Evaluation Of The Curative Effect Of Jiawei Shengxian Decoction Combined With EDP In The Treatment Of AECOPD Patients With Deficiency Of Vital Energy And Mutual Accumulation Of Phlegm And Blood Stasis

Objective:To evaluate the curative effect of Weishengshen Decoction combined with EDP on AECOPD with deficiency of Zong Qi and intercombination of phlegm and blood stasis,and to explore an effective method for the treatment of chronic obstruction exacerbation.Methods:A total of 108 patients were enrolled into the experimental group,control group 1 and control group 2 by stratified random method.Control group 1 was conventional treatment of Western medicine;The control group（2）was treated with conventional western medicine and external diaphragmatic pacing.Experimental group on the basis of conventional western medicine therapy（oxygen therapy and anti-infection,expectorant,atomization inhalation budesonide,compound isopropyl bromide,exercise）used in vitro diaphragm pacemaker,1 times a day,every time 30minutes,internal and"flavored rise in soup"granules,warm boiled water,300 ml blunt,1 bag each time,middle-late three points early after dinner warm clothing,joint application to patients discharged from hospital.Comparison before and after treatment in patients with pulmonary function（FVC,FEV1,FEV1/FVC%）,serum levels of T lymphocyte subsets in（CD3⁺,CD4⁺,CD4⁺/CD8⁺,CD8⁺）,6 minutes walk test,blood gas analysis,CAT score changes,and the total score of TCM syndromes at the same time observe the liver and kidney function,and adverse drug reactions,flavored rise in soup combine EDP of qi deficiency,phlegm and blood stasis type and the treatment effect of AECOPD.Results:1.Baseline situation:8 cases were detached out of 108 cases enrolled in this study,and the remaining 100 cases.There was no statistical difference（P>0.05）in the three groups compared with each other in terms of gender,age,disease duration,and GOLD stratification before treatment,and the three groups were comparable.2.Comparison between groups before treatment:There was no difference in each index and score（P>0.05）.3.There was no significant difference in lung function（FEV1%、FEV1/FVC、FVC）and Pa O₂、CD4⁺/CD8⁺、CD8⁺、hospitalization time（P>0.05）.There were significant differences in CAT score,total score of TCM syndromes,six-minute walking test（"m"Brog score"）and Pa CO₂（P<0.01）,The CAT score,TCM syndrome total score,Brog score were better than control group 1 and control group2,control group 2 than control group 1,There was no significant difference between the control group 2 6minute walking test"m",Pa CO₂ and control group 1（P>0.05）.There was a significant difference in the comparison of CD3⁺and CD4⁺（P<0.05）,and the test group was better than the control group 1 and the control group 2（P<0.05）,and there was no significant difference between the control group 2 and the control group 1（P>0.05）.4.Within-group comparison before and after treatment:No differences in FEV1/FVC%,CD4⁺/CD8⁺in the test group（P>0.05）,differences in FVC,Pa O₂,Pa CO₂（P<0.05）,FEV1 as%of expected value,CAT score,total TCM evidence score,six-minute walk test（"m""Brog score"）,CD3⁺,CD4⁺,CD8⁺differed significantly（P<0.01）.In the peal control group 1 there were no differences in CD4⁺/CD8⁺,CD8⁺（P>0.05）,differences in FVC,CD3⁺,CD4⁺,Pa O₂,Pa CO2（P<0.05）,FEV1/FVC%,FEV1 as%of expected value,CAT score,total TCM evidence score,six-minute walk test（"m""Brog score"）were significantly different（P<0.01）.There were no differences in 2 CD4⁺,CD4⁺/CD8⁺（P>0.05）,FVC,CD3⁺,CD8⁺,Pa O₂,Pa CO₂（P<0.05）,FEV1/FVC%,FEV1 as%of expected value,CAT score,total TCM evidence score,six-minute walk test（"m""Brog score"）differed significantly（P<0.01）.5.Safety analysis:Treatment after the three groups of patients ALT,AST,Scr did not see no significant differences（P>0.05）.The BUN of the test group was better than that of the control group 1 and the control group 2 after treatment（P<0.01）,and no significant difference was seen between the control group 2 and 1（P>0.05）.The ALT in the test group was lower than before treatment（P<0.01）,but still within the normal range.There was no significant difference in AST,BUN,and Scr before and after treatment（P>0.05）.There was no statistically significant difference in the indexes of liver and kidney function before and after treatment in control group 1 and control group 2（P>0.05）.Conclusion:Through the study of this topic,the efficacy of Gao Wei Sheng Shen Tang combined with EDP in patients with AECOPD with Zong Qi deficiency and Phlegm and Blood stasis interconnection was further confirmed.The combination of Jiawei Shengchi Tang with EDP increased CD3⁺and CD4⁺in patients with zongqi deficiency and phlegm-stasis interconnection type AECODP,thus improving immunity.And improve the Pa CO₂ value,increase the patient’s ventilation.In addition this therapy also reduced CAT score,total TCM evidence score,and improved six-minute walk test results,resulting in significant improvement in patients’quality of life.The mechanism of action may be related to the reduced airway inflammatory response in patients with AECOPD.It provides a clinical trial basis for the combined internal and external treatment of Chinese and Western medicine in AECOPD,and makes a useful attempt to enrich the treatment or control means of AECOPD.