A Study On The Curative Effect Of The Method Of Replenishing Qi To Clear The Organs And Enema On Aging AECOPD With Phlegm-heat Obstructing The Lung And Qi Deficiency Syndrome

This paper consists of two parts:literature review and clinical research.Literature review:there are two parts.The first part of the review discusses the research progress of modern medicine on chronic obstructive pulmonary disease,including its epidemiology,pathogenesis,inducing factors of acute exacerbation,diagnosis,risk assessment and treatment.The second part of the review discusses the research progress of traditional Chinese medicine enema in chronic obstructive pulmonary disease,including the understanding of traditional Chinese medicine on chronic obstructive pulmonary disease,the research progress of traditional Chinese medicine enema and its application in chronic obstructive pulmonary disease.Clinical research:Objective:To observe the effect of Yiqi Tongfu prescription enema combined with routine western medicine treatment on elderly patients with phlegm-heat obstructing the lung and qi deficiency syndrome of AECOPD,and to compare the difference of routine treatment before and after treatment with simple western medicine in improving clinical symptoms,blood routine+CRP,arterial blood gas analysis,pulmonary function,mMRC and CAT,so as to explore the clinical efficacy and safety of Yiqi Tongfu prescription enema.Methods:From January 2019 to January 2020,64 patients who meet the syndrome of phlegm-heat obstructing the lung and qi deficiency with the chronic obstructive pulmonary disease in acute exacerbate period were collected from the wards of the Respiratory Department of Beijing Longfu Hospital,and the patients were randomly divided into control group(n=32)and treatment group(n=32).The control group was treated with routine western medicine,including oxygen therapy,bronchodilator,antibiotics,expectorant and other treatments.The treatment group was treated with Yiqi Tongfu prescription enema on the basis of routine treatment of western medicine.The treatment group was treated with astragalus 10g,Codonopsis pilosula 10g,rhubarb 12g,Magnolia officinalis 6g,Fructus Aurantii 9g once a day for a total of 10 days.The values of grading and quantification score sheet of TCM symptom,WBC,NE%,LY%,CRP,PH,PO2,PCO2,FVC,FEV1%pred,FEV1/FVC,mMRC and CAT of patients were recorded before and after treatment as curative effect indexes and were used to calculate the integral improvement rate and efficiency.At the same time,the ALT,AST,UREA,CREA and urine routine of the patients before and after treatment were recorded as safety evaluation indexes,and the adverse reactions were recorded.At the end of the experiment,the data were analyzed by SPSS22.0 software,and the difference was statistically significant(P>0.05).Results:64 cases were collected,4 cases were removed and finally 60 cases were included in the treatment group,including 29 cases in the treatment group and 31 cases in the control group.1.Comparison of general data before treatment between the two groups:sex,age,smoking history and pulmonary function classification of airflow limitation severity,there was no statistical difference between the two groups(P>0.05),and there was comparability between the two groups.2.Before treatment,there was no statistical difference in grading and quantification score sheet of TCM symptom,blood routine+CRP,arterial blood gas analysis,pulmonary function,mMRC and CAT score between the two groups(P>0.05),and it was comparable.3.Before treatment,there was no statistical difference in ALT,AST,UREA and CREA,between the two groups(P>0.05),and there was no obvious abnormality in urine routine between the two groups,which was comparable.4.After treatment,the total effective rate of the control group was 93.5%,and that of the treatment group was 96.6%.The total effective rate of the treatment group was higher than that of the control group,but there was no statistical difference(P>0.05).5.After treatment,there were significant differences in grading and quantification score sheet of TCM symptom between groups(P<0.05),and there were significant differences in total scores,main symptom scores,cough,wheezing,shortness of breath and constipation between groups(P<0.05).It is proved that the effect of the treatment group is better.6.After treatment,there were significant differences in blood routine,CRP,PH,PO2,PCO2,pulmonary function,mMRC and CAT scores between the two groups(P<0.05),and it is proved that the two treatment schemes were effective.Lacking of significant difference between the two groups(P>0.05)could not proved that the effect of the treatment group was better,but the mean values of CRP,PO2,PCO2,pulmonary function,mMRC and CAT in the treatment group changed more and showed a trend of improvement.7.After treatment,there was no significant difference in ALT,AST,UREA and CREA,between the two groups(P>0.05),and there was still no obvious abnormality in urine routine between the two groups,and no adverse events such as nausea,vomiting,abdominal pain and severe diarrhea were found in all patients,indicating that there were no adverse reactions in the treatment group with Yiqi Tongfu prescription enema,which was safe and reliable.Conclusion:1.The combination of Yiqi Tongfu prescription enema can significantly improve the TCM symptoms of patients,especially in cough,wheezing,shortness of breath and constipation,with statistical difference.2.Compared with routine western medicine treatment,there was no significant difference in CRP,PO2,PCO2,pulmonary function,mMRCand CAT between Yiqi Tongfu prescription enema and western medicine routine treatment,but the mean value changed more and had a trend of improvement.3.Yiqi Tongfu prescription enema in the treatment of elderly AECOPD patients with phlegm-heat obstructing the lung and qi deficiency syndrome,there is no adverse reaction,short-term application is safe and reliable.