5.Health economics:The cost-effectiveness ratio of the treatment group CAT score was ￥1539.89,and that of the control group was Y4081.95;the cost-effectiveness ratio of the treatment group 6MWT was ￥216.47,and that of the control group was ￥769.06,suggesting that the treatment group was more economical.Compared with the control group,there was no significant difference regarding to total hospitalization expenses and hospital stay in the treatment group(P>0.05).ConclusionXiaoqinglong Decoction might be able to treat AECOPD through ameliorating airway inflammation,thereby improving patients’ TCM syndrome scores,living condition and physical endurance.