| This article consists of two parts:theoretical research and clinical research.Theoretical researchThe review of western medicine outlines the research progress of AECOPD from the aspects of current situation,risk factors,pathogenesis,therapeutic measures and prevention,which is based on the research of modern medicine on acute exacerbation of COPD in recent years.The review of traditional Chinese medicine systematically summarizes the current research on the theory of "poison" and "lung collateral" in Chinese medicine,then expounds the research progress on the correlation between the theory of "poison damaged lung collateral" and COPD,and finally introduces the treatment ideas of traditional Chinese medicine for COPD based on the theory of "poison damaged lung collateral".Clinical studyObjective:Evaluate the clinical efficacy of western medicine combined with "Qingre paidu tongluo " prescription in the treatment of patients with phlegm-heat obstructing lung syndrome during acute exacerbation of COPD,and the safety of this prescription,so as to provide experimental basis for the application of "Qingre paidu tongluo" prescription in the treatment of AECOPD.And then explore the possible mechanism of "Qingre paidu tongluo "prescription in the treatment of this disease.Methods:Randomized single blind control intervention was used to select the patients who were in line with the syndrome of phlegm heat obstructing lung in the acute exacerbation stage of COPD.The patients were divided into control group and treatment group according to the random number table.The control group received conventional western medicine treatment in accordance with the 2019 GOLD guidelines,and the treatment group received "Qingre paidu tongluo"decoction on the basis of the treatment of the control group,continuous treatment for 7 days.On 1 st day and 8th day,instructed patients to fill in symptom integral scale,CAT scale,took determination of peripheral blood test indicators,compared the change of symptoms and signs scores,CAT scores,inflammatory bio-markers and blood gas analysis index of the two group before and after treatment.Meanwhile,observed safety index changes and adversed reactions occurred in the process of treatment.Finally,SPSS21.0 software was used for statistical processing to evaluate its clinical efficacy.Results:A total of 48 cases of clinical symptom observers were included in this study,and 3 cases were shed.There are 45 patients of complete clinical data,including 23 cases in the treatment group and 22 cases in the control group.(1)The baseline data of the two groups of patients(gender,age,BMI,smoking history,smoking or not,COPD grade,total score of symptom scale and various scores,CAT score,inflammatory index,blood gas analysis index)were compared,with no statistical difference(P>0.05).Therefore the data of the two groups were comparable.(2)Clinical efficacy:the significant efficiency of the treatment group after treatment was 43.48%,and the total effective rate was 95.65%.The control group was 27.27%and 86.36%,respectively,and the difference of clinical efficacy between the two groups was statistically significant(P<0.05).(3)Intra-group comparison:Two groups of symptoms scale total score and the integral(cough,sputum volume,degree of difficulty cough up phlegm,chest tightness,shortness of breath,wheezing,crackles,anorexia,abdominal distension,mouth thirst,constipation,etc.),CAT scores,inflammation index(WBC,N%,CRP and PCT,IL-10,TNF-α),blood gas analysis index(PaO2,PaCO2,SaO2)are obviously improved compared with before treatment.The difference is statistically significant(P<0.01).(4)Comparison between groups:①CAT score,expression of N%,PCT,IL-10 and TNF-αin inflammatory indexes,and levels of PaO2 and PaCO2 in blood gas indexes in the treatment group are significantly better than the control group(P<0.05),and that there is a significant statistical difference in the decrease of total score of symptoms and CRP level(P<0.01).While the changes of the WBC and SaO2 levels have no statistical difference(P>0.05).②Improvement of each symptom:the scores of sputum volume,chest tightness,shortness of breath,wheezing,crackles,abdominal distension,mouth thirst,constipation in the treatment group decrease compared with the control group.This is proved to be statistically significant(P<0.05),and the improvement of sputum cough and wheezing is statistically significant difference(P<0.01).While the improvement of cough,sputum difficulty and anorexia is not different(P>0.05).(5)Adverse reactions:no serious adverse reactions occurred in either group.Conclusion:On the basis of conventional treatment of western medicine,the prescription of "Qingre paidu tongluo" is more effective in improving clinical symptoms,especially in improving symptoms such as sputum volume,wheezing,crackles,abdominal distention,mouth thirst,constipation(chest tightness,shortness of breath).The effectiveness of "Qingre paidu tongluo" prescription in the treatment of AECOPD(phlegm-heat obstructing lung syndrome)has been verified.2."Qingre paidu tongluo" prescription can not only promote lung tangible the excretion of sputum,alleviate symptoms of limited airflow of AECOPD patients,but also by reducing the patient’s level of inflammation factors,improve the state of high stress and inflammatory airway mucus secretion to increase the oxygen partial pressure and promote the role of the carbon dioxide discharge,which is helpful to improve the quality of survival.Meanwhile it has good safety and clinical application. |
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